Barriers to family planning use amongst the urban poor in Pakistan

This paper examines the determinants of family planning service use and the barriers in accessing family planning services among urban poor women in Pakistan. Data were collected from a household survey of 5338 married women of reproductive age (15-45) from slum areas of six cities.The use of family planning services by women in urban slums is strongly linked to individual and household socioeconomic factors. In particular, women were ten times more likely to have used a family planning service if her husband approved. This research has highlighted two key issues regarding the provision of family planning services to the urban poor. First, the urban poor cannot be treated as a homogenous group; there exist important socio-demographic variations within the urban poor population in relation to their use of family planning services and the barriers faced in service utilization. Second, although the urban poor are both economically and physicallydisadvantaged in access to services, women identified socio-cultural factors as the greatest barrier to family planning service use. This finding is consistent with studies focusing on the general population of Pakistan

Giving voice to the ‘silent majority’

"There appears to be a widespread assumption that there is a ‘silent majority’ of people who support proposals but do not make submissions, and that those who do make submissions tend to be opposed and therefore do not reflect the true state of public opinion. The New Zealand Wind Energy Association (a membership-based wind industry association) suggested that it would be useful to examine whether this was actually the case, in respect to wind farms in particular. As researchers we were also interested in the broader question of why non-submitters might not be participating in formal planning processes, so we developed our research to address two questions: (a) how do non-submitters’ perspectives of proposed wind farms differ from those of submitters; and (b) why do nonsubmitters not make submissions? While these questions are relevant to all development proposals, wind farms are an excellent context for inquiry because they are highly visible, and thus potentially have an impact on a geographically widespread population, and because they are known to create strong feelings of support or opposition." • Janet Stephenson is a social scientist with a particular interest in societal responses to environmental challenges. She is the Director of the Centre for Sustainability at the University of Otago. Rob Lawson is in the marketing department at the University of Otago. His special area of expertise is in the study of consumer behaviour, with strong interests in the development of marketing theory. Policy Quarterly – Volume 9, Issue 1 – February 201

Impact of estimation techniques on regression analysis: an application to survey data on child nutritional status in five African countries

This paper illustrates the impact of ignoring survey design and hierarchical structure of survey data when fitting regression models. Data on child nutritional status from Ghana, Malawi, Tanzania, Zambia, and Zimbabwe are analysed using four techniques: ordinary least squares; weighted regression using standard statistical software; regression using specialist software that accounts for the survey design; and multilevel modelling. The impact of ignoring survey design on logistic and linear regression models is examined. The results show bias in estimates averaging between five and 17 per cent in linear models and between five and 22 per cent in logistic regression models. The standard errors are also under-estimated by up to 49 per cent in some countries. Socio-economic variables and service utilisation variables are poorly estimated when the survey design is ignored

HIV-Negative Partnered Men's Willingness to Use Pre-Exposure Prophylaxis and Associated Factors Among an Internet Sample of U.S. HIV-Negative and HIV-Discordant Male Couples

Purpose: Research on male couples' willingness to use pre-exposure prophylaxis (PrEP) is critically lacking. Methods: A cross-sectional 2011 Internet survey collected dyadic data from 275 HIV-negative and 58 HIV-discordant male couples to describe 631 HIV-negative partnered mens' willingness to use PrEP and associated couple-level demographic and behavioral factors with multivariate multilevel modeling. Results: Fifty-three percent were very to extremely likely to use PrEP. Willingness was positively associated with being in a mixed race and behaviorally non-monogamous relationship, and with amyl nitrate use with sex outside the relationship. Willingness was negatively associated with having a college education. Conclusion: Prevention efforts should educate male couples about the potential benefits of PrEP.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140159/1/lgbt.2014.0092.pd

Reporting of Intimate Partner Violence among Men Who Have Sex with Men in an Online Survey

Objective: A growing body of literature suggests that IPV occurs within same-sex relationships and that members of the LGBT community face a number of unique challenges in accessing IPV related services. This paper examines the use of an on-line survey, marketed through a popular social networking site, to collect data on the experience and perpetration of IPV among men who have sex with men (MSM) in the US.Methods: Internet-using MSM were recruited through selective placement of banner advertisements on MySpace.com. Participants were eligible for the baseline survey if they were males ≥ 18 years of age, and reported at least one male sex partner in the last 12 months. In total 16, 597 men responded to the ad, of which 11, 681 were eligible for the study, and 5602 completed the questionnaire: in total 543 men completed the follow-up survey which included questions on the experience and perpetration of IPV. The final analysis sample was 402 MSM.Results: The prevalence of violence among the sample was relatively high: 11.8% of men reported physical violence from a current male partner, and about 4% reported experiencing coerced sex. Reporting of perpetration of violence against a partner was generally lower, with approximately 7% reporting perpetrating physical violence and less than 1% reporting perpetration of sexual violence.Conclusion: The results presented here find lower levels of experiencing both physical and sexual IPV than have been shown in previous studies, yet show relatively high levels of reporting of perpetration of IPV. Collecting IPV data through surveys administered through social networking sites is feasible and provides a new opportunity to reach currently over-looked populations in IPV research

