Tables

Table 1. Mothers' Lives at Risk
Table 2. Summary Women's Reproductive Lives
Table 2. Relationship Between Contraceptive Prevalence and Other Aspects of Womne's Lives
Table 3. Trends in Contraception and Women's Lives
Table 4. Gender and Family Planning Services: Assumptions and Possible Consequences
Table 5. Who Decides?
Table 6. Discussion with Husbands
Table 7. Men's Role in Family Planning

Table 1. Mother's Lives at Risk
Maternal Mortality Ratio, Total Fertility Rate, and Lifetime Risk of Maternal Death by Region
Selected World Regions Estimated Maternal Mortality Ratio
(Maternal Deaths Per 100,000 Live Births), 1988		 Total Fertility Rate1 Lifetime Risk of Maternal Death (As Odds)2
AFRICA 630 6.1 1 in 22
  North 360 6.0 1 in 28
  East 680 6.8 1 in 19
  Middle 710 6.1 1 in 20
  West 760 6.4 1 in 19
  South 270 5.2 1 in 29
ASIA 380 3.9 1 in 57
  East 120 2.1 1 in 722
  Southeast 340 4.5 1 in 44
  South 570 4.4 1 in 34
  West 280 4.9 1 in 61
EUROPE 23 1.7 1 in 2,132
NORTH AMERICA 12 2.6 1 in 2,671
SOUTH AMERICA 220 3.3 1 in 165
OCEANIA 600 2.6 1 in 54
WORLD 390 3.7 1 in 58
DEVELOPED COUNTRIES 26 1.9 1 in 1,687
DEVELOPING COUNTRIES 420 3.9 1 in 51
1 Total Fertility Rate (TFR) = Average number of live births a woman would have by the end of her reproductive life if she experienced the currently prevailing age-specific fertility rates.
2 Lifetime Risk = Risk of dying of pregnancy-related causes by the end of the reproductive period. Calculated as lifetime risk = 1–(1–MMR)1.2(TFR), where MMR (maternal mortality ratio) is expressed as a decimal. The TFR is multiplied by 1.2 to adjust for pregancies not ending in live births.

Source: Tinker et al. 1993 (312)


Return to Chapter 2.2


Summary of Table 2.
Women's Reproductive Lives
  Average Among Countries with Above- and Below-Average Contraceptive Prevalence
Contraceptive Prevalence Median Age at Marriage Median Age at 1st Birth Median Age at Last Birth Additional Years of Life at Age at Last Birth Years Between 1st and Last Births Years Spent Pregnant Years Spent with a Child under Age 6
>40% 20.6 22.3 34.3 40.1 13.5 2.6 13.7
<40% 18.0 19.6 37.5 33.0 18.1 4.5 19.5
Note: For definitions of column headings, see footnotes to Table 2 below.

