scholarly journals Understanding family planning decision-making: perspectives of providers and community stakeholders from Istanbul, Turkey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Duygu Karadon ◽  
Yilmaz Esmer ◽  
Bahar Ayca Okcuoglu ◽  
Sebahat Kurutas ◽  
Simay Sevval Baykal ◽  
...  
Keyword(s):  
Decision Making ◽  
Family Planning ◽  
Low Income ◽  
Cultural Context ◽  
Service Providers ◽  
Comparative Method ◽  
Analytical Strategy ◽  
Planning Decisions ◽  
Community Stakeholders ◽  
Planning Decision

Abstract Background A number of factors may determine family planning decisions; however, some may be dependent on the social and cultural context. To understand these factors, we conducted a qualitative study with family planning providers and community stakeholders in a diverse, low-income neighborhood of Istanbul, Turkey. Methods We used purposeful sampling to recruit 16 respondents (eight family planning service providers and eight community stakeholders) based on their potential role and influence on matters related to sexual and reproductive health issues. Interviews were audio-recorded with participants' permission and subsequently transcribed in Turkish and translated into English for analysis. We applied a multi-stage analytical strategy, following the principles of the constant comparative method to develop a codebook and identify key themes. Results Results indicate that family planning decision-making—that is, decision on whether or not to avoid a pregnancy—is largely considered a women’s issue although men do not actively object to family planning or play a passive role in actual use of methods. Many respondents indicated that women generally prefer to use family planning methods that do not have side-effects and are convenient to use. Although women trust healthcare providers and the information that they receive from them, they prefer to obtain contraceptive advice from friends and family members. Additionally, attitude of men toward childbearing, fertility desires, characteristics of providers, and religious beliefs of the couple exert considerable influence on family planning decisions. Conclusions Numerous factors influence family planning decision-making in Turkey. Women have a strong preference for traditional methods compared to modern contraceptives. Additionally, religious factors play a leading role in the choice of the particular method, such as withdrawal. Besides, there is a lack of men’s involvement in family planning decision-making. Public health interventions should focus on incorporating men into their efforts and understanding how providers can better provide information to women about contraception.

GENDER RELATIONS: HUSBAND–WIFE FERTILITY AND FAMILY PLANNING DECISIONS IN KENYA

2001 ◽  
Vol 33 (1) ◽  
pp. 13-23 ◽  
Author(s):  
SITAWA R. KIMUNA ◽  
DONALD J. ADAMCHAK
Keyword(s):  
Decision Making ◽  
Family Planning ◽  
Doubling Time ◽  
Sociodemographic Characteristics ◽  
Demographic Health Survey ◽  
Men And Women ◽  
Planning Decisions ◽  
Married Men ◽  
Planning Decision ◽  
Health Survey Data

Although Kenya’s fertility rate has declined from 6·7 births per woman in the mid-1980s to 5·4 births per woman in 1993 (NCPD, 1994), population growth is still high, yielding a doubling time of 35 years. This study uses the 1993 Kenya Demographic Health Survey data collected from 1257 couples to examine the socioeconomic and sociodemographic characteristics of married men and women and their communication with their spouses over fertility and family planning decision-making practices. The logistic regression analysis shows that education for both men and women, discussion of fertility and family planning between spouses, male approval of use of contraception and male family size desires are important factors that influence ever-use of family planning.

scholarly journals Women’s empowerment for abortion and family planning decision making among marginalized women in Nepal: a mixed method study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Heera KC ◽  
Mangala Shrestha ◽  
Nirmala Pokharel ◽  
Surya Raj Niraula ◽  
Prajjwal Pyakurel ◽  
...  
Keyword(s):  
Decision Making ◽  
Family Planning ◽  
Mixed Method ◽  
Women's Empowerment ◽  
Women’S Empowerment ◽  
Key Informants ◽  
Marginalized Communities ◽  
Modern Contraceptives ◽  
Marginalized Women ◽  
Planning Decision

Abstract Background Women’s empowerment is multidimensional. Women’s education, employment, income, reproductive healthcare decision making, household level decision making and social status are vital for women’s empowerment. Nepal is committed to achieving women empowerment and gender equality, which directly affects the reproductive health issues. This can be achieved by addressing the issues of the poor and marginalized communities. In this context, we aimed to find the association of women’s empowerment with abortion and family planning decision making among marginalized women in Nepal. Methods A cross sectional study was conducted at selected municipalities of Morang district of Nepal from February 2017 to March 2018. A mixed method approach was used, where 316 married marginalized women of reproductive age (15–49 years) and 15 key informant interviews from representative healthcare providers and local leaders were taken. From key informants, data were analysed using the thematic framework method. Findings obtained from two separate analyses were drawn together and meta inferences were made. Results Women’s empowerment was above average, at 50.6%. Current use of modern contraceptives were more among below average empowerment groups (p 0.041, OR 0.593 C.I. 0.36–0.98). We could not find any statistically significant differences among levels of women’s empowerment, including those women with abortion knowledge (p 0.549); family planning knowledge (p 0.495) and women’s decision for future use of modern contraceptives (p 0.977). Most key informants reported that unsafe abortion was practiced. Conclusions Women’s empowerment has no direct role for family planning and abortion decision making at marginalized communities of Morang district of Nepal. However, different governmental and non-governmental organizations influence woman for seeking health care services and family planning in rural community of Nepal irrespective of empowerment status.

