A prospective study of two combined oral contraceptives was conducted in the Sudan. No pregnancies occurred. Overall incidence of side effects was low. Headache was most frequently reported. Elevations were observed for weight, systolic and diastolic blood pressures, and SGOT and SGPT values while a decrease was seen for hemoglobin levels. Menstrual irregularities were not a problem for the users. Total 6-month use discontinuation rates were low for both pill groups.

This dissertation contains three chapters in the field of development economics and applied microeconomics. The first chapter studies the effect of higher education on an individual’s life outcomes and how the effect evolves over her life cycle. The second chapter examines how a woman-centered, preference-based counseling procedure shapes women’s contraceptive preferences and behavior. The third chapter investigates the impact of construction activities of transportation infrastructure on local economic outcomes. Chapter 1 examines the effect of higher education on an individual’s life outcomes, and how the effect evolves over her life cycle. I use as a natural experiment the most ambitious educational reform in Chinese history, the reinstatement of the National College Entrance Examination (the Gaokao) following the end of the Cultural Revolution. Using Census data in 1990 and 2000, I find discontinuous changes in the likelihood of completing high school and attending college around a cutoff birth date, which are shown to be induced by the policy shock. Through a combination of regression discontinuity and difference-in-difference methods, this chapter finds that cohorts that were more likely to complete high school and obtain a college education as a result of the reform were more likely to have a high-socioeconomic (SES) occupation in their early 30s, and the effect becomes smaller in their 40s. More educated cohorts, and in particular women, tend to marry later. Individuals with higher education were less likely to be ever married in their 40s. Finally, individuals with higher education tend to delay childbearing and migrate more in both their 30s and 40s, plausibly due to greater returns to migration for the more educated. Chapter 2 (with Mahesh Karra) examines how a woman-centered, preference-based approach to family planning counseling shapes women's contraceptive preferences and behavior. By implementing a randomized controlled trial in urban Malawi, we explore how a woman's decision-making may be shaped by: 1) the number and types of contraceptive methods presented to her based on her stated preferences for contraception (targeted counseling); and 2) the presence of her husband / male partner at the time of counseling. Women were subsequently offered free transport and access to family planning methods and services at a clinic for one month. We find that women who received targeted counseling were 15.6 percent less likely to be using their stated ideal contraceptive method at follow-up and were 17.5 percent more likely to exhibit discordance between their stated and ideal method at follow-up. On the other hand, women who were encouraged to invite their husbands to the counseling session were 13.5 percent less likely to change their stated ideal method from counseling to follow-up but 16.6 percent more likely to be using their stated ideal method at follow-up. While both approaches aim to achieve the goal of ``helping women make informed choices on family planning'', neither seems to yield strictly preferred outcomes for women. Chapter 3 investigates how the construction of the three earliest high-speed railway (HSR) lines in mid-Southern China affects economic activity. By formulating a set of counterfactual railway lines following the HSR planbook (MLTRP) issued by the central government, and by utilizing nighttime light data (NTL) from 1992 to 2013, I implement an event-study analysis to quantify how HSR construction transforms the local economic activity as proxied by the NTL. Furthermore, I employ county-level data on economic indicators to pin down the channels at work underlying the effects. I find that: 1) the grid-level NTL significantly increased compared to the counterfactual regions one year after the HSR construction, but there is no significant impact following the operation of the HSR lines; 2) the positive construction impacts can be explained by the provisions of associated local amenities, temporary clearing of households, as well as structural transformation from agricultural towards non-agricultural sectors.

[pt] A interseção entre população, conflito, mudanças climáticas e migração é o ponto central dos debates contemporâneos sobre controle populacional e reacende iniciativas cujo alvo são os corpos de mulheres e meninas, majoritariamente não- brancas e do Sul Global. À medida que uma população crescente passa a ser enquadrada como um problema global, a fertilidade dessas mulheres se torna uma ameaça e os seus corpos um espaço para intervenções de organizações internacionais, agências de desenvolvimento e governos. O propósito do trabalho é investigar uma dessas intervenções, a maior em termos de recursos financeiros e de metas estabelecidas – Family Planning 2020. Mais especificamente, será focado no papel desempenhado por dados quantitativos para fundamentar intervenções na saúde reprodutiva de milhões de mulheres. A hipótese da dissertação é que esses dados desempenham um papel fundamental no posicionamento de políticas de planejamento familiar como objetivas e baseada em evidências, e não como fundadas em fatores raciais. Ademais, que a adesão a uma ética do cuidado pode orientar tais políticas de maneira que se evite instrumentalizar a fertilidade e a saúde de mulheres para enfrentar a questões atribuídos à superpopulação. / [en] The intersection between population, conflict, climate change and migration is the cornerstone of contemporary population control debates and rekindles initiatives that target the bodies of women and girls, largely of colour and from the Global South. As a growing population becomes framed as a global problem, the fertility of those women turns into a threat and their bodies into a space for interventions by international organizations, development agencies, and governments. The purpose of this work is to investigate one of said interventions, the largest one when it comes to targets and financial investment - the Family Planning 2020.More specifically, the project will look to FP 2020 to analyse the role played by quantified data in substantiating interventions in the reproductive health of millions of women. The working hypothesis of this dissertation is that data is a crucial element to the rebranding of family planning policies as not racially oriented, but rather as objective and evidence-based and that, by adhering to an ethics of care, one might avoid the pitfalls of instrumentalizing women s fertility and overall health in order to address other pressing issues.

