Absent and problematic men: Demographic accounts of male reproductive roles

Both men and women make important contributions to the production of children, yet demographic studies of fertility and family planning have tended to focus on women alone. This paper traces the development of demography’s emphasis on women and describes how the limitations of its theoretical approaches to reproduction and empirical neglect of men have been mutually reinforcing. The paper is structured around four aims: 1) to describe why men have had a relatively low profile as subjects in demographic research on reproduction; 2) to explain growing interest in studying men’s roles; 3) to evaluate existing research on men in developing countries; and 4) to suggest directions for future research on men’s reproductive roles. We argue that men, once neglected, now feature prominently in demographic research but principally from a problem-oriented perspective and on a limited range of topics. Our review of existing studies, though, does not fully support a problem-oriented approach. Demographic research should examine men not only as women’s partners, but also as individuals with distinct and interesting reproductive histories of their own. As the links between marriage and childbearing continue to weaken around the world, the differences in men’s and women’s reproductive experiences and their costs and benefits related to parenting will become even more salient for future research

Migration, sexual behavior and HIV diffusion in Kenya

The association of migration with the spread of AIDS in sub-Saharan Africa is well documented, yet the social and behavioral mechanisms underlying this relationship remain poorly understood. Using data from the 1993 Kenya Demographic and Health Survey, this paper examines whether migrants are more likely than nonmigrants to have multiple recent sexual partners and not to use condoms with those partners. Results indicate that migation is a critical factor in high-risk sexual behavior and that its importance varies by gender and by the direction of movement. Independent of marital and cohabitation status, social milieu, awareness of AIDS, and other crucial influences on sexual behavior, male migrants between urban areas, and female migrants within rural areas, are much more likely than nonmigrant counterparts to engage in sexual practices conducive to HIV infection. In rural areas, migrants from urban places are more likely than nonmigrants to practice high-risk sex. Given the predominance of men in urban migration and the large volume of circulatory movement between urban and rural areas, these results have serious implications for HIV transmission throughout Kenya

Covert contraceptive use: Prevalence, motivations, and consequences

This paper examines women’s covert use of contraceptives, that is, use without the knowledge of their husbands. Covert use may highlight conflict between husbands and wives about family planning, or it may reflect behaviors that spouses find difficult to discuss together. This study addresses three questions: 1) How is covert use measured in different settings? 2) How prevalent is it? and 3) What are the factors underlying covert use? We examine these questions by drawing on existing studies and detailed survey and qualitative data collected in 1997 in an urban setting in Zambia from married women and a subsample of their husbands. The prevalence of women’s covert use of contraceptives is estimated to account for between 6 and 20 percent of all current contraceptive use and is more widespread in settings where contraceptive prevalence is low. A multivariate analysis of women’s covert use based on the Zambia survey data indicates that difficult spousal communication about contraception is the strongest determinant of covert use. The positive effect of husbands’ disapproval of contraception on covert use works through spousal communication rather than as a direct influence. Husbands’ pronatalism had no significant effect on covert use. The paper concludes with a discussion of the implications of covert use for policies and programs addressing reproductive health issues and gender relations, especially the extent and nature of partner involvement that should be encouraged

The need to promote behaviour change at the cultural level: one factor explaining the limited impact of the MEMA kwa Vijana adolescent sexual health intervention in rural Tanzania. A process evaluation

Background - Few of the many behavioral sexual health interventions in Africa have been rigorously evaluated. Where biological outcomes have been measured, improvements have rarely been found. One of the most rigorous trials was of the multi-component MEMA kwa Vijana adolescent sexual health programme, which showed improvements in knowledge and reported attitudes and behaviour, but none in biological outcomes. This paper attempts to explain these outcomes by reviewing the process evaluation findings, particularly in terms of contextual factors. Methods - A large-scale, primarily qualitative process evaluation based mainly on participant observation identified the principal contextual barriers and facilitators of behavioural change. Results - The contextual barriers involved four interrelated socio-structural factors: culture (i.e. shared practices and systems of belief), economic circumstances, social status, and gender. At an individual level they appeared to operate through the constructs of the theories underlying MEMA kwa Vijana - Social Cognitive Theory and the Theory of Reasoned Action – but the intervention was unable to substantially modify these individual-level constructs, apart from knowledge. Conclusion - The process evaluation suggests that one important reason for this failure is that the intervention did not operate sufficiently at a structural level, particularly in regard to culture. Recently most structural interventions have focused on gender or/and economics. Complementing these with a cultural approach could address the belief systems that justify and perpetuate gender and economic inequalities, as well as other barriers to behaviour change