scholarly journals Concordance, communication, and shared decision-making about family planning among couples in Nepal: A qualitative and quantitative investigation

2019 ◽  
Vol 37 (2) ◽  
pp. 357-376
Author(s):  
Carol R. Underwood ◽  
Lauren I. Dayton ◽  
Zoé Mistrale Hendrickson
Keyword(s):  
Decision Making ◽  
Family Planning ◽  
Shared Decision Making ◽  
Quantitative Study ◽  
Shared Decision ◽  
Partner Communication ◽  
Joint Decision ◽  
Couple Communication ◽  
Spousal Concordance ◽  
Planning Decision

Couple communication and joint decision-making are widely recommended in the family planning and reproductive health literature as vital aspects of fertility management. Yet, most studies continue to rely on women’s reports to measure couple concordance. Moreover, the association between communication and decision-making is often assumed and very rarely studied. Arguably, associations between dyadic communication and shared decision-making constitute a missing link in our understanding of how communication affects fertility-related practices. Informed by Carey’s notions of transmission and ritual communication, this study sought to address those gaps with two complementary studies in Nepal: a qualitative study of married men and women and a quantitative study of 737 couples. To assess spousal concordance on matters of family planning-related communication and decision-making in the quantitative study, responses from the couple were compared for each question of interest and matched responses were classified as concordant. Quantitative results found that more than one-third of couples reported spousal communication on all measured family planning-related topics. Nearly, 87% of couples reported joint decision-making on both family planning use and method type. Partner communication was significantly and positively associated with concordant family planning decision-making in both bivariate and multivariate models. Couples communicating about three family planning topics had more than twice the odds of concordant family planning decision-making than did those not reporting such communication. The qualitative findings provided insights into discordant as well as concordant interactions, revealing that decision-making, even when concordant, is not necessarily linear and is often complex.

Pregnancy and Fertility Trends Among Female Otolaryngologists

2021 ◽  
pp. 019459982110645
Author(s):  
Makenzie Huguet ◽  
Angela Beliveau ◽  
Sandra L. Taylor ◽  
Debbie A. Aizenberg
Keyword(s):  
Decision Making ◽  
Family Planning ◽  
General Population ◽  
Career Decision ◽  
Neck Surgery ◽  
Career Decision Making ◽  
Workplace Support ◽  
Fertility Trends ◽  
Planning Decisions ◽  
The Mean

Objective This study sought to determine childbearing patterns and decision making among female otolaryngologists. Study Design Anonymous survey. Setting An anonymous survey was sent in 2020 to female otolaryngologists identified through their membership with the American Academy of Otolaryngology–Head and Neck Surgery. Methods Data were analyzed concerning individual fertility and childbearing history, reflections regarding decision making, perceptions of workplace support, and estimations of objective childbearing potential. Results There were 398 responses. The mean age at first pregnancy was 32.3 years. Almost one-third of respondents who attempted to conceive (30.4%) were diagnosed with infertility. Of those who had their first pregnancy during training, 55% reported having substantial workplace support, as opposed to 70% of those whose first pregnancies followed completion of training ( P = .01). When asked what they would do differently in retrospect, most women with infertility (65.0%) would have attempted conception earlier; 41 (41.0%) would have used cryopreservation to extend fertility; and 14 (14.0%) would have gone into a different specialty. Conclusion Female otolaryngologist respondents have children later in life than the general population, and a substantial proportion face infertility or have regrets about family planning decisions and career decision making. Increased awareness, further investigation, and targeted programs are needed to support the growing number of female otolaryngologists who desire both a career and a family.

scholarly journals Engaging the Senses: The Potential of Emotional Data for Participation in Urban Planning

Urban Science ◽  
2018 ◽  
Vol 2 (4) ◽  
pp. 98 ◽  
Author(s):  
Afif Fathullah ◽  
Katharine Willis
Keyword(s):  
Decision Making ◽  
Urban Planning ◽  
Urban Environment ◽  
Physical Space ◽  
Urban Setting ◽  
City Centre ◽  
Planning Decisions ◽  
Information Layer ◽  
Stress Levels ◽  
Planning Decision

This paper presents an exploratory study on the potential for sharing urban data; one where citizens create their own data and use it to understand and influence urban planning decisions. The aim of the study is to explore new models of participation through the sharing of emotional data and focuses on the relationship between the physical space and emotions through identifying the links between stress levels and specific features of the urban environment. It addresses the problem in urban planning that, while people’s emotional connection with the physical urban setting is often valued, it is rarely recognised or used as a source of data to understand future decision making. The method involved participants using a (GSR) device linked to location data to measure participant’s emotional responses along a walking route in a city centre environment. Results show correlations between characteristics of the urban environment and stress levels, as well as how specific features of the city spaces create stress ‘peaks’. In the discussion we review how the data obtained could contribute to citizens creating their own information layer—an emotional layer—that could inform a shared approach to participation in urban planning decision-making. The future implications of the application of this method as an approach to public participation in urban planning are also considered.