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Table 2. Relationship Between Contraceptive Prevalence and Other Aspects of Women's Lives, Demographic and Health Surveys, 1986–1992
Country Contraceptive Prevalence1 Median Age at Marriage2 Median Age at 1st Birth3 Median Age at Last Birth4 Additional Years of Life at Age at Last Birth5 Years Between 1st and Last Births6 Years Spent Pregnant7 Years Spent with a Child under Age 68
Thailand 1987 66 21.0 23.0 32.9 40.2 11.4 1.7 10.5
Brazil 1986 66 21.1 22.4 33.6 42.2 11.9 2.5 14.0
Colombia 1990 66 21.5 22.5 33.3 42.3 12.2 1.6 12.2
Sri Lanka 1987 62 23.2 24.7 33.5 43.4 11.6 2.0 11.0
Peru 1991-92 59 21.8 22.1 34.7 39.5 13.4 2.6 13.9
Dominican Republic 1991 56 19.8 21.7 31.2 44.7 11.6 2.5 12.4
Mexico 1987 53 20.2 21.1 35.1 40.5 14.6 3.0 14.6
Trinidad & Tobago 1987 53 19.8 22.2 31.7 42.9 11.3 2.3 12.0
Indonesia 1991 50 18.6 20.4 33.3 39.0 13.7 2.3 12.9
Tunisia 1988 50 22.9 24.5 36.3 37.0 14.8 3.1 14.3
Ecuador 1987 44 19.8 20.7 35.6 38.0 14.6 3.1 15.5
Zimbabwe 1988-89 43 18.8 19.5 37.3 35.0 17.9 4.0 19.8
Morocco 1992 42 19.4 24.9 36.9 37.2 16.4 3.0 14.6
Egypt 1988-89 38 19.5 21.7 34.6 36.3 14.8 3.4 15.7
Togo 1988 34 18.4 19.2 38.8 32.1 19.3 4.6 21.8
Botswana 1988 33 NA 19.2 37.4 36.4 17.4 3.5 19.1
Bolivia 1989 30 20.0 20.6 36.7 35.0 15.5 3.7 16.9
Kenya 1988-89 27 18.6 18.7 37.8 34.7 18.9 4.9 20.8
Guatemala 1987 23 18.5 19.7 36.1 36.4 16.1 4.1 18.1
Cameroon 1991 16 16.9 18.6 36.5 33.7 18.0 4.4 19.1
Zambia 1992 15 18.0 18.8 38.5 32.3 20.1 4.9 19.9
Ghana 1988 13 18.5 20.0 37.9 33.2 18.9 4.6 20.8
Senegal 1986 11 16.7 19.0 38.7 31.2 20.0 4.7 20.6
Burundi 1987 9 19.5 20.9 39.2 30.3 18.1 4.9 20.9
Sudan 1989-90 9 20.5 22.8 36.4 32.9 17.4 3.5 15.8
Liberia 1986 6 17.9 19.0 37.3 32.1 17.7 4.8 19.9
Nigeria 1990 6 17.2 19.6 37.3 32.5 17.5 4.5 19.2
Uganda 1988-89 5 17.5 18.3 37.8 32.3 19.6 5.4 20.7
Mali 1987 5 15.9 19.0 38.2 30.8 19.0 5.2 21.3
Niger 1992 4 15.1 17.8 37.6 28.8 19.3 5.3 20.6
1Contraceptive Prevalence = Percentage of married women of reproductive age currently using contraception
2Age at First Marriage = Median for women age 25-29
3Age at First Birth = Median for women age 25-29
4Age at Last Birth = Median for ever-married women ages 40-49 with at least one birth (40-44 for Brazil and Guatemala)
5Life Expectancy at Age at Last Birth = Based on Coale-Demeny model life tables; mortality level from United Naitons (389); mortality pattern from United Nations (388)
6Number of Years Between First and Last Births = For ever-married women ages 40-49 with at least one birth (40-44 for Brazil and Guatemala)
7Number of Years Spent Pregnant = TFR (0-2 yrs for women 15-44) x 9/12
8Number of Years with Child under Age 6 = For all women (current status estimate based on proportions with a child under 6 by age)
NA = Not available

