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[The formation of adolescent unions in northeast Brazil] La formation des unions chez les adolescentes du Nordeste (Bresil).
CAHIERS QUEBECOIS DE DEMOGRAPHIE. 2000 Autumn; 29(2):287-306.Data are used from Demographic and Health Surveys (DHS) conducted in Brazil in 1986, 1991, and 1996 to study recent trends in union formation among adolescents of the country's Nordeste region. Approximately 45.5 million people inhabit the mainly rural area. Nordeste has a 61% literacy rate, while 54% of households have running water, percentages marked lower than the national average of 85% for both rates. Fertility and mortality levels in Nordeste are among Brazil's highest, 74 infants die per 1000 live births, and the total fertility rate (TFR) is approximately 20% higher than the national average. Between 1986 and 1996, the proportion of female adolescents having children increased from 12% to 17% despite advances in education, urbanization, and access to media. It remains rather rare for never-married female adolescents to bear children, but approximately one-third of first births are the result of prenuptial conception. Early marriage and prenuptial conception by adolescents are thought to be socially unacceptable by one's peers. Results from a survey of men and women aged 15-24 in Salvador, a city in Nordeste, show the ideal marriage age for women to be 20-24 years. Beyond age, educational status was one of the most important determinant factors for first marriage during adolescence among women in Nordeste during 1986-96. Relatively better educated women had a greater tendency to assess and understand the advantages of delaying marriage to realize the future they desire.
HEALTH POLICY AND PLANNING. 1996 Dec; 11(4):428-37.Health sectors are being restructured in many parts of the world to shift the financial burden of health care away from the public sector onto individual citizens. This paper describes a study conducted to investigate the willingness of patients and households to pay for rural district hospital services in northwestern Tanzania. Surveys conducted included interviews with 500 outpatients and 293 inpatients at 3 district-level hospitals, interviews with 1500 households, and discussions with 22 focus groups within the catchment areas of the primary health care programs of these hospitals. Information was collected on the willingness to pay fees for certain hospital services, willingness to become a member of a local insurance system, and exemptions for cost-sharing. The surveys found a considerable willingness among respondents to pay for district hospital services. However, most respondents favored a local insurance system over user fee systems, a finding which applied at all places and in all of the surveys. More female respondents favored a local insurance scheme. The conditions needed to introduce a local insurance system are discussed.
Lexington, Kentucky, University of Kentucky, Center for Developmental Change, 1985 Jun. vii, 141 p. (CDC Development Papers No. 21)An interdisciplinary study, which incorporates a community-based and multimethod approach in a rural, historically high fertility community of Southern Appalachia, was conducted to describe the current pattern of fertility regulation behavior among the study population and to discern the most significant factors associated with such regulation in this contemporary rural-mountain community. A 3-phase research design was used, combining an inventory of local public opinion about birth control and family planning services with a social survey and related ethnographic field studies on the fertility regulation behavior of individuals and specifically married couples living in the community. In addition, the research team conducted a county-wide survey consisting of interviews with 407 married women of childbearing age (15-45) in intact conjugal units and a follow-up study involving indepth interviews with 107 of the 407 women. The county community hospital and health department have played a major role in the provision and delivery of family planning services to community residents since at least the early to mid-1960s. There is general agreement among community leaders, health professionals, and survey respondents that family planning services are now widely available and accessible to individuals and families throughout the county. There is general community support for smaller families and the decision of young married couples to use birth control and to postpone childbearing for a period of time following their marriage. Also there is general community support for educational activities in secondary schools. Family has declined for several reasons since the 1970s, including a tendency to think of childbearing in terms of socioeconomic conditions and to consider the costs of raising and educating children. Active fertility management practices among married couples appear to be rooted primarily in biological, economic, and family considerations as well as increased knowledge of wives and husbands about birth control and greater availability and accessibility of modern contraceptive methods. 8 out of 10 couples with wives who are not currently pregnant are using a method of fertility management. About half of these couples have chosen sterilization. Almost 2/3 of the wives among couples who were sterilized were either pregnant or just had a baby when the couple first considered sterilization. It is concluded that the contemporary patterns of fertility regulation among married couples in the study community are strikingly similar to those found among most other American couples today.