Gender equality and ensuring the equal rights of women and girls is the fifth United Nations Sustainable Development Goal set for 2030. Access to quality reproductive healthcare and information is a critical aspect of gender equality, including access to information about family planning and contraceptives. However, there are many barriers that impact a woman’s access to contraception in rural sub-Saharan Africa, such as financial constraints, supply shortages, stigma, and misconceptions. Through and African Feminist lens, this study examines how these perceived barriers intersect with each other, and how they negatively impact women’s access to family planning and their perceived value of contraceptives in Luweero, Uganda. This qualitative study analyzed data collected from healthcare workers at one private clinic and one public clinic that offer family planning services in four focus group discussions in Luweero, Central Region, Uganda. Two focus group discussions were held in each clinic. Coded transcripts were analyzed using a reflexive methodology through an African Feminist lens. Most of the responses indicated that financial constraints experienced either by the clinic or the women significantly impact access family planning. Healthcare workers and Village Health Teams (VHTs) reported that funding constraints impact their ability to reach the clients with the resources they need in the rural areas, and clients in rural areas are often not able to afford the cost of family planning methods, especially when considered with the hidden costs of contraception. Social barriers were also discussed, and the participants explained that barriers such as stigma, misconceptions, lack of knowledge, religiosity and cultural values impact women’s motivation or ability to access contraceptive methods. Side effects also have a significant role to play in women’s ability or motivation to navigate through these perceived social barriers. Participants determined that increased funding for transportation for VHTs, consistent funding for free contraception, and expanded sensitization efforts that particularly target men would be some of the most impactful methods they can adapt to address some of these barriers. This study demonstrates that increasing women’ access to contraception in rural Uganda requires increased state funding for sensitization efforts and subsidized contraceptive methods. Social barriers can be more deeply understood and addressed by the international development community through an African Feminist lens, which explores modern contraceptives in the Ugandan context in a more culturally, socially and historically conscientious way.

This thesis draws on a political economy of fertility framework and the concept of biocitizenship to analyze changing family size and family planning among women and men in northern Ghana. I draw on a variety of ethnographic sources from eight months of fieldwork conducted under the umbrella of the Navrongo Health Research Centre in 2013 and 2014 in two rural communities in Kassena-Nanakana (K-N) West District in the Upper East region. The primary questions behind this thesis are: 1. How has the desire for smaller families emerged and to what is this transformation linked? 2. What role have family planning programs played in the reduction in family size? Have they been the most important driver of the transition to smaller families? 3. What are the current ideas about family planning and contraceptives in K-N West? Are they gendered? How have they changed over time? 4. Are local views about family planning and contraceptives in K-N West in keeping with those of public health practitioners? These questions are addressed in this sandwich thesis in three papers, which have been submitted or accepted for publication. A major contribution of this thesis is its call for health programmes to pay greater attention to the social context of both women’s and men’s lives where family planning takes place. Contrary to existing public health studies, I argue that while health programming has affected fertility decline, larger social and economic shifts have been some of the most important drivers of women’s and men’s changing practices of family formation and views of contraceptives. In Kassena-Nakana West, the desire for smaller families is linked to processes such as decreasing levels of child mortality and agricultural productivity, as well as parents’ increasing focus on educating their children. In addition, the emerging concepts of responsible manhood and companionate marriage, combined with the decline of polygamy, have helped improve communication between husbands and wives about family planning. Narratives of changing family formation from Kassena-Nankana West expand understandings of biocitizenship by illustrating the important role intergenerational relationships play in the construction of “political economies of hope”. When young people adopt family planning, they not only consider the well-being of their own children and the larger community, but make the decision in the context of their aspirations for a more successful life than their parents experienced. Due to larger political-economic shifts, the majority of Kassena women and men today think family planning is beneficial; however, worries about the side effects of contraceptives remain. Women’s ongoing concerns about infertility and the stability of their marriages and men’s conditional acceptance of family planning also reveal that gender inequality persists. I argue that typical policy recommendations, which focus primarily on educating and sensitizing communities to increase the use of contraceptives are problematic in that they often focus on decreasing fertility and are not articulated within a broader, multi-sectoral agenda. Greater attention to local biologies and expanding reproductive rights and freedoms would improve existing family planning programs. / Dissertation / Doctor of Philosophy (PhD)