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Table 3. Trends in Contraception and Women's Lives: How Indicators of Women's Lives Have Changed as Contraceptive Use Has Risen, Demographic and Health Surveys and World Fertility Survey, 1977-1992
    Contraceptive Prevalence1 Age at First Birth2 Age at Last Birth2 Childbearing Period3 Years with Child under Age 64
Years of Surveys WFS DHS-I DHS-II WFS DHS-I DHS-II WFS DHS-I DHS-II WFS DHS-I DHS-II WFS DHS-I DHS-II
Ghana 1979-80, 88 10 13   20.1 19.0   38.2 37.9   18.1 18.9   21.1 20.8  
Kenya 1977-78, 88-89  7 27   19.1 18.9   39.3 37.8   19.4 18.9   22.9 20.8  
Senegal 1978, 86  4 11   18.1 18.7   38.0 38.7   19.9 20.0   20.8 20.6  
Sudan 1978-79, 88-90  5  9   20.2 19.0   36.3 36.4   16.2 17.4   17.7 15.8  
Egypt 1980, 88-89 24 38   18.9 19.8   35.1 34.6   16.2 14.8   16.2 15.7  
Morocco 1979-80, 87, 92 19 36 42 18.8 19.7 20.5 37.0 37.6 36.9 18.2 17.9 16.4 17.3 15.6 14.6
Tunisia 1978, 88 31 50   21.5 21.5   37.8 36.3   16.3 14.8   16.9 14.3  
Indonesia5 1976, 87, 91 26 48 53 19.5 19.3 19.2 34.9 34.1 32.5 15.4 14.8 11.9 17.0 12.4 11.9
Sri Lanka 1975, 87 34 62   20.5 21.9   35.5 33.5   15.0 11.6   13.2 11.0  
Thailand 1978, 88 37 66   21.6 21.5   37.3 32.9   15.7 11.4   16.2 10.5  
Colombia 1976, 86, 90 43 65 66 21.1 20.6 21.1 36.4 33.6 33.3 15.3 13.0 12.2 15.1 13.1 12.2
Dominican Rep. 1975, 86, 91 33 50 56 19.8 19.6 19.6 36.0 34.0 31.2 16.2 14.4 11.6 16.3 13.3 12.4
Equador 1979, 87 35 44   20.8 21.0   36.9 35.6   16.1 14.6   16.8 15.5  
Mexico 1976, 87 30 53   20.2 20.5   37.4 35.1   17.2 14.6   21.5 14.6  
Peru 1977-79, 86, 91-92 31 46 59 20.9 20.5 21.3 37.5 36.2 34.7 16.6 15.7 13.4 17.2 15.4 13.4
Trinidad & Tobago 1977, 87 52 53   19.7 20.4   33.4 31.7   13.7 11.3   11.9 12.0  
WFS = World Fertility Survey; DHS-I = Demographic and Health Survey, first round; DHS-II = Demographic and Health Survey, second round
1Contraceptive prevalence = Percentage currently using any method among currently married women ages 15-49
2Age at First Birth, Age at Last Birth = Median for ever-married women ages 40-49 with at least one birth
3Number of Years Between First and Last Births = Median age at last birth minus median age at first birth
4Number of Years with Child under Age 6 = For all women (current status estimate based on age-specific proportions with a child under age 6) 5Java and Bali only

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Table 4. Gender and Family Planning Services: Assumptions and Possible Consequences
ASSUMPTIONSPOLICY RESULTSSERVICE CONSEQUENCESGENDER CONSEQUENCES
NEGATIVE ASSUMPTIONS:
  • Women cannot make wise choices.
  • Women cannot tell rumor from fact, and they will stop using methods.




    POSITIVE ALTERNATIVE:
  • Women can make good choices
    		•
  • Select method for client.
  • Offer only long-term methods.
  • Ignore or play down side effects during counseling.

  • Provide thorough counseling for informed choice.
  • Expect women to change methods as needs change.
    		•
  • Women disrust providers.
  • Women fear family planning services.
  • Women do not return.
  • Women who want short-term methods stay away.



  • Women trust providers.
  • Women return for help or new method if dissatisfied rather than discontinue contraceptive use.
    		•
  • Women given no opportunity to make choices.
  • Women denied opportunity to take responsibility.
  • Women's opinions dismissed.
  • Image of women suggests incompetence, dependency.

  • Women learn to weigh choices and make dicisions in new subject areas.
  • Women gain confidence in making new choices; learn to trust own judgement.
  • Image of women suggests competence, self-determination.
    • NEGATIVE ASSUMPTIONS:
  • Women, not men, should take care of contraception.






    POSITIVE ALTERNATIVE:
  • Couples can decide matters together.
  • Men and women both need family planning services.
    		•
  • Peovide services that are convenient only for women.







  • Provide information and counseling for couples.
  • Provide convenient services for men and women.
    		•
  • Only women seek services.
  • Men have little access to services.







  • Increased use of contraception.
  • Both men and women use family planning information and services.
    		•
  • Women bear all responsibility for contraceptive use.
  • Men distrust contraceptive use.
  • Men suspect their wives of being unfaithful.
  • Spousal communication not improved.

  • Husband-wife communication improves.
  • All individuals recognize that they can and should take care of their reproductive health needs.
    • NEGATIVE ASSUMPTIONS:
  • Men do not care about family planning.
  • Men do not like condoms and will not choose vasectomy.

    POSITIVE ALTERNATIVE:
  • Men care about preventing unintended pregnancies.
    		•
  • Provide and/or promote only female methods; neglect vasectomy and condoms.


