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As countries become more prosperous, people nursing their babies become fertile sooner after birth. As countries become more prosperous, people nursing their babies become fertile sooner after birth., Author Affiliations: A woman in Taruma, Brazil, breastfeeds her son, a practice that in some countries is losing its effectiveness as a safeguard against pregnancy. Credit: Ricardo Oliveira/AFP/Getty An indigenous [...]

Objectives. We evaluated the efficacy of skills training designed to increase female condom use among women. Methods. We conducted a randomized controlled trial of 409 women, recruited from family planning clinics in northern California, who were randomly assigned to the experimental 4-session female condom skills training intervention or the comparison 4-session women's general health promotion intervention. Participants received condom use instructions at baseline and male and female condoms during the study. They completed audio computer-assisted self-interviews at baseline and at 3 and 6 months. Results. At 3 and 6 months, women in the experimental group were more likely than those in the comparison group to have used the female condom at least once in the prior 3 months. The increase in the percentage of sexual acts protected by female condoms from baseline to the 6-month follow-up was greater for the experimental group. The percentage of sexual acts during which any condom was employed was higher in the experimental group at 6 months. There were no group differences in male condom use. Conclusions. Outcomes suggest that skills training can increase female condom use and protected sexual acts without reducing male condom use among women.

Induced abortion remains the major form of birth control among Armenian women, contributing to their excess mortality and preventable morbidity. Reliance on abortion is attributed to limited access to information concerning modern methods of contraception and to widely held misinformation among women regarding family planning and reproductive health. Based on the Steps to Behavior Change model, the Green Path Campaign for Family Health, an information-education-communication (IEC) campaign, was launched in June 2000. This multimedia campaign promoted greater awareness, knowledge, acceptance, and adoption of modern contraception through increased utilization of counseling and related services provided at underutilized family planning centers. A representative panel of 1088 married women aged 18-35 were surveyed on reproductive health/family planning knowledge, attitudes, and practices immediately prior to and immediately following the 6-month national campaign. Exposure to the campaign was associated with significant increases in factors associated with contraceptive behavior change: knowledge, favorable attitudes toward modern methods, favorable attitudes toward family planning services, and information seeking and utilization of family planning services. Women who were more educated, more affluent, and slightly older were more likely to use family planning services as well as modern contraceptive methods. New visits to family planning centers increased by 84%. Despite the usual 25% turnover among those using modern methods at the start of the study, use of modern contraceptive methods increased by 4.6%, significantly exceeding the projected 3% increase. The results document changes in underlying behavioral predictors consistent with the Steps to Behavior Change model and highlight the relatively untapped potential of media-based health promotion efforts in post-Soviet Republics. Keywords: Armenia; Behavior change; Family planning; Program evaluation; Health communication

Choice in contraceptive options was a static issue in the United States until recently. It appeared that options were shrinking when Norplant was taken off the market last summer due [...]

In a 1985 Geography article. John Clarke demonstrated the very limited demographic transition experienced by North Africa as part of the Muslim World. Over a decade later all the Maghreb countries, together with Egypt, have achieved quite marked demographic transition based on strong fertility decline. Recent statistics on birth rates and age-specific fertility rates demonstrate this change and allow projections through to near zero population growth for North Africa by the year 2025. Factors behind this transition include urbanisation, the education of women and their greater participation in employment, and family planning. Another factor, whose potential was considered by Clarke in 1985, is the contribution of Maghreb immigrant families in Europe to changing value systems in their home communities, leading to fertility decline.