iPrevent

Curso de Especial InterésLa siguiente propuesta, contiene la información necesaria para poder asesorar y brindar una mejor atención a los procesos que son inherentes a la sexualidad del ser humano. El diseño de la creación de una aplicación llamada iPrevent, usada en aparatos tecnológicos como los móviles con sistema Android y Apple. Esta aplicación está encaminada a presentar y a exponer los distintos métodos anticonceptivos que se encuentran en el mercado, así mismo brindar un marco de conocimiento de cada uno, para facilitar la toma de decisiones de los adolescentes; de esta manera teniendo una correlación con la salud pública y mitigar los embarazos no deseados y posibles interrupciones voluntarias del embarazo (IVE) y uso de Métodos Anticonceptivos de emergencia en esta población.101 p.1. Resumen 2. Justificación 3. Marco teórico 4. Objetivos 5. Metodología 6. Estudio de mercadeo 7. Resultados 8. Discusión 9. Conclusiones y recomendaciones 10. Referencias 11. ApéndicesPregradoPsicólog

Reproductive decisionmaking in the context of HIV/AIDS in Ndola, Zambia

Family planning (FP) programs are increasingly being considered as a logical focal point for STD and HIV/AIDS prevention services because they serve large numbers of women at risk, address the sensitive issue of sexual behavior and fertility control, and the methods for preventing unwanted pregnancy and disease can be the same. FP programs, by providing contraceptive methods, are currently one of the few sources of assistance in the sub-Saharan African region for preventing perinatal transmission of HIV, while the promotion of barrier methods contributes to the prevention of heterosexual transmission. Given this potential, research is needed to understand how the HIV epidemic influences reproductive decision-making. The Africa OR/TA II Project undertook an exploratory study of women and men’s attitudes and experiences regarding reproductive decision-making in a setting of high HIV prevalence in Ndola, Zambia. The objectives, as described in this report, were to examine perceptions of risk by men and women living in a high HIV prevalence setting, how these perceptions are related to decisions about childbearing and contraceptive use, and to identify opportunities for FP programs to expand services to address HIV prevention

Reproductive health and lifestyle factors associated with health-related quality of life among perinatally HIV-infected adolescents in Uganda

Background With increased survival of perinatally HIV - infected adolescents due to antiretroviral therapy (ART), the focus of HIV care has shifted to health-related quality of life (HRQoL) as a measure of disease progression, effects of ART co-morbidity and prognosis. We assessed factors associated with better HRQoL in perinatally HIV -infected adolescents in Uganda by determining the associations between sexual and reproductive health (SRH) or lifestyle experiences on HRQoL. Methods In a cross-sectional study, data on SRH, lifestyle experiences, socio demographic factors, communication with parents on sexuality and satisfaction of SRH services in ART clinics were collected from 614 HIV perinatally infected adolescents aged 10–19 using an interviewer-administered survey questionnaire. HRQoL data were collected using the Medical Outcomes Study HIV Health Survey instrument (MOS-HIV). Factors associated with better HRQoL were analysed using multiple logistic regression. Results The mean age was 16.2 ± 2.1 years, 362 (58.8 %) were females and 210 (34.2 %) were sexually active. Adolescents on ART were twice likely to present with better physical health (AOR = 2.07, 95 % CI: 1.24–3.46) and four times more likely to present with better mental health (AOR = 3.9, 95 % CI: 2.22–6.92) than those who were not on ART. There were no statistically significant associations between SRH (ever had sex, ever been pregnant, condom use, contraceptive use) or life style factors and physical health or mental health. Those with secondary or tertiary education were more likely to present with a better mental health (AOR = 5.3, 95 % CI: 1.86–15.41) compared those who had attained primary or no education. Participants who desired to have a child in future more likely (AOR 1.7, 95 % CI: 1.05–3.00) to present with a better mental health. Lack of communication with guardians on sexuality (AOR = 0.6, 95 % CI: 0.40–0.89), or dissatisfaction with SRH services (AOR 0.34, 95 % CI: 0.18–0.62) were associated with poorer mental health. Conclusion Among perinatally HIV-infected adolescents in Uganda, being on ART was associated with better physical and mental health while lack of communication with guardians on sexuality or dissatisfaction with SRH services was associated with poor mental health. Adolescents with pregnancy intentions were more likely to have a better mental health

