Submitted by Gilvan Almeida (gilvan.almeida@icict.fiocruz.br) on 2016-09-26T14:06:08Z No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) 197.pdf: 2558637 bytes, checksum: 2898ec090dce064508ba7eef51ba68db (MD5) / Approved for entry into archive by Barata Manoel (msbarata@coc.fiocruz.br) on 2016-10-13T17:04:58Z (GMT) No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) 197.pdf: 2558637 bytes, checksum: 2898ec090dce064508ba7eef51ba68db (MD5) / Made available in DSpace on 2016-10-13T17:04:58Z (GMT). No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) 197.pdf: 2558637 bytes, checksum: 2898ec090dce064508ba7eef51ba68db (MD5) Previous issue date: 2014 / Fundação Oswaldo Cruz. Casa de Oswaldo Cruz. Rio de Janeiro, RJ, Brasil. / Esta tese tem como foco o Centro de Pesquisas e Atenção Integral à Mulher e à Criança. O recorte temporal se inicia em 1975, ano de início efetivo do CPAIMC, e finaliza em 1994, ano do seu fechamento. Envolto em polêmicas, acusado de realizar esterilizações em massa em populações pobres da cidade, alvo de uma Comissão Parlamentar Mista de Inquérito pelo poder legislativo federal e com dificuldades financeiras, fechou suas portas em 1994. Criado por Hélio Aguinaga junto ao Hospital Escola São Francisco de Assis da Universidade Federal do Rio de Janeiro, defendo a hipótese de que o CPAIMC se caracterizou como um espaço ambivalente em que postulados de atenção primária em saúde, integralidade e atendimento às populações marginalizadas conviviam com um projeto de controle populacional sob influência de entidades internacionais envolvidas com projetos de controle demográfico, principais financiadoras de suas atividades. Inicialmente, abordo a constituição da percepção de que o mundo passava por excesso populacional e a organização de entidades internacionais engajadas em frear o crescimento populacional dos países do chamado terceiro mundo. Em seguida, analiso a recepção dessa tese dentro do Brasil a partir de alguns setores sociais, como economistas, a Igreja e, em especial, médicos ginecologistas obstetras. O segundo capítulo trata da estrutura de funcionamento e do financiamento do CPAIMC, assim como o seu ocaso. O terceiro capítulo trata dos fundamentos ideológicos que justificavam a existência do CPAIMC, tendo como foco a figura de Hélio Aguinaga, seu diretor-geral. Por fim, abordo os movimentos de oposição ao projeto do CPAIMC, a já referida CPMI no início da década de 1990 e que culminaram na criação da Lei de Planejamento Familiar em 1996. / This thesis focuses on the Centre for Research and Integral Care for Women and Children (Centro de Pesquisas e Atenção Integral à Mulher e à Criança - CPAIMC).The time frame of this research begins in 1975, year of effective beginning of CPAIMC’s activities, and ends in 1994. Involved in controversies, accused of mass sterilization of poor women of Rio de Janeiro, target of a Mixed Parliamentary Commission of Enquiry (CPMI) by the Federal Legislative Power and facing financial troubles, closed its doors in 1994. Created by Hélio Aguinaga next to Federal University of Rio de Janeiro’s St. Francis Hospital (Hospital Escola São Francisco de Assis da Universidade Federal do Rio de Janeiro), I support the hypothesis that CPAIMC was a ambivalent institution in which postulates like primary health care, integral health and attention to marginalized communities coexisted with a population control orientation, under influence