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Objectives: To examine how the contraceptive behavior of women in rural southern Mozambique is shaped by their individual and household characteristics; community characteristics; access to family planning services; and characteristics of health facilities., Methods: Quantitative and qualitative data were collected mostly between January 20 and December 15, 2011, in rural areas of four districts in Gaza Province, Mozambique. The data included: a retrospective household-based survey of women of reproductive age (the analytical sample consisted of 1554 non-pregnant women in marital union); qualitative interviews with a subsample of surveyed women; a survey of communities where the women resided (n=56); and a survey of all health facilities in the study area (n=56). Binomial and multinomial logistic models were fitted to predict current use of modern contraceptive methods. Statistical analyses were complemented by insights from qualitative data., Results: Positive associations were detected between contraceptive use and education, household wealth, and perceived HIV infection status. Distance to the clinic was negatively associated with contraceptive use. These effects were additive, with some varying by type of contraceptive method. Examination of qualitative data highlighted frequent cognitive dissonance between service providers and users., Conclusion: A simultaneous consideration of user-level and provider-level perspectives on contraceptive use improves our understanding of contraceptive dynamics and can usefully inform policy., (Copyright © 2015. Published by Elsevier Ireland Ltd.)

The relationship between contraceptive use and religion remains a subject of considerable debate. This article argues that this relationship is rooted in context-specific institutional and organizational aspects of religious belonging and involvement. Drawing upon unique recent data from a population-based survey of women conducted in a predominantly Christian high-fertility area of Mozambique, this study examines the connections between religion and contraception from two complementary angles. First, differences in current use of modern contraceptives across main denominational groups are analyzed. The results show higher prevalence of modern contraceptive use among Catholics and, to a lesser extent, traditional Protestants net of other individual- and community-level factors. Second, an analysis of religious involvement reveals that frequent church attendance has a net positive association with modern contraceptive use regardless of denominational affiliation. These findings are situated within the historical context of religious, demographic, and socio-political dynamics of Mozambique and similar sub-Saharan settings., (© 2013 The Population Council, Inc.)

Labor migration profoundly affects households throughout rural Africa. This study looks at how men's labor migration influences marital fertility in a context where such migration has been massive while its economic returns are increasingly uncertain. Using data from a survey of married women in southern Mozambique, we start with an event-history analysis of birth rates among women married to migrants and those married to nonmigrants. The model detects a lower birth rate among migrants' wives, which tends to be partially compensated for by an increased birth rate upon cessation of migration. An analysis of women's lifetime fertility shows that it decreases as the time spent in migration by their husbands accrues. When we compare reproductive intentions stated by respondents with migrant and nonmigrant husbands, we find that migrants' wives are more likely to want another child regardless of the number of living children, but the difference is significant only for women who see migration as economically benefiting their households. Yet, such women are also significantly more likely to use modern contraception than other women. We interpret these results in light of the debate on enhancing versus disrupting effects of labor migration on families and households in contemporary developing settings.

In this paper, longitudinal data from northern Ghana is used to assess the effects of encouragement to use family planning that men receive from their personal network partners on the adoption of modern contraception by their wives. The study tests a conceptual model that, in addition to the effect of men's network encouragement, incorporates the effect of encouragement to use family planning that women receive from their respective network partners and the effect of spousal communication on reproductive matters and approval of family planning. Results show that encouragement received by men from their social networks significantly increases the likelihood of subsequent contraceptive use by their wives but this effect operates primarily by galvanizing spousal communication on reproductive matters. The effect of encouragement received by women from their respective network partners is largely independent from the effect of male network encouragement but it influences contraceptive adoption both directly and through spousal communication.

The Soviet legacy of widespread reliance on induced abortion is of critical importance to reproductive trends and policies in post-Soviet nations, especially as they strive to substitute contraception for abortion. Using data from two Demographic and Health Surveys conducted in 1995 and 1999, this study analyzes and compares trends in abortion and contraception, women's attitudes toward abortion, and their perceptions of problems associated with abortion and contraception in Kazakhstan. Despite an overall decline in abortion and an increase in contraceptive use since Kazakhstan's independence in 1991, abortion has remained a prominent part of the country's reproductive culture and practices. This study shows how abortion-related views reflect the long-standing ethnocultural differences between the indigenous Kazakhs and Kazakhstan's residents of European roots, as the latter continue to have significantly higher levels of abortion. The study, however, also reveals the internal diversity among Kazakhs with respect to abortion experiences and views, stemming from decades of the Soviet sociocultural influence in Kazakhstan. In addition, the analysis points to some generational differences in views concerning abortion and contraception. Finally, the study demonstrates parallels in attitudes toward abortion and toward contraception, thereby questioning straightforward assumptions about the replacement of abortion with contraception.

The study employs survey data from rural Mozambique to examine how men's labor migration affects their non-migrating wives' perceptions of HIV/AIDS risks. Using a conceptual framework centered on tradeoffs between economic security and health risks that men's migration entails for their left-behind wives, it compares women married to migrants and those married to non-migrants while also distinguishing between economically successful and unsuccessful migration. The analysis finds that the economic success of men's migration, rather than migration itself, significantly predicts women's worries about getting infected by their husbands or extramarital partners, and their husbands' position on condom use. These findings are situated within a broader context of socio-economic, gender, and marital dynamics and vulnerabilities engendered or amplified by male labor migration in sub-Saharan and similar developing settings. (Contains 2 tables.)

