Wednesday 10 September 2003, 2pm, U Lounge.
Teenage conceptions, sexually transmitted infections (STIs) and family planning: evidence from England 1998-2001
David Paton, Nottingham University Business School
Economic models of rational choice suggest that family planning provision for adolescents may increase rates of sexual activity and can have an ambiguous impact on teenage pregnancy. Alternative models from other disciplines argue that adolescent sexual activity is essentially random in nature and that the provision of family planning will unambiguously reduce teenage pregnancy. Existing empirical evidence has not proved able to distinguish between these competing theories, a point of obvious concern for policy makers.
I argue that examining the differential impact of adolescent family planning services on pregnancy rates and rates of STIs may be a fruitful method of discriminating between alternative theoretical models. New policy initiatives in England since mid 1999 have caused a significant increase in family planning clinic services aimed at young people. Promotion of emergency birth control has also dramatically increased.
I use health authority data from England between 1998 and 2001 to examine the impact of these two policy initiatives on teenage pregnancy and STI rates. I use a fixed-effects panel data specification to control for the fact that clinic services are more likely to be set up in areas where pregnancy rates are high. I also control for correlations across different health authorities and for the fact that STI data in England represents diagnoses and not infections. Policy implications of the results are discussed.
Email: david.paton@nottingham.ac.uk
Why is use of family planning so low in Guatemala?
Sofie De Broe, Andrew Hinde and Zoë Matthews, University of Southampton
Guatemala has the highest total fertility rate in Latin American. Low use of family planning is one of the explanations for this high fertility. According to the Demographic and Health Survey (DHS) 1998/99 only 13 per cent of the indigenous Maya and 50 per cent of ladino women use family planning. The overall contraceptive prevalence rate (CPR) of 38 per cent is low compared to the rest of Latin America where CPRs range between 47 per cent and 75 per cent.
This paper seeks to provide an explanation for the low use of family planning among both ethnic groups. Data come from two household surveys, one carried out in the town of Jocotán, the capital of the Ch'orti area, in 2001 and one carried out in two nearby indigenous villages in 1994.
The analysis of the data and an extensive literature review will explore whether the low reported CPRs can be explained by the used definition of ethnicity in the DHS or whether it can be attributed to an overall so called 'national effect'. We will measure the national effect through a comparison with eight different Latin American countries to investigate whether Guatemalan women in both ethnic groups with similar socio-demographic characteristics are less likely to use contraception than their Latin American counterparts. It is hypothesised that the combination of the two factors (definition of ethnicity and a 'national effect') will provide part of the explanation why family planning remains so low in Guatemala.
Email: Sofie@socsci.soton.ac.uk
Organisational objectives versus local expectations
Jane Diamond, University of Southampton
The development of a new reproductive health centre always poses many problems, not least of which is ensuring that it is financially sustainable and able to survive without long term donor funding.
Marie Stopes International has developed a set of criteria which aim to ensure sustainability. These include factors such as the use of paramedical staff rather than doctors where possible; multi-skilling and multi-tasking among the staff; and identifying the range of services to provide (together with their price) so as to ensure the income to cost ratio is favourable. While these organisational objectives are very laudable they are often challenged in practice when local expectations, which may be rather different, interact so as to make their operationalisation difficult. This paper describes research into the development of the first reproductive health centre in Yemen and present a test of the Marie Stopes model of service delivery in a harsh programming environment.
Email: jdiamond@socsci.soton.ac.uk