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Notes
1. Singh, S., et al. 2004. Adding It Up:
The Benefits of Investing in Sexual
and Reproductive Health Care.
Washington, D.C., and New York:
The Alan Guttmacher Institute
and UNFPA.
2. UNFPA. 2004a. Investing in People:
National Progress in Implementing the
ICPD Programme of Action. New York:
UNFPA; and WHO. 2003.
Reproductive Health: Draft Strategy
to Accelerate Progress towards the
Attainment of International
Development Goals and Targets
(EB113/15 Add.1). Geneva: WHO.
3. United Nations. 2004. Review and
Appraisal of the Progress made in
Achieving the Goals and Objectives
of the Programme of Action of the
International Conference on Population and Development: Report of the
Secretary-General (E/CN.9/2004/3).
New York: United Nations.
4. In Bangladesh, prevalence increased
by 1.8 percentage points overall but
3 quintiles—to the largest extent in
the poorest quintile—experienced
decreases in desires satisfied by
modern method use.
5. Details about the calculations, and
an extended discussion of the reliability,
validity and implications of the
concept, can be found in: Casterline,
J. B., and S. W. Sinding. 2000.
“Unmet Need for Family Planning
in Developing Countries and
Implications for Population Policy.”
Population and Development Review
26(4): 691-723.
6. United Nations. 1995. Population and
Development, vol. 1: Programme of
Action adopted at the International
Conference on Population and
Development: Cairo: 5-13 September
1994, paragraph 7.16. New York:
Department of Economic and Social
Information and Policy Analysis,
United Nations.
7. United Nations. 1999. Key Actions
for the Further Implementation of
the Programme of Action of the
International Conference on Population
and Development(A/S-21/5/Add.1),
paragraph 58. New York: United
Nations.
8. Reports of total and wanted fertility
in most recent surveys obtained
from: Demographic and Health
Surveys’ StatCompiler. Web site:
www.orcmacro.org, accessed 8
March 2004.
9. The dynamics of this relationship,
and the corresponding impact on
recourse to abortion are analyzed
in: Bongaarts, J. 1997. Trends in
Unwanted Childbearing in the
Developing World. Policy Research
Division Working Paper. No. 98.
New York: The Population Council;
and Bongaarts, J., and C. F. Westoff.
2000. “The Potential Role of
Contraception in Reducing
Abortion.” Studies in Family
Planning 31(3): 193-202.
10. Singh, S., et al. 2004.
11. Modern contraceptive techniques
include male and female sterilization,
oral contraceptives, implants
and injections and barrier methods
(male and female condoms and
diaphragms). Traditional methods
include periodic abstinence, withdrawal
and lactational amenorrhea
(extended breast-feeding).
12. Adding those using traditional
methods into those with unmet
need for modern methods, fully
63 per cent of sub-Saharan women
and couples have unmet limiting
and spacing desires.
13 This can include shortages of
support for and supply of temporary methods for birth spacing, the need
to address cultural sensitivities (e.g.,
bleeding or spotting side effects
where blood taboos are prevalent).
14. Rudy, S., et al. 2003. “Improving
Client-Provider Interaction.”
Population Reports. Series Q. No. 1.
Baltimore, Maryland: The INFO
Project, Center for Communication
Programs, the Johns Hopkins
Bloomberg School of Public Health.
Web site: http://www.infoforhealth.org/
pr/q01/q01.pdf, last accessed 27
April 2004.
15. See the discussion of Youth Friendly
Services in: UNFPA. 2003. The State
of World Population 2003: Making
1 Billion Count: Investments in
Adolescents’ Health and Rights.
New York: UNFPA.
16. Calculated from data provided by
John Ross from the 1999 Family
Planning Program Strength survey
(See: Ross, J., and J. Stover. 2000.
Effort Indices for National Family
Planning Programs: 1999 Cycle.
Measure Evaluation Working Paper.
No. WP-00-20. Chapel Hill, North
Carolina: Carolina Population Center,
University of North Carolina. See
also: Ross, J., J. Stover, and A.