Thesis advisor: Corrine Y. Jurgens / Background: Infertility is a source of significant distress to women, their partners, and their families. If women are unable to identify the time in their cycle when conception is most likely (the fertile window) then they may be referred to fertility services unnecessarily, which incur costly, invasive, and risky interventions. Little is known about women’s experiences trying to conceive using fertility-awareness based methods. Objective: The purpose of this dissertation research is to examine fertility-awareness based method (FABMs) use among women seeking pregnancy, specifically as it relates to fertility knowledge, method frequency, predictors of use, and duration of pregnancy attempt. Methods: This manuscript-style dissertation will utilize multiple data sources and methods to address four major goals. First, an integrative review of peer-reviewed publications will synthesize the literature regarding fertility knowledge and fertility- awareness practices (Aim 1). Second, a secondary analysis of data from the CDC’s National Survey of Family Growth (2015-2017) will be used to identify factors that influence women’s decision to use FABMs (Aim 2). Third, an analysis of data from the Nurses’ Health Study 3 will be used to evaluate whether duration of current pregnancy attempt is associated with FABM(s) use (Aim 3). Lastly, a case study will be presented using the qualitative methodology of narrative interview to describe women’s experiences using FABMs to achieve pregnancy (Aim 4). Conclusions: Collectively, this work advances the science by providing researchers and clinicians with the knowledge to support women in their journey to natural, spontaneous conception. / Thesis (PhD) — Boston College, 2021. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.

Background: A significant amount of research has previously been conducted in developing countries such as India, to improve women’s sexual and reproductive health. However, women living in North Indian slums still have poor access to proper sexual and reproductive healthcare. The aim of this thesis is to investigate the published literature to create a consolidated understanding of the key barriers faced by women in slum populations when accessing sexual and reproductive health services in Northern India. Methods: A scoping review was carried out following the five stages outlined in Arksey and O’Malley’s framework. Five online databases (MEDLINE, Global Health, Ovid Emcare, Embase, and Web of Science) were searched. An interpretive thematic analysis was conducted to extract meaningful themes from the data using the Conceptual Framework for Reproductive Empowerment developed by the International Center for Research on Women Results: In total, 28 articles were identified to be incorporated into the scoping review. The results of this study were grouped according to the CFFRE to understand how they compared in regard to women’s reproductive empowerment. This scoping review found reproductive empowerment was significantly hindered by women lacking a proper education and understanding of SRH services, lack of employment and financial resources. Additionally, women’s husbands and mothers-in-laws were barriers to contraceptive use. Finally, poor interactions with healthcare providers and the healthcare system, and systemic factors such as behaviours in treatment seeking, son preference and religion were barriers to accessing SRH services. Conclusion: This scoping review investigated the barriers faced by women living in slum populations in Northern India to accessing SRH services. The results of this study contribute to the literature by identifying areas that require improvement to SRH services for women living in slums, and will be integral to implementing strategies and interventions to allow better access to SRH services in the future. / Thesis / Master of Science (MSc) / A significant amount of research has previously been conducted in India, to improve women’s sexual and reproductive health. However, women living in North Indian slums still have poor access to proper sexual and reproductive healthcare. Therefore, this study investigated the key barriers faced by women in slum populations when accessing sexual and reproductive health services in Northern India. A review of previous studies was conducted by searching five electronic databases and a total 28 articles were included into the review. This study found that women lacking a proper education and understanding of SRH services, lack of employment and financial resources, and women’s husbands and mothers-in-laws were barriers to SRH services. Finally, poor interactions with healthcare providers and the healthcare system, and systemic factors such as behaviours in treatment seeking, son preference, and religion were also barriers to accessing SRH services.

No description available.

No description available.

過去關於臺灣家庭計劃發展的觀點主要有兩種，一種是視家庭計畫為一成功的「臺灣經驗」，一種則從女性史的角度，強調家庭計畫是政府對於女性身體的控制與壓迫。本文則試著從第三種觀點出發，回到歷史原本的脈絡中，引領讀者從臺灣家庭計畫最初的前十年開始看起，首先使讀者了解到臺灣實施家庭計畫的緣由及其背景，而後在這樣的背景之下，第一個推動家庭計畫的機構：中國家庭計畫協會成立了，在本文中將呈現家庭計畫協會的創辦人──舒子寬女士及其他工作者，他們是在怎樣的動機之下加入家庭計畫的推展並成為開拓者，他們在此特殊的時空背景之下，如何獲得各方的資助而得以順利推動，而他們推動的方法又為何？藉由這些面向的探討，以呈現臺灣家庭計畫發展中的女性經驗。 本文相對於過去研究的突破如下：在資料的運用上，本文的寫作運用了過去研究者所未曾使用的農復會檔案，並和家庭計畫的工作者舒子寬女士進行口述訪談，以補充過去研究所未探討到的問題；在新的發現上，本文試圖呈現家庭計畫中的女性經驗，並試圖提出一新的主張：臺灣家庭計畫最初的推動者，基於自身的女性經驗，以試圖改善母性健康為出發點而推動家庭計畫。