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This chapter examines the published work and careers of American conservationist William Vogt and Brazilian physician-geographer Josué de Castro during the early Cold War. It emphasizes the different affective strategies that the two men employed to persuade readers of their competing positions regarding the relationship between human population, arable land, food supply, and global security. As a briefly prominent intellectual from the global South, De Castro challenged the emerging, US-led consensus that population control was essential for economic development. Based on his own experiences among marginalized Brazilians, De Castro viewed Vogt’s concern with “carrying capacity” limits as an imperialist imposition on the autonomy of less empowered people. He feared that prioritizing population reduction as the solution to resource scarcity would undermine movements for social and economic transformation, such as agrarian reform in rural Latin America. With little personal experience of the world’s poor, Vogt projected a pessimistic vision of the future on continents overrun by desperate, starving hordes. De Castro’s contrasting vision, on the other hand, stemmed from frequent encounters with the chronically hungry and a more sympathetic understanding of their plight.
Limited evidence exists about the contraception uptake in indigenous tribal groups of the north-eastern region of India. This study based on the National Family Health Survey (NFHS) IV (2015–2016) reports aimed to describe the pattern and factors associated with contraceptive non-use in the tribal women of the north-eastern part of India. The study was a cross-sectional analytical study based on secondary analysis of NFHS-IV data. All women in the age group of 15–49 years from the north-eastern part of India were included. Data were extracted and analysed using modified STATA-14 software. The association of socio-demographic and economic characteristics with contraceptive non-use was assessed using logistic regression. The inter-group differences of population characteristics for non-use contraceptives were assessed by modified Blinder–Oaxaca decomposition technique using ‘Fairlie decomposition’. A total of 65,941 women were included, of whom 34,936 (52.9%) were tribal women. The proportion of contraceptive non-use was higher in tribal women. Tribal women with age at marriage above 30 years, Christian community, and women from Assam and Manipur state had higher odds of contraceptive non-use. The decomposition analysis showed that geographical variations, parity, and Christian religion contributed the most to contraceptive use disparity in the population. A huge gap was observed in contraceptive non-use among tribal and non-tribal women in the north-eastern part of India. The healthcare system must involve community representatives in designing context-specific community-based initiatives to increase the uptake of contraceptive use in these remote vulnerable communities.
Family Planning (1968), a short, animated film featuring Donald Duck, was translated into at least twenty-four languages and viewed in the span of two years by nearly 1.4 million people around the world. Commissioned by the Rockefeller’s Population Council and expensively produced by Disney, the movie represents the international family planning industry’s single largest investment in a media object. It has since been perceived as largely effective in achieving its goal of promoting contraception to culturally diverse audiences. Using an unusually rich collection of archival records and other previously neglected sources, we demonstrate how Family Planning failed to connect with local viewerships. Our historical analysis recovers the Population Council’s homogenizing and infantilizing view of the global poor and critiques of this view that emanated from the Global South – not just with the benefit of hindsight but at the time. We conclude that the Rockefeller–Disney collaboration was ill-suited for communicating to a heterogeneous, global audience, and that a misplaced optimism in animation as a universal language all but guaranteed failure.
This chapter attempts to explore global trajectories of birth control, family planning, and reproductive health and rights discourses in the modern world by comparing experiences of countries in the Global South with the Global North. Women all over the world have long had some control over their reproductive bodies. “Planning” became a very crucial concept within the global development discourse put forward during the post Second World War. One of the main resources that needed to be planned was population, thus “family planning” emerged as a novel form of population control. This ideology was supported by philanthropic institutions such as the Rockefeller Foundation and the International Planned Parenthood Federation, and by international conferences on population and development. Sri Lanka was a colony of the Western powers for four centuries (1505-1948), then a development “model” for South Asia in the 1970s, then the site of a civil war (1983-2009). Sri Lanka offers a more inclusive conceptual framework to understand how policy decisions taken in the Global North fails to have the same impact in the Global South. This chapter shows how policies must adapt to the local realities of the Global South irrespective of ratifying global population and development conventions.
Most studies of sex education center on local Anglo-Euro-American contexts, tracing the origin of sex education to a coordinated response to the spread of venereal diseases. These neglect the circumstances in which sex education developed in the developing world between the 1950s and 1980s: a growing collective anxiety about rising birth rates that culminated in the adoption of population control measures. This paper examines the “glocal” history of population-centered sex education in the developing world in the 1960s and 1970s, through the case study of Singapore. Examining the emergence of the first sex education curriculum in post-independence Singapore between 1966 and 1973, I argue that population-centered sex education that emerged in Singapore was intimately connected with global population politics. Analysis of how the policy was formulated shows that the Singapore state reacted to both domestic and global concerns. In connecting local developments to global contexts, this paper gestures toward the possibilities of studying the global history of population-centered sex education.