ObjectivesTo examine how the contraceptive behavior of women in rural southern Mozambique is shaped by their individual and household characteristics; community characteristics; access to family planning services; and characteristics of health facilities.MethodsQuantitative and qualitative data were collected mostly between January 20 and December 15, 2011, in rural areas of four districts in Gaza Province, Mozambique. The data included: a retrospective household-based survey of women of reproductive age (the analytical sample consisted of 1554 non-pregnant women in marital union); qualitative interviews with a subsample of surveyed women; a survey of communities where the women resided (n=56); and a survey of all health facilities in the study area (n=56). Binomial and multinomial logistic models were fitted to predict current use of modern contraceptive methods. Statistical analyses were complemented by insights from qualitative data.ResultsPositive associations were detected between contraceptive use and education, household wealth, and perceived HIV infection status. Distance to the clinic was negatively associated with contraceptive use. These effects were additive, with some varying by type of contraceptive method. Examination of qualitative data highlighted frequent cognitive dissonance between service providers and users.ConclusionA simultaneous consideration of user-level and provider-level perspectives on contraceptive use improves our understanding of contraceptive dynamics and can usefully inform policy.

For four decades, Angola has experienced war, which has inevitably inè uenced the country’s social development. The intensity and geographical spread of the war has è uctuated over that period. This paper examines fertility and other relevant socio-demographic characteristics in Angola and attempts to relate them to its protracted civil conè ict. To situate Angola’s fertility in the sub-Saharan context, comparisons are made with a selection of other African countries. The analysis paints a picture of a generally pre-transitional society characterised by an early start of childbearing, high fertility and a contraceptive prevalence that is among the lowest in Africa. Angola also trails behind most of the sub-continent in childhood mortality and maternal care indicators. The available data suggest that Angola’s fertility drops when hostilities peak and rebounds in the periods of relative peacefulness, and that these è uctuations are stronger in regions more affected by the é ghting than in less affected ones. However, there is no indication that the war has exerted any enduring and direct impact on trends in Angola’s fertility beyond its generally inhibiting effect on any improvements in social welfare that might otherwise have encouraged some fertility decline.

Provision of effective contraception to HIV-positive women of reproductive age is critical to effective management of HIV infection and prevention of both vertical and horizontal HIV transmission in developing countries. This exploratory retrospective study examines contraceptive use during the prolonged post-partum period in a sample of 285 HIV-positive and HIV-negative women who gave birth at four rural maternity clinics in a high HIV-prevalence region in Mozambique. Multivariate analyses show no significant variations by HIV status in contraceptive timing (mean time to first contraceptive use of 7.1 months) or prevalence (31% at time of survey) but detect a moderating effect of fertility intentions: while HIV status makes no difference for women wishing to stop childbearing, among women who want to continue having children, or are unsure about their reproductive plans, HIV-positive status is associated with higher likelihood of contraceptive use. Regardless of HIV status, virtually no condom use is reported. These results are situated within the context of a rapidly widening access to post-partum antiretroviral therapy in the study site and similar sub-Saharan settings. [ABSTRACT FROM AUTHOR]

As in other post-Soviet settings, induced abortion has been widely used in Armenia. However, recent national survey data point to a substantial drop in abortion rates with no commensurate increase in modern contraceptive prevalence and no change in fertility levels. We use data from in-depth interviews with women of reproductive age and health providers in rural Armenia to explore possible underreporting of both contraceptive use and abortion. While we find no evidence that women understate their use of modern contraception, the analysis suggests that induced abortion might indeed be underreported. The potential for underreporting is particularly high for sex-selective abortions, for which there is growing public backlash, and medical abortion, a practice that is typically self-administered outside any professional supervision. Possible underreporting of induced abortion calls for refinement of both abortion registration and relevant survey instruments. Better measurement of abortion dynamics is necessary for successful promotion of effective modern contraceptive methods and reduction of unsafe abortion practices. [ABSTRACT FROM AUTHOR]

Drawing upon two identical surveys conducted among high school seniors in the Czech Republic and Armenia, the present study examines within-country and between-country differences in adolescents' attitudes toward childbearing, contraception, and abortion, and in their perceptions of trends in fertility, contraceptive use, and recourse to abortion after the fall of communism. Focusing in particular on the effects of gender and selected socioeconomic characteristics, I find greater gender differences in reproductive and contraceptive views among Armenians, but greater gender and socioeconomic diversity in abortion attitudes among Czechs. I explain how the detected patterns of variations reflect the embeddedness of adolescents' views within the social, cultural, and reproductive contexts of their respective societies. [ABSTRACT FROM AUTHOR]

Explores women's choice between western methods available from state-run family clinics and indigenous contraception in Maputo, Mozambique. Cultural idiosyncrasies; Women's social and cultural characteristics and resources.