District-level Religious Composition and Adoption of Sterilization in India

This paper examined the influence of religion on the adoption of female sterilization, using data from the 1992/93 Indian National Family Health Survey. The influence of religion at both individual and district levels was examined, and a multi-level modelling methodology was used for assessing community variations in the influence of religion on the adoption of sterilization. Individual religion was a strong predictor of the decision to adopt sterilization, and residence in a district in which more than 20% of the people were Muslims significantly lowered the odds of adoption of sterilization. There was more variation in the adoption of sterilization between districts for Muslim women and women from minority religious groups. The results demonstrate the influence of community conservatism on the choice of contraceptive methods and point to the mediating effects that community characteristics can have on access to sterilization services for women from religious minority sub-groups

Spatial variation in contraceptive use in Bangladesh: Looking beyond the borders

This paper tries to promote a more complete understanding of social change by analyzing spatial patterns of contraceptive use in Bangladesh and the contiguous state of West Bengal in India. The paper takes it’s cue from earlier analysis which found strong evidence of higher contraceptive prevalence in districts of Bangladesh that border Bengali speaking districts on India, as well as from analysis of fertility decline in historical Europe where language played a critical role. Using multilevel analysis to control for variations in individual and household level correlates, mapping districts that deviate considerably from their regional averages, the analysis highlights an important role for cross border influences only in districts that share the same language across the border. Both in Bangladesh and in West Bengal, the districts that are positive outliers in contraception hug the Bangladesh- West Bengal border. Maps of outliers show that the positive outliers show a complete disregard for international borders and form a contiguous band in a manner suggestive of a role for contagion in explaining the levels of contraceptive use

Exploring the Impact of Targeted Distribution of Free Bed Nets on Households Bed Net Ownership, Socio-Economic Disparities and Childhood Malaria Infection Rates: Analysis of National Malaria Survey Data from three Sub-Saharan Africa countries.

The last decade has witnessed increased funding for malaria control. Malaria experts have used the opportunity to advocate for rollout of such interventions as free bed nets. A free bed net distribution strategy is seen as the quickest way to improve coverage of effective malaria control tools especially among poorest communities. Evidence to support this claim is however, sparse. This study explored the effectiveness of targeted free bed net distribution strategy in achieving equity in terms of ownership and use of bed nets and also reduction of malaria prevalence among children under-five years of age. National malaria indicator survey (MIS) data from Angola, Tanzania and Uganda was used in the analysis. Hierarchical multilevel logistic regression models were used to analyse the relationship between variables of interest. Outcome variables were defined as: childhood test-confirmed malaria infections, household ownership of any mosquito net and children's use of any mosquito nets. Marginal effects of having free bed net distribution on households with different wealth status were calculated. Angolan children from wealthier households were 6.4 percentage points less likely to be parasitaemic than those in poorest households, whereas those from Tanzania and Uganda were less likely to test malaria positive by 7 and 11.6 percentage points respectively (p < 0.001). The study estimates and present results on the marginal effects based on the impact of free bed net distribution on children's malaria status given their socio-economic background. Poorest households were less likely to own a net by 21.4% in Tanzania, and 2.8% in Uganda, whereas both poorer and wealthier Angolan households almost achieved parity in bed net ownership (p < 0.001). Wealthier households had a higher margin of using nets than poorest people in both Tanzania and Uganda by 11.4% and 3.9% respectively. However, the poorest household in Angola had a 6.1% net use advantage over children in wealthier households (p < 0.001). This is the first study to use nationally representative data to explore inequalities in bed net ownership and related consequences on childhood malaria infection rates across different countries. While targeted distribution of free bed nets improved overall bed net ownership, it did not overcome ownership inequalities as measured by household socioeconomic status. Use of bed nets was disproportionately lower among poorest children, except for Angola where bed net use was higher among poorest households when compared to children in wealthier households. The study highlights the need for malaria control world governing bodies and policy makers to continue working on finding appropriate strategies to improve access to effective malaria control tools especially by the poorest who often times bears the brunt of malaria burden than their wealthier counterparts

Factors Associated with Self-Reported HBV Vaccination among HIV-Negative MSM Participating in an Online Sexual Health Survey: A Cross-Sectional Study

Background: A substantial proportion of men who have sex with men (MSM) in the United States remain unvaccinated against hepatitis B. We sought to understand which factors are associated with vaccination among HIV-negative MSM. Methodology/Principal Findings: Data were from a 2010 web-based survey of adult MSM. We calculated the prevalence of self-reported hepatitis B vaccination among 1,052 HIV-negative or HIV-untested men who knew their hepatitis B vaccination status, and used multivariate logistic regression to determine associated factors. 679 (64.5%) MSM reported being vaccinated. Younger men were more likely to report being vaccinated than older men, and there was a significant interaction between age and history of hepatitis B testing. Men with at least some college education were at least 2.1 times as likely to be vaccinated as men with a high school education or less (95 % CI = 1.4–3.1). Provider recommendation for vaccination (aOR = 4.2, 95 % CI = 2.4–7.4) was also significantly associated with receipt of vaccination. Conclusions/Significance: Providers should assess sexual histories of male patients and offer those patients with male sex partners testing for hepatitis infection and vaccinate susceptible patients. There may be particular opportunities fo