The aim of this study was to develop a scale based on the Health Belief Model (HBM) to assess the family planning (FP) attitudes of postpartum women with 0- to 12-month-old infants residing in eight neighbourhoods of the Bornova province, Izmir, Turkey.
Introduction:
Family planning is an integral component of maternal and infant health during the postpartum period and is a fundamental aspect of healthcare services in the prenatal and postnatal period.
Methods:
The Postpartum Family Planning Attitude Scale (PFPAS) was developed in four stages: item pool development, content validity evaluation, pilot study, and reliability and validity assessment. The PFPAS was administered to 292 women. The developed scale comprised 27 items and six sub-dimensions. Cronbach’s alpha coefficient was used to evaluate the reliability of the scale. Construct validity was evaluated using confirmatory factor analysis.
Findings:
Cronbach’s alpha coefficient was 0.88, indicating good reliability. Confirmatory factor analysis validated the structural validity of the scale, with a chi-square/degree of freedom ratio of 2.24, an RMSEA value of 0.068, and a CFI value of 0.95. The lowest and highest possible scores for the PFPAS were 27 and 135, respectively, with a mean total score of 105.32 ± 11.91.
Unmet need for family planning is a valuable concept to indicate the discrepancy between women’s fertility preferences and contraceptive use. Unmet need may lead to unintended pregnancies and unsafe abortions. These may result in health deterioration and reduced employment opportunities for women. The 2018 Turkey Demographic and Health Survey report indicated that the estimated unmet need for family planning doubled from 2013 to 2018, returning to the high levels of the late 1990s. Considering this unfavourable change, this study aims to investigate the determinants of unmet need for family planning among married women of reproductive age in Turkey by using the 2018 Turkey Demographic and Health Survey data. Logit model estimations revealed that women who were at older ages, more educated, wealthier, and had more than one child were less likely to have unmet need for family planning. Employment statuses of women and their spouses and place of residence were significantly associated with unmet need. Results emphasised that training and counselling to enhance the use of family planning methods should effectively target young, less educated, and poor women.
From the late 1960s to late 1970s, a number of family planning clinics were established across the country. This chapter explores the experiences of activists involved in these clinics, the personal risks they took and their motivations for involvement. The importance of national and international networks is explored. The demand for the clinics across the country shows that many Irish men and women were beginning to exercise their own agency in relation to their reproductive choices. The stories of these family planning clinics, also show the importance of medical authority and how the medical model was seen to legitimise the work they were doing, but also enabled the clinics to provide a wider range of family planning options. While the groups ultimately did not succeed in broadening contraceptive access to a wide range of socioeconomic classes, they played a significant role in the liberalisation of family planning law in 1970s Ireland and opening up debates on the issue.
This chapter highlights how, in the absence of legal access to artificial methods, natural methods of family planning, in particular calendar-based methods remained popular, particularly for couples who were born in the 1930s and 1940s. In addition, for many couples, having children was an accepted part of marriage; contraceptive methods only tended to be used after participants had already had children in order to ‘space’ subsequent pregnancies, or in order to ‘stop’ pregnancies following the completion of the family. In contrast to Ireland, visions of England as a ‘permissive’ society persisted well into the twentieth century. The chapter also seeks to explore the dynamics of decision-making around family planning in the period, illustrating how women began to exhibit more agency around these choices, and that contraception was generally seen as a female responsibility. It will also illuminate the impact that lack of access to artificial contraception had on individuals.
Lasting from 1979 to 2015, China's One Child Policy is often remembered as one of the most ambitious social engineering projects to date and considered emblematic of global efforts to regulate population growth during the twentieth century. Drawing on a rich combination of archival research and oral history, Sarah Mellors Rodriguez analyses how ordinary people, particularly women, navigated China's shifting fertility policies before and during the One Child Policy era. She examines the implementation and reception of these policies and reveals that they were often contradictory and unevenly enforced, as men and women challenged, reworked, and co-opted state policies to suit their own needs. By situating the One Child Policy within the longer history of birth control and abortion in China, Reproductive Realities in Modern China exposes important historical continuities, such as the enduring reliance on abortion as contraception and the precariousness of state control over reproduction.