  • Provide convenient services for men.
  • Provide methods that men can use.
  • Inform men about reproductive health, including women's health.
    		•
  • Only women seek family planning.
  • Portection against STDs not maximized.




  • Men use more services.
    		•
  • Women seen as solely responsible for family planning.
  • Men do not feel responsible or able to control fertility.


  • Men share responsibility for contraceptive use.
  • Men understand and trust family planning services.

    • Return to Chapter 4.3


    Table 5. Who Decides?
    Percentage of Couples, by Who Decides and Nature of Decision, Survey Responses in Three Countries
      Nature of Decision
    Place/No. of Respondents, Family Member Deciding Use of Family Planning Number of Children Major Purchase Household Budget Education of Children Visiting Friends Child's Marriage
    Semi-Urban Turkey/366 women
       Wife 62 NA   5 49 11 23   3
       Husband   8 NA 59 27 32 53 24
       Joint 25 NA 28 16 45 14 31
       Extended Family   1 NA   6   8   1   9   2
       Other   4 NA   2   1 11   2 40
    Rural Turkey/358 women
       Wife 29 NA   2 11   4 13 <3
       Husband 23 NA 54 52 36 40 21
       Joint 46 NA 10   7 39   7 38
       Extended Family   1 NA 23 20 10 33 11
       Other   1 NA 11 10 11   7 30
    Rural India/250 women
       Wife   4   5   1 NA   1 NA   1
       Husband 24 11   6 NA 19 NA   1
       Joint 38 44 58 NA 50 NA 32
       Extended Family 22 28 34 NA 20 NA 44
       Data missing 12 12   1 NA 11 NA 22
    Egypt/9,000 women
       Wife 14   6 NA 15   3   3   1
       Husband 25 32 NA 48 34 62 36
       Joint 61 62 NA 27 63 32 61
       Other   1   1 NA   9   1   2   2
       Data missing — — NA — — —   1
    Upper Egypt/1,053 men
       Wife   4   4 NA   7   1   2   1
       Husband 59 67 NA 84 72 82 68
       Both 36 26 NA   9 27 16 26
       Other   1   4 NA   1 — —   4
    NA = Not asked
    Sources: Turkey: Cilingiroglu (56); India: Murty (222); Egypt: Demographic and Health Surveys; Upper Egypt: Sayed et al. (291)

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    Table 6. Discussion with Husbands
    Use of Family Planning in Seven Sub-Saharan African Countries Among Women Who Approve of Family Planning
      % Using Family Planning Among Those Who:
    Country & Year of Survey Discussed with Husband* Did Not Discuss with Husband*
    Botswana 1988 40 18
    Burundi 1987 14   2
    Ghana 1988 24   7
    Kenya 1989 36 11
    Senegal 1986 23   9
    Sudan 1989-90 19   3
    Togo 1988 39 31
    *In the year preceding the survey
    Source: Demographic and Health Surveys

    Return to Chapter 4.3


    Table 7. Men's Role in Family Planning
    Husband's Knowledge, Approval, Discussion, and Use of Family Planning in Seven Countries
    Country & Year of Survey Number of Husbands % Who Know at Least One Method % Who Approve FP1 % Who Have Discussed FP with Their Wives in the Last Year1 % Who Have Ever Used Contraception % Currently Using Contraception
    Modern Any Modern Any
    Burundi 1987 542 92 94 48 2 52 NA NA
    Cameroon 1991 814 74 37 30 17 48 6 20
    Egypt 1988-89
       Cairo
       Upper Egypt
    469
    1,053
    100
    96
    92
    84
    61
    47
    78
    52
    81
    56
    65
    40
    70
    44
    Ghana 1988 943 79 77 46 26 41 9 20
    Kenya 1989 1,170 95 91 65 35 65 25 49
    Mali 19872 970 65 16 28 2 16 1 4
    Pakistan 1990-91 1,354 79 56 NA 18 25 10 15
    FP = Family Planning
    NA = Not applicable
    1Among those who know at least one contraceptive method
    2Includes all men, regardless of marital status
    Source: Demographic and Health Surveys: Egypt: Sayed et al. (291)

    Return to Chapter 5.1 | Return to Chapter 5.2 | Return to Chapter 7.2 |


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