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  • Title: Assessment of the fertility impact of family planning programmes in Egypt.
    Author: Abdelghany AM, Naguib M, Abdelmauty N.
    Journal: Egypt Popul Fam Plann Rev; 1990 Dec; 24(2):42-59. PubMed ID: 12343741.
    Abstract:
    The effects of Egypt's family planning programs (FPPs) on fertility are evaluated using the following approaches: standardization method (changes in fertility and determinants), prevalence method (impact measures of contraception in births averted and reduction of the crude birth rate--CBR), multivariate analysis (aggregate levels), and log linear model (magnitude of effects). FPPs before 1980 and between 1980-88 are discussed in terms of knowledge of FP, contraceptive use, and attitude toward FP. Data were obtained from the 1980 Egyptian Fertility Survey (EFS), the 1984 Contraceptive Prevalence Survey (ECPS), and the 1988 Demographic and Health Survey (EDHS). The results show a decline in the CBR from 38/1000 in 1980 to 32/1000 in 1988 based on the EFS and EDHS: 3/1000 was due to marital fertility and 2.46/1000 was due to the proportion of married women, and .32/1000 due to change in age structure. The decomposition of the change in GFR showed a decline of 27/1000 from 165.6 to 138.7: 13.48 was due to change in marital fertility, 10.7 was due to change in marital status, and 1.37 was due to change in the age structure of women in the reproductive ages. The prevalence method revealed that 875,000 births were averted in 1980 due to contraceptive prevalence. The births averted were responsible for a 16.3/1000 reduction in the CBR. In 1984, 833,829 births were averted or a 13.8/1000 reduction in the CBR. 940,799 averted births in 1988 were responsible for a 17/1000 reduction in the CBR. Ordinary least squares models in 1976 showed that variance in the total fertility rate (TFR) was explained by selected sociodemographic, demographic, and FP variables (R2=0.93). Beta coefficients were low for the FP variables i.e., contraceptives use effectiveness rate (CPE) beta=.145 and FP clinics (FPC) beta=.2526. The proportion of illiterate women was significant (beta=.799) as was the infant mortality rate (beta=.561) both of which lead to increasing fertility. Substituting CBR for TFR in 1976 showed similar results, with the exception of the oral contraceptive pill having the strongest effect (Beta=.741). In 1986, the largest direct effect on fertility was CPE (Beta=-.532) and FPC (Beta=-.32). CPE is explained by the variation in FPC, illiterate women which had the most significant effect, and women's density (R2=.79). In the multivariate analysis the mean number of children is explained by socioeconomic development, FP, and fertility. In the path analysis, children ever born (CEB) is decreased to the greatest extent by age at 1st marriage for total, urban, and rural areas. In the log linear analysis, contraceptive use increased with the number of working women and increasing levels of education. The challenges ahead are to avoid unplanned or unwanted births and high risk pregnancies and to contend with discontinuance of contraceptives. Efficiency of the delivery system needs to be improved. Socioeconomic development must continue with FP.
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