Willard. 1999. Profiles for Family
Planning and Reproductive Health
Programs: 116 Countries, Ch. 5.
Glastonbury, Connecticut: The
Futures Group International.). This
survey has been conducted periodically
since 1982. An update is
scheduled for late 2004. Data on
unmarried women lacking access to
contraceptives are less available, but
would add significant numbers to
this estimate.
17. Bongaarts, J., and S. C. Watkins
(1996). “Social Interactions and
Contemporary Fertility Transitions.
Population and Development Review
22(4): 639-682; and Merrick, T. W.
2002. “Population and Poverty:
New Views on an Old Controversy.”
International Family Planning
Perspectives 28(1): 41-46.
18. Merrick 2002.
19. The term is used here to denote
those who are using a method when
they wish to avoid a pregnancy.
More complete definitions take into
account whether or not users have
access to a range of choice and have
selected a method appropriate to
their desires (see: Sinding and
Casterline 2000; Jain, A. K. 2001.
“Family Planning Programs: Quality
of Care.” In: The International
Encyclopedia of the Social and
Behavioral Sciences, edited by
N. J. Smelser and P. B. Baltes. 2001.
Amsterdam: Elsevier; and RamaRao,
S., and R. Mohanam. 2003. “The
Quality of Family Planning Programs:
Concepts, Measurements, Interventions,
and Effects.” Studies in Family Planning
34[4]: 227-248). An important
historical contribution focused on attainment of intentions can be
found in: Jain, A., and J. Bruce. 1994.
“A Reproductive Health Approach
to the Objectives and Assessment
of Family Planning Programs.”
Pp. 192-208 in: Population Policies
Reconsidered: Health, Empowerment,
and Rights, edited by G. Sen,
A. Germain, and L. Chen. 1994.
Cambridge, Massachusetts:
Harvard University Press.
20. Merrick, T. 2004. “Maternal-
Newborn Health and Poverty.” Draft.
Washington, D.C.: The World Bank.
Cited in: UNFPA 2004a.
21. UNFPA 2004a.
22. WHO. 1998. Emergency
Contraception: A Guide for Service
Delivery (WHO/FRH/FPP/98.19).
Geneva: Family Planning and
Population, Reproductive Health
Technical Support, Family and
Reproductive Health, WHO.
23. WHO. n.d. “Sexually Transmitted
Infections: A Persistent Public
Health Burden.” Geneva:
Department of Reproductive
Health and Research, WHO.
24. WHO 2003.
25. WHO n.d.
26. UNFPA. 2004b. “Sexually
Transmitted Infections: Breaking the
Cycle of Transmission,” p. 16. Draft.
New York: Reproductive Health
Branch, Technical Support Division,
UNFPA.
27. United Nations 1995, paragraph
7.32.
28. WHO n.d.
29. Coggins, C., and A. Heimburger.
2002. “Sexual Risk, Sexually
Transmitted Infections, and
Contraceptive Options: Empowering
Women in Mexico with Information
and Choice,” pp. 274-275. Ch. 15 in:
Responding to Cairo: Case Studies of
Changing Practice in Reproductive
Health and Family Planning, edited
by N. Haberland and D. Measham.
2002. New York: The Population
Council.
30. WHO n.d.
31. WHO 2003.
32. UNFPA 2004b, pp. 25-26.
33. Ibid., pp. 26-27.
34. UNFPA 2004a, p. 37.
35. Ibid.
36. The World Bank. 2004. World
Development Report 2004: Making
Services Work for Poor People, pp. 1-5.
New York: Oxford University Press.
37. Bruce, J. 1990. “Fundamental
Elements of the Quality of Care:
A Simple Framework.” Studies in
Family Planning 21(2): 61-91.
38. Huezo, C., and S. Diaz. 1993.
“Quality of Care in Family Planning:
Clients’ Rights and Providers’
Needs.” Advances in Contraception
9(2): 129-139.
