These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: Alternate scenarios for population control in Pakistan: the issue of contraceptive method mix.
    Author: Ahmed T, Ali SM.
    Journal: Pak Dev Rev; 1992; 31(4 Pt 2):1281-92. PubMed ID: 12286742.
    Abstract:
    The authors review Pakistan's population program, with a focus on the ideal mix of contraceptive methods needed to slow population growth. "Our objective in this exercise is to estimate the extent of services required to achieve a certain level of the Contraceptive Prevalence Rate (CPR) necessary to bring fertility down to a level desired by women." Comparison is made between single- and multiple-method approaches. In this study, the objective was to examine the fertility transition and the impact of proximate determinants such as age at marriage and contraceptive use. Simulation models using data from the 1990-91 Pakistan Demographic and Health Survey were developed to estimate the extent of services required for the single method approach and the multiple method approach in achieving particular levels of contraceptive prevalence rate (CPR) and fertility (total fertility rate [TFR]) reductions. TARGET software by Bongaarts and Stover was used to generate the models. Theoretical issues were discussed with a focus on the intervening factors of demand for children, supply of children, and fertility regulation. Variables included base and target years, age specific fertility rates, the number of women in the reproductive ages, the proportion of women currently married, the contraceptive method mix, the effectiveness of contraceptives (based on Bangladesh data), and some proximate determinants of fertility. The average use effectiveness was around .84. The trends showed younger women with low fertility rates and higher contraceptive use than in previous surveys. Simulations were based on the estimated TFR decline from 5.5 to 4.5 over the next 10 years. The goal was a population growth rate of 2.5%. The results showed that condom use would need to be increased by 4 times from 2.2 million to 8.9 million in 10 years in order to reduce the TFR by 1 child. Pill use would have to be tripled to 6.9 million users by 2001. IUD and injection use, or female sterilization would need to be tripled. Efficiency of use would actually be greater since most new users are younger. Without door to door service, it is unlikely that user rates could be increased by 2001 with a single method approach. In a multiple method mix model with no changes, CPR would need to be 29% to reduce fertility by 1 child. If program efforts focus on IUDs, condoms, and injectables, CPR would be 28% with 7.2 million users by 2001. Changing marriage age would result in a CPR of 25.7% and 6.2 million users. Adding a program emphasis on sterilizations would enhance the model. Continuation has been shown to be more effective than large numbers with low continuation rates. A multitargeted program should provide multiple methods, improved services, thoughtful and sensitive communication, and mobilization of well trained community workers for maternal-child health delivery.
    [Abstract] [Full Text] [Related] [New Search]