Chapter 6 traces the One Child Policy’s lifespan from its introduction in 1979 until its replacement with the Two Child Policy in 2015. I show that the extent to which the One Child Policy was actually enforced and the ways in which it was received differed significantly in Shanghai, Tianjin, and Luoyang. For some couples, particularly those in more economically developed cities like Shanghai and Tianjin, the policy simply affirmed personal convictions that smaller families are more economical and allow children to have better educational opportunities. In smaller cities like Luoyang, however, policy violations were more common as family size – as well as the existence of a male heir – remained more important than the opportunities allocated to those children. This chapter also interrogates the renewed interest in eugenics among parents wishing to “optimize” the qualities of their one and only child, as well as the limited scale and scope of sex education, a trend that exacerbated the reliance on abortion as premarital birth control.
Using detailed data from the third round of the District Level Household Survey of India, this paper examines in detail the effect of child marriage of women on contraceptive usage and access to skilled care during pregnancy and delivery. This paper particularly focuses on sixteen different outcome variables categorized under four broad sub-groups; namely, family planning and contraceptive usage, birth history, utilization of antenatal care; and finally, natal and postnatal care. The overall results presented in the paper suggest that women who marry early, i.e. before they reach the legal age of marriage are more likely to have experienced miscarriage, give birth before they turn 18 and lose children. They also lack current contraception usage and are less likely to access public health facilities during both pregnancy and childbirth. These results, however, vary widely based on the state of residence and age of the women in question.
In Does v. Gillespie, Medicaid beneficiaries sued the director of the Arkansas Department of Human Services claiming that terminating Planned Parenthood’s Medicaid provider agreements violated their federal right under the Medicaid Act to choose any “qualified” provider that offers covered services. The Eighth Circuit held that the free choice of provider provision in the federal Medicaid Act did not create rights enforceable by individual beneficiaries. In their feminist judgment, Melissa Alexander and Jennifer Oliva argue that the clear language of the Medicaid Act unambiguously demonstrates that Congress intended to confer a private right of enforcement under the free choice of provider provision. Elizabeth Kukura’s commentary emphasizes the importance of focusing on the lived experience of Medicaid beneficiaries who rely on Planned Parenthood for basic health care needs. Kukura highlights the influence of anti-abortion politics and ideology on health care access and the structural forms of discrimination that shape it.
The Gaza Strip lives in a protracted emergency crisis and experienced several Israeli escalations. These escalations have overwhelmed the hospitals and highlighted the need to optimize Primary Health Care Centers (PHCCs) to form part of the emergency response system. This study, therefore, aimed to assess the emergency preparedness of the Ministry of Health (MoH)-run level-four PHCCs in the Gaza Strip (where Emergency Medical Services are provided along with preventive and curative services).
Methods:
The study was cross-sectional, used quantitative methods, and utilized two tools. The first tool was a self-administered structured questionnaire exploring Primary Care Providers’ ([PCPs]; doctors and nurses) experiences, perceived capabilities, and training needs. The second tool was an observational checklist used to assess the preparedness of the emergency rooms (ERs) at level-four PHCCs in the Gaza Strip.
Results:
Two hundred and thirty-eight PCPs (34.5% doctors and 65.5% nurses) working in 16 level-four PHCCs were included. Overall, 64.4% of the participants had experience working in PHCCs during Israeli escalations, though 35.3% of them were unaware of the contingency plan (CP) of PHCCs. More nurses were aware of CPs than doctors (66.9% versus 42.7%; P <.001). Moreover, 65.7%, 46.7%, and 42.5% of the participants were trained in Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), and Primary Trauma Care (PTC), respectively. However, many had received the training for more than two years, and none of the PHCCs had all its staff trained. Only 36.8% of the participants were trained in Post-Trauma/Post-Operative Care (wound care and dressing), and the percentage of trained nurses was significantly higher than those of doctors (36.8% versus 13.9%; P <.001). The majority of the participants admitted they need ACLS training (89.2%), PTC training (89%), BLS training (81.1%), and Post-Trauma/Post-Operative Care training (76.8%). Only 29.63% of emergency drugs and 37.5% of the equipment and disposables were available in the ERs of all PHCCs, and none of the PHCCs had all the essential emergency drugs, equipment, and disposables available.
Conclusion:
Level-four PHCCs in the Gaza Strip are not adequately prepared to respond to emergencies. Generally, PCPs lack appropriate competencies for emergency response, and many PHCCs lack the infrastructure to support Primary Emergency Care (PEC). Thus, PCPs need continuous education and training in disaster preparedness and response and PEC.
