INTERNATIONAL FAMILY PLANNING PERSPECTIVES

United States of America (New York) 76

JUNE 1995 - VOLUME 21, NUMBER 2

96.76.1 - English - Teresa CASTRO MARTêN, UN Population Division, New York (U.S.A.), and F?ima JUçREZ, Centre for Population Studies, London School of Hygiene and Tropical Medicine, London (U.K.)

The impact of women's education on fertility in Latin America: Searching for explanations (p. 52-57)

According to data from Demographic and Health Surveys for nine Latin American countries, women with no education have large families of 6-7 children, whereas better educated women have family sizes of 2-3 children, analogous to those of women in the developed world. Despite these wide differentials in actual fertility, desired family size is surprisingly homogeneous throughout the educational spectrum. While the least educated and the best educated women share the small family norm, the gap in contraceptive prevalence between the two groups ranges from 20-50 percentage points. Better educated women have broader knowledge, higher socioeconomic status and less fatalistic attitudes toward reproduction than do less educated women. Results of a regression analysis indicate that these cognitive, economic and attitudinal assets mediate the influence of schooling on reproductive behavior and partly explain the wide fertility gap between educational strata. (LATIN AMERICA, FERTILITY DETERMINANTS, DIFFERENTIAL FERTILITY, LEVELS OF EDUCATION)

96.76.2 - English - Si‰n L. CURTIS and Ian DIAMOND, Department of Social Statistics, University of Southampton (U.K.)

When fertility seems too high for contraceptive prevalence: An analysis of Northeast Brazil (p. 58-63)

Standard regression equations relating the total fertility rate to contraceptive prevalence indicate that the fertility rate of 5.5 lifetime births per woman observed for Northeast Brazil in the 1986 Brazil Demographic and Health Survey is about 1. 6 births per woman higher than would be expected on the basis of contraceptive prevalence at that time. An exploratory approach for evaluating the reasons for higher-than-expected levels of fertility attributes 0.6 of the apparent excess births in Northeast Brazil to the lag effects of recent increases in contraceptive use and 0.6 to the relatively small fertility-inhibiting effect of breastfeeding. Marriage patterns play a smaller role, but appear to be responsible for 0.3 births of the remaining difference between observed and expected fertility. (BRAZIL, FERTILITY TRENDS, DESIRED FAMILY SIZE, CONTRACEPTIVE USAGE)

96.76.3 - English - Jane T. BERTRAND, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (U.S.A.), Karen HARDEE, Family Health International, Research Triangle Park, NC (U.S.A.), Robert J. MAGNANI, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (U.S.A.), and Marcia A. ANGLE, International Training Program in Health, University of North Carolina, Chapel Hill, NC (U.S.A.)

Access, quality of care and medical barriers in family planning programs (p. 64-69)

Access to family planning, quality of care and medical barriers to services are key factors in the adoption of contraceptive use. Access helps determine whether the individual makes contact with the family planning provider, while quality of care greatly affects the client's decision to accept a method and the motivation to continue using it. Medical barriers are scientifically unjustifiable policies or practices, based at least in part on a medical rationale, that inappropriately prevent clients from receiving the contraceptive method of their choice or impose unnecessary process barriers to access to family planning services. In the past, international family planning efforts have been criticized as placing too much emphasis on issues of access and the quantity of contraceptives distributed. The climate now exists for pursuing improvements in quality and access simultaneously and for exploring through research the linkages between access, quality and medical barriers. (FAMILY PLANNING PROGRAMMES, CONTRACEPTIVE USAGE)

96.76.4 - English - Cornelis VANDERPOST Preconditions for a population policy in Botswana (p. 70-74)

Botswana is generally regarded as a model of economic growth and democracy in Africa, but like other countries in the region, is faced with rapid population increase: An annual growth rate of 3% threatens to undermine rising living standards. Nevertheless, a population policy is not a high priority within the government. In spite of Botswana's well-developed health infrastructure, low infant mortality and high literacy rate, other conditions are needed for implementation of an effective population policy. Favorable attitudes among the people toward smaller family sizes and a commitment among political leaders to long-term policies may not presently be strong enough, and socioeconomic problems related to rapid population growth may not be extreme enough, to prompt the government to take definite action. (BOTSWANA, POPULATION POLICY, POPULATION GROWTH)

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