Family Planning

Adolescent Childbearing in Nicaragua: A Quantitative Assessment of Associated Factors

Katherine C. Lion
Ndola Prata
Chris Stewar
2009

CONTEXT: Nicaragua has one of the highest adolescent fertility rates in the world, but little is known about why approximately half of Nicaraguan women give birth before age 20.

METHODS: Data from the 2001 Nicaragua Demographic and Health Survey were used to examine the sexual and reproductive behavior of 3,142 females aged 15–19. Age at sexual debut and age at first birth were assessed using life table analysis, and the impacts of various factors on these measures were then examined in Cox proportional hazard models. Among sexually active females, current use of modern...

The theoretical and political framing of the population factor in development

Martha Campbell
Kathleen Bedford
2009

The silence about population growth in recent decades has hindered the ability of those concerned with ecological change, resource scarcity, health and educational systems, national security, and other global challenges to look with maximum objectivity at the problems they confront. Two central questions about population—(i) is population growth a problem? and (2) what causes fertility decline?—are often intertwined; if people think the second question implies possible coercion, or fear of upsetting cultures, they can be reluctant to talk about the first. The classic and economic theories...

Where next? Conclusion for ‘The impact of population growth on tomorrow’s world’

Malcolm Potts
2009

This paper provides a personal perspective on the rich discussions at the Bixby Forum. The size, rate of growth and age structure of the human population interact with many other key factors, from environmental change to governance. While the details of future interactions are sometimes difficult to predict, taken together they pose sombre threats to a socially and economically sustainable future for the rich and to any realistic possibility of lifting the world’s bottom two billion people out of poverty. Adaptive changes will be needed to cope with an ageing population in countries with...

Are the population policies of India and China responsible for the fertility decline?

Nadia Diamond-Smith
Malcolm Potts
2010

In the 1970s, policy-makers in both India and China, convinced that reducing population growth was critical for ending poverty, instituted coercive population policies. Yet fertility had already been declining in both countries before the population policies were instituted. In China, the total fertility rate (TFR) had already fallen to 2.9 before the institution of the One-Child Policy. In India, fertility continued to decline at roughly the same rate before, during and after ‘The Emergency’. Regardless of government mandates, couples in both countries before the policies and since have...

Another lesson unlearned: access to family planning in Niger

Gidi V
2010
Samuel Loewenberg provides a vivid description of increasing hunger in Niger (Aug 21, p 579), but gives insufficient emphasis to the imperative to increase access to voluntary family planning. Niger has a total fertility rate of 7·4, 49% of the population is younger than 15 years, and the current population of 15·9 million is projected to grow to between 52 and 64 million by 2050, making it the second most populous country in Africa. Only 15% of women enter primary school, and only one in ten uses any form of contraception. The total fertility rate of 3·3 assumed in “low” population projections...

Maternal mortality: one death every 7 min

Ndola Prata
Malcolm Potts
Nuriye Nalan Sahin-Hodoglugil
2010

This comment in the explores the role of policy and research in using the prevention of postpartum hemorrhage and suggest a joint meeting by WHO and FIGO to revisit the 2009 statement by WHO which does not recommend the use of misoprostol at the community level.

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Setting priorities for safe motherhood interventions in resource-scarce settings

Ndola Prata
Amita Sreenivas
Fiona Greig
Julia Walsh
Malcolm Potts
2010

Objective: Guide policy-makers in prioritizing safe motherhood interventions.

Methods: Three models (LOW, MED, HIGH) were constructed based on 34 sub-Saharan African countries to assess the relative cost-effectiveness of available safe motherhood interventions. Cost and effectiveness data were compiled and inserted into the WHO Mother Baby Package Costing Spreadsheet. For each model we assessed the percentage in maternal mortality reduction after implementing all interventions, and optimal combinations of interventions given restricted budgets of US$ 0.50, US$ 1.00, US$ 1.50 per...

Maternal mortality in developing countries: challenges in scaling-up priority interventions

Ndola Prata
Paige Passano
Amita Sreenivas
Caitlin Elisabeth Gerdts
2010

Although maternal mortality is a significant global health issue, achievements in mortality decline to date have been inadequate. A review of the interventions targeted at maternal mortality reduction demonstrates that most developing countries face tremendous challenges in the implementation of these interventions, including the availability of unreliable data and the shortage in human and financial resources, as well as limited political commitment. Examples from developing countries, such as Sri Lanka, Malaysia and Honduras, demonstrate that maternal mortality will decline when...

Health education for microcredit clients in Peru: a randomized controlled trial

Rita Hamad1
Lia CH Fernald
Dean S Karlan
2011

Background: Poverty, lack of female empowerment, and lack of education are major risk factors for childhood illness worldwide. Microcredit programs, by offering small loans to poor individuals, attempt to address the first two of these risk factors, poverty and gender disparity. They provide clients, usually women, with a means to invest in their businesses and support their families. This study investigates the health effects of also addressing the remaining risk factor, lack of knowledge about important health issues, through randomization of members of a microcredit organization to...

Niger: Too Little, Too Late

Malcolm Potts
Martha Campbell
Sarah Zureick
Virginia Gidi
2011

Niger—with the world’s fastest growing population, its highest total fertility rate (TFR), a small and diminishing amount of arable land, low annual rainfall, a high level of malnutrition, extremely low levels of education, gross gen- der inequities and an uncertain future in the face of climate change—is the most extreme example of a catastrophe that is likely to overtake the Sahel. The policies chosen by Niger’s government and the international community to reduce rapid population growth and the speed with which they are implemented are of the utmost importance. In this comment, we...