Ole Taeao Afua, the New Morning: A Qualitative Investigation Into Samoan Perspectives on Mental Health and Culturally Appropriate Services

2005 ◽  
Vol 39 (4) ◽  
pp. 300-309 ◽  
Author(s):  
Kiwi Tamasese ◽  
Carmel Peteru ◽  
Charles Waldegrave ◽  
Allister Bush
Keyword(s):  
Mental Health ◽  
Cultural Values ◽  
Low Income ◽  
Cultural Context ◽  
Research Method ◽  
Mental Health Problems ◽  
Service Providers ◽  
Relational Self ◽  
Cultural Norms ◽  
Culturally Appropriate

Objectives: The first objective was to develop a culturally appropriate research method to investigate Samoan perspectives on mental health issues. The second objective was to apply this to identify cultural values and understandings important in the care and treatment of Samoan people with mental health problems. Method: Gender-specific focus groups consisting of Samoan elders and service providers were facilitated by Samoan researchers in the Samoan language. Systematic analysis of the transcripts, adapted to the cultural context, were conducted in Samoan and later translated into English. Results: A culturally derived method, referred to as Fa'afaletui, reflecting Samoan communal values and familiar institutional structures within the community, allowed each focus group to come to a consensual view on issues discussed. The Samoan self was identified as an essential concept for understanding Samoan views of mental health. This self was described as a relational self and mental wellness as a state of relational harmony, where personal elements of spiritual, mental and physical are in balance. Mental ill health was sometimes linked to breaches of forbidden and sacred relationships, which could be addressed effectively only within protocols laid down in the culture. Additional stressors contributing to mental ill-health were identified as low income, unemployment, rising housing costs and the marginalization of Samoan cultural norms in New Zealand. Participants identified the need for a culturally based mental health service for Samoan people to address key cultural factors. Conclusions: The Fa'afaletui method is a new research method which is sensitive and responsive to Samoan cultural norms and is methodologically rigorous. Such an approach may be relevant for other Pacific Island cultures and other cultures, which have a strong emphasis on collectivity. The Samoan concept of self provides a theoretical foundation for understanding the mental health needs of Samoan people and a basis for developing appropriate services.

scholarly journals Challenges to effective governance in a low income healthcare system: a qualitative study of stakeholder perceptions in Malawi

2020 ◽  
Author(s):  
Sarah C Masefield ◽  
Alan Msosa ◽  
Jean Grugel
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Health System ◽  
National Health ◽  
Low Income ◽  
Service Providers ◽  
Health Sector ◽  
National Health System ◽  
Low Income Countries ◽  
Health Coverage

Abstract BackgroundAll countries face challenging decisions about healthcare coverage. Malawi has committed to achieving Universal Health Coverage (UHC) by 2030, the timeframe set out by the Sustainable Development Goals (SDGs). As in other low income countries, scarce resources stand in the way of more equitable health access and quality in Malawi. Its health sector is highly dependent on donor contributions, and recent poor governance of government-funded healthcare saw donors withdraw funding, limiting services and resources. The 2017 National Health Plan II and accompanying Health Strategic Plan II identify the importance of improved governance and strategies to achieve more effective cooperation with stakeholders. This study explores health sector stakeholders’ perceptions of the challenges to improving governance in Malawi’s national health system within the post-2017 context of government attempts to articulate a way forward.MethodsA qualitative study design was used. Interviews were conducted with 22 representatives of major international and faith-based non-government organisations, civil society organisations, local government and government-funded organisations, and governance bodies operating in Malawi. Open questions were asked about experiences and perceptions of the functioning of the health system and healthcare decision-making. Content relating to healthcare governance was identified in the transcripts and field notes and analysed using inductive content analysis.ResultsStakeholders view governance challenges as a significant barrier to achieving a more effective and equitable health system. Three categories were identified: accountability (enforceability; answerability; stakeholder-led initiatives); health resource management (healthcare financing; drug supply); influence in decision-making (unequal power; stakeholder engagement).ConclusionsHealth sector stakeholders see serious political, structural, and financial challenges to improving governance in the national health system in Malawi which will impact the government’s goal of achieving UHC by 2030. Stakeholders identify the need for improved oversight, implementation, service delivery and social accountability of government-funded service providers to communities. Eighteen months after the introduction of the policy documents, they see little evidence of improved governance and have little or no confidence in the government’s ability to deliver UHC. The difficulties stakeholders perceive in relation to building equitable and effective healthcare governance in Malawi have relevance for other resource-limited countries which have also committed to the goal of UHC.

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