Predictors of nurses’ and midwives’ intentions to provide maternal and child healthcare services to adolescents in South Africa

BACKGROUND: Adolescent mothers are at a much higher risk for maternal mortality compared to mothers aged 20 years and above. Newborns born to adolescent mothers are also more likely to have low birth weight, with the risk of long-term effects such as early onset of adult diabetes than newborns of older mothers. Few studies have investigated the determinants of adequate quality maternal and child healthcare services to pregnant adolescents. This study was conducted to gain an understanding of nurses’ and midwives’ intentions to provide maternal and child healthcare and family planning services to adolescents in South Africa. METHODS: A total of 190 nurses and midwives completed a cross-sectional survey. The survey included components on demographics, knowledge of maternal and child healthcare (MCH) and family planning (FP) services, attitude towards family planning services, subjective norms regarding maternal and child healthcare and family planning services, self-efficacy with maternal and child healthcare and family planning services, and intentions to provide maternal and child healthcare and family planning services to adolescents. Pearson’s correlation analysis was conducted to determine the association between knowledge, attitude, subjective norms, self-efficacy, and intention variables for FP and MCH services. A 2-step linear regression analysis was then conducted for both FP and MCH services to predict the intentions to provide FP and MCH services to adolescents. RESULTS: Self-efficacy to conduct MCH services (β = 0.55, p < 0.01) and years of experience as a nurse- midwife (β = 0.14, p < 0.05) were associated with stronger intentions to provide the services. Self-efficacy to provide FP services (β = 0.30, p < 0.01) was associated with stronger intentions to provide FP services. CONCLUSIONS: Self-efficacy has a strong and positive association with the intentions to provide both MCH and FP services, while there is a moderate association with attitude and norms. There is a need to improve and strengthen nurses’ and midwives’ self-efficacy in conducting both MCH and FP services in order to improve the quality and utilization of the services by adolescents in South Africa.IS

Environmental Effects on Family Size Preferences and Subsequent Reproductive Behavior in Nepal

This study investigates the relationship between environmental degradation and men and women’s family size preferences and subsequent reproductive behaviors in Nepal. We draw on unique environmental data at the local level, household and individual-level survey data and individuals reproductive behavior over a 3 year time period in Western Chitwan Valley, Nepal. Results from Ordinary Least Squares (OLS) and logistic regression models show that poorer environmental quality and greater reliance on publicly owned natural resources are associated with higher family size preferences and higher rates of pregnancy. The analyses provide support for the “vicious circle” argument that environmental degradation can lead to rising population growth via positive effects on fertility. As environmental conditions decline and when households rely on public lands for natural resources, men and women desire larger family sizes and women are more likely to get pregnant in the near future.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/43509/1/11111_2005_Article_1874.pd

Neighborhood Social Change and Perceptions of Environmental Degradation

This paper investigates how changes in neighborhood facilities—new schools, health posts, bus services, mills, dairies, agricultural cooperatives, and other facilities—influence perceptions of environmental degradation. We use three types of data from a rural area in Nepal: (1) data on changing neighborhood facilities from 171 neighborhoods, collected using ethnographic, survey, and archival methods; (2) survey data on household characteristics and environmental perceptions from 1,651 households; and (3) individual-level survey data. We find that new neighborhood facilities are associated with perceptions of environmental degradation. This is important because perceptions may indicate objective environmental degradation, encourage participation in programs to improve the environmental, and influence environmental behavior.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/43500/1/11111_2004_Article_479782.pd