[Demographic aging and local activities. Study carried out at the request of and with the cooperation of the Authority for Resource Development and Regional Action (DATAR)] Vieillissement de la population et activites locales. Etude effectuee a la demande et avec le concours de la DATAR
Paris, France, Institut National d'Etudes Demographiques [INED], 1985. viii, 318 p. (INED Travaux et Documents Cahier no. 109)This study of the impact of demographic aging on local economic activities in rural France is based on fieldwork and analysis in 3 arrondissements selected for their geographic, demographic, and economic diversity: Saint-Girons in the Pyrenees, in which 40% of the population was aged 65 or over, Rochefort on the Atlantic Coast, a traditional attraction for retired persons, and Forcalquier in Provence, which had a higher rate of population growth in the study period than the other areas. The 1st part of the volume consists of a comparative analysis of the relationship between demographic aging and local economic activity in the 3 areas, and also analyzes the process of demographic aging. The 2nd part examines the viewpoints of local authorities and others interviewed personally and by mail concerning problems resulting from demographic aging. During the period under study, 1962-75, the trend toward population aging was always greater in rural than in urban areas, and the rural population showed a tendency to concentrate in specific zones rather than dispersing throughout the sparsely populated territory. The aging trend was more marked in the more urban communes of rural areas. In all 3 arrondissements, overall contractions in the economically active population were always due exclusively to the rural communes, and when there were increases in the active population they were stronger in urban than in rural communes. Only a minority of communes in the 3 arrondissements had increased activity rates between 1962-75. The total active population tended to become younger during the study period because of both the entry of younger workers and the departure of older workers. Women played a preponderant role in the labor force changes in all 3 arrondissements, and the role of agriculture became less important in all 3. Saint-Girons was, in the view of its inhabitants, the arrondissement most lacking in resources and services to assure a good quality of life. Decision makers in all 3 areas expressed a need for new economic activities to revitalize their communities, but few were in favor of increasing the population of elderly as an "activity". Demographic aging appeared to hamper local activity by rendering the affected areas inhospitable to innovation and renewal.
Ottawa, Canada, International Development Research Centre, 1973. 30 p. (IDRC-009e)This paper evaluates the progress of a Latin American population through stages in family planning adoption. The focus is on changes in knowledge of contraception, attitudes, and practices which occurred over 5 years (1964-69) of widespread public discussion concerning family planning and of program activity in Bogota, Colombia. Data from 2 surveys, 1 in 1964 and the other in 1969, permit the 1st temporal analysis of family planning adoption for a major metropolitan city in Latin America. Additional data on rural and small urban areas of Colombia from the 2nd survey permit a limited assessment of diffusion of family planning from the city to the nation as a whole. The 1st survey in Bogota revealed moderate to high levels of knowledge of contraceptive methods and generally favorable attitudes to birth limitation. However, at this time many women had never spoken to their husbands about the number of children they wanted, nor tried a contraceptive method at any time. The 2nd survey showed substantial changes in this picture. The proportion of currently mated women who had spoken to their husbands about family size preference changed from 43 to 62% for an increase of 71%. Fertility fell appreciably over this period, especially among younger women. Family planning program services had a significant direct contribution to the adoption process, since 36% of mated women had been to a clinic by 1969. The most modern methods of birth control -- the anovulatory pill and the intrauterine device -- which were scarcely known in 1964 were widely known in 1969, and contributed most to the observed increase in current contraceptive practice. However, among the previously known methods, the simplest method of all, withdrawal (coitus interruptus), showed the greatest increase in current practice and remained the most commonly used method. These findings suggest that favorable attitudes and knowledge tend to become rather widespread before levels of husband-wife discussion of family size preferences and levels of contraceptive trial increase appreciably. The results also indicate that contraceptive knowledge and favorable family planning attitudes are spreading rapidly outward from the cities into the rural areas, but that contraceptive practice is still predominantly restricted to urban populations. (author's)
American Journal of Public Health. 1985 Jan; 75(1):73-5.In this study of 1600 men ages 25-50 from semirural Guatemala, 3/4 had heard of vasectomy. Among these, 54% approved of it. However, the survey reveals a widespread lack of knowledge regarding the procedure, as well as negative perceptions or doublts about its effect on sexual performance, ability to do hard work, health, and manhood. 1/4 of the respondents who knew of vasectomy and who desired no more children expressed interest in having the operation, a finding which raises questions as to the potential (unrecognized) demand for vasectomy in other developing countries. (author's modified)