Fertility decline in human history is a complex enigma. Different triggers have been proposed, among others the increased demand for human capital resulting in parents making a quantity–quality (QQ) trade-off. This is the first study that examines the existence of a QQ trade-off and the possible gender bias by analyzing fertility intentions rather than fertility outcomes. We rely on the unified growth theory to understand the QQ trade-off conceptually and a discrete choice experiment conducted among 426 respondents in Ethiopia to analyze fertility intentions empirically. We confirm the existence of a QQ trade-off only when the number of children is less than six and find that intentions are gendered in two ways: (i) boys are preferred over girls, and (ii) men are willing to trade-off more education in return for more children. Results imply that a focus on both stimulating intentions for education, especially girls' education, and on family size intentions is important to accelerate the demographic transition.
This chapter examines the birth control survey research conducted by population technocrats c.1947–60, and analyzes how this research resonated with government efforts to manage the emerging problem of “overpopulation” via fertility regulation. Focusing on the leading population technocrat Shinozaki Nobuo, this chapter depicts how human agency participated in the at times precarious relationship between policy and practice. It also shows how the epistemological framework inscribed in the scientific knowledge produced by the survey research, harmonized with the economic and political rationale that buttressed the post-WWII state’s reconstruction efforts. To illustrate this point, the chapter examines: (1) the evident absence of the category of race and (2) the categorization of data by region and the research participants’ socioeconomic status. For (1), it contends that, by maintaining silence on the question of race, the research consolidated an image of Japan’s population as ethnically homogeneous, which was becoming increasingly dominant political discourse during this period. The phenomenon (2), I argue, embodied the burgeoning developmentalist logic that explicitly portrayed reproductive practices in terms of a nation’s socioeconomic achievement. Together, these phenomena served to produce a certain knowledge of the Japanese population that was particularly compatible with post-WWII Japan’s reconstruction efforts.
Twenty-first-century Japan is known for the world's most aged population. Faced with this challenge, Japan has been a pioneer in using science to find ways of managing a declining birth rate. Science for Governing Japan's Population considers the question of why these population phenomena have been seen as problematic. What roles have population experts played in turning this demographic trend into a government concern? Aya Homei examines the medico-scientific fields around the notion of population that developed in Japan from the 1860s to the 1960s, analyzing the role of the population experts in the government's effort to manage its population. She argues that the formation of population sciences in modern Japan had a symbiotic relationship with the development of the neologism, 'population' (jinkō), and with the transformation of Japan into a modern sovereign power. Through this history, Homei unpacks assumptions about links between population, sovereignty, and science. This title is also available as Open Access.
The level of awareness of one’s own sexuality and of its expression have always depended not only on a person’s stage of life but, first and foremost, on the specific cultural and religious milieus in which the person lives and operates. Since time immemorial, a special place in female sexuality has been reserved for the period of gestation, whether planned or unwanted. Becoming pregnant represents a unique time in a woman’s life, involving changes that are not only physical but also psychological. It is a period of change in a woman’s behavior and even sexual life, although we have entered an era of major evolution of the way we see sexuality and reproduction. Today, advances in reproductive medicine are progressively transforming basic human behavior in which the main emphasis has been on “sex for reproduction” into a situation where “sex without reproduction” is widely accepted. Finally, over the last few decades, “reproduction without sex” is increasingly taking hold. Indeed, an rising number of couples worldwide have been creating families where the offspring are the fruit of one of the many assisted reproduction technologies (ART). Therefore, reproduction without sex, looked at with suspicion and even open hostility only 30 years ago, has now entered a stage where it is considered a perfectly “natural” way of creating a family and – at least in the Western world – is increasing utilized by couples made by two individuals of the same genetic sex. Obviously, this new situation, not approved in a number of countries and perfectly legal in others, has created problems and is opposed by vocal groups with various arguments. The evolving relationship between sexuality and reproduction, the emergence of the new paradigm of reproduction without sex, with its influence on the two adult partners as well as on the offspring, will be briefly discussed from the point of view of its links to traditional sexuality, as well as taking into account the new options that are surfacing today.
Egg freezing was initially introduced as a fertility preservation measure in women without a male partner who were about to undergo gonadotoxic treatments. The use of oocyte cryopreservation for social reasons has been an increasingly popular strategy for women to preserve their fertility potential, a term most referred to as ‘social egg freezing’ (SEF). As well as for career progression or waiting until they are financially more secure, some women may be single, or may decide to egg freeze to relieve pressure on a relationship, until they decide they are ready to have children with their partner. Upon introduction, success rates with SEF were low due to poor oocyte survival rates. With the advent of oocyte vitrification techniques, assisted reproductive technology (ART) procedures using frozen oocytes have shown a similar live birth rate (LBR) to those using fresh oocytes. Due to this growing evidence for the efficacy of egg freezing, both the European Society for Human Reproduction and Embryology (ESHRE) and the American Society for Reproductive Medicine (ASRM) changed their stances and no longer consider oocyte freezing to be an experimental technique.