39. John Snow, Inc. 2000.
Mainstreaming Quality Improvement
in Family Planning and Reproductive
Health Service Delivery: Context and
Case Studies. Arlington, Virginia:
Family Planning Expansion and
Technical Support (SEATS II)
Project, John Snow, Inc.; Lynam, P.,
L. M. Rabinowitz, and M. Shobowale.
1993. “Using Self-Assessment to
Improve the Quality of Family
Planning Clinic Services.” Studies in
Family Planning 24(4): 252-260;
and Hardee, K., and B. Gould. 1993.
“A Process for Service Quality
Improvement in Family Planning.”
International Family Planning
Perspectives 19(4): 147-152.
40. Hardee, K. Forthcoming. “The
Intersection of Access, Quality of
Care and Gender in Reproductive
Health and STI/HIV Services:
Evidence from Kenya, India and
Guatemala.” Washington, D.C.:
Interagency Gender Working Group
and the POLICY Project.
41. Mensch, B., M. Arends-Kuenning,
and A. Jain. 1996. “The Impact of
the Quality of Family Planning
Services on Contraceptive Use in
Peru.” Studies in Family Planning
27(2): 59-75.
42. Mroz, T. A., et al. 1999. “Quality,
Accessibility, and Contraceptive
Use in Rural Tanzania.” Demography
36(1): 23-40.
43. Pariani, S., D. M. Heer, and M. D.
Van Arsdol, Jr. 1991. “Does Choice
Make a Difference to Contraceptive
Use: Evidence from East Java.”
Studies in Family Planning 22(6):
384-390.
44. Cotton, N., et al. 1992. “Early
Discontinuation of Contraceptive
Use in Niger and the Gambia.”
International Family Planning
Perspectives 18(4): 145-149.
45. Quality of care was defined as the
fieldworker usually or always being
responsive to a client’s questions,
appreciating her need for privacy,
being perceived as dependable to
help with problems, sympathetic to
the client’s needs, providing enough
information, spending 10 minutes or
more with the client during the past
visit, and providing a choice of
methods.
46. Koenig, M. 2003. The Impact of
Quality of Care On Contraceptive Use:
Evidence from Longitudinal Data from
Rural Bangladesh. Baltimore, Maryland:
Department of Population and
Family Health Sciences, Bloomberg
School of Public Health, Johns
Hopkins University.
47. Rudy, S., et al. 2003.
48. John Snow, Inc. 2000; Nguyen, M. T.,
et al. 1998. “Improving Quality and
Use of Family Planning in Three
Sites in Vietnam.” Paper presented
at the American Public Health
Association Annual Meeting,
Washington, D.C., 15-19 November
1998; Bradley, J., et al. 1998. Quality
of Care in Family Planning Services:
An Assessment of Change in Tanzania
1995/6 to 1996/7. New York: AVSC
International. All cited in: RamaRao,
S., and R. Mohanam. 2003.
“The Quality of Family Planning
Programs: Concepts, Measurements,
Interventions, and Effects.” Studies
in Family Planning 34(4): 227-248.
49. RamaRao and Mohanam 2003.
50. Schuler, S. R., L. M. Bates, and M. D.
K. Islam. 2002. “Paying for
Reproductive Health Services in
Bangladesh: Intersections between
Cost, Quality and Culture.” Health
Policy and Planning 17(3): 273-280.
51. UNFPA. 2004c. “Donor Support for
Contraceptives and Condoms for
STI/HIV Prevention 2002.” Draft.
New York: UNFPA.
52. The average cost per user of contraceptives
has been calculated at
$1.52 a year. It is assumed that the
unavailability of contraceptives
would have an adverse impact on
women’s reproductive health, even
where other reproductive health
services exist. To estimate the
consequences, we have used the
formulas employed in: UNFPA. 1997.
Meeting the Goals of the ICPD:
Consequences of Resource Shortfalls
up to the Year 2000: Report of the
Executive Director (DP/FPA/1997/12).
New York: UNFPA.
53. UNFPA. 2002. Reproductive Health
Essentials: Securing the Supply: Global
Strategy for Reproductive Health
Commodity Security, Chapter 1.
New York: UNFPA.
54. See: UNFPA. 2001. Reproductive Health
Commodity Security: Partnerships for
Change: A Global Call to Action.
New York: UNFPA. Web site:
www.unfpa.org/upload/lib_pub_file/
135_filename_rhcstrategy.pdf, last
accessed 17 June 2004.
55. WHO and UNFPA. 2002. “Essential
Drugs and Other Commodities for
Reproductive Health Services.”
Draft. Geneva and New York: WHO
and UNFPA.
56. United Nations. 2003. World
Population Prospects: The 2002
Revision. New York: Population
Division, Department Economic
and Social Affairs, United Nations;
and United Nations. 2002. World
Urbanization Prospects: The 2001
Revision. New York: Population
Division, Department Economic
and Social Affairs, United Nations.
57. Malhotra, A., and R. Mehra. 1999.
Fulfilling the Cairo Commitment: Enhancing Women’s Economic and
Social Options for Better Reproductive
Health. Washington, D.C.:
International Center for Research
on Women.
58. Greene, M. E., and A. E. Biddlecom.
2000. “Absent and Problematic
Men: Demographic Accounts of
Male Reproductive Roles.” Population
and Development Review 26(1):
81-115.
59. Ezeh, A. C., M. Seroussi, and
H. Raggers. 1996. Men’s Fertility,
Contraceptive Use, and Reproductive
Preferences. Demographic and
Health Surveys Comparative
Studies. No. 18. Calverton,
Maryland: Macro International.
60.Research exploring this topic included:
Mason, K. O., and A. M. Taj. 1987.
“Differences Between Women’s
and Men’s Reproductive Goals in
Developing Countries.” Population
and Development Review 13(4):
611-638; and Coombs, L. C., and
M. C. Chang. 1981. “Do Husbands
and Wives Agree: Fertility Attitudes
and Later Behaviour.” Population and
Environment 4(2): 109-127.
61. The Alan Guttmacher Institute.
2003. In Their Own Right: Addressing
the Sexual and Reproductive Health
Needs of Men Worldwide. New York:
The Alan Guttmacher Institute.
62. Ibid.
63. Examples of this orientation can be
found in context-specific programmes
and research in Latin
America (Loaiza, E. 1998. “Male
Fertility, Contraceptive Use, and
Reproductive Preferences in Latin
America: The DHS Experience.”
Paper prepared for the seminar,
“Men, Family Formation and
Reproduction”, organized by the
Committee on Gender and
Population of the International
Union for the Scientific Study of
Population [IUSSP] and the Centro
de Estudios de Poblacion [CENEP],
Buenos Aires, Argentina, 13-15 May
1998. Liege, Belgium: IUSSP) and in
Ghana (Lamptey, P. et al. 1978. “An
Evaluation of Male Contraceptive
Acceptance in Rural Ghana.” Studies
in Family Planning 9(8): 222-226.).
64. Basu, A. M. 1996. “Women’s
Education, Marriage And Fertility:
Do Men Really Not Matter?”
Population and Development
Program Working Paper Series. No.
96.03. Ithaca, NewYork: Cornell
University; Hull, T. H. 1999. “Men
and Family Planning: How Attractive
is the Programme of Action?” Paper
presented at the Psychosocial
Workshop, New York, New York, 23-
24 March 1999; and Hawkes, S.
1998. “Providing Sexual Health
Services for Men in Bangladesh.”
Sexual Health Exchange 3: 14-15.
65. White, V., M. Greene, and E. Murphy.
2003. “Men and Reproductive
Health Programs: Influencing Gender
Norms.” Washington, D.C.: The
Synergy Project. Available at
www.synergyaids.com/
SynergyPublications/Gender_Norms.
pdf, accessed 5 March 2004.
66. Rivers, K., and P. Aggleton. 2001.
Working with Young Men to Promote
Sexual and Reproductive Health.
London: Safe Passages to
Adulthood, University of London.
67. Brady, M., and A. B. Khan. 2002.
Letting Girls Play: The Mathare Youth
Sports Association's Football Program
for Girls. New York: The Population
Council.
68. See: Estudos e Comunicaçao em
Sexualidade e Reproducao Humana
(ECOS) web site: www.ecos.org.br/,
accessed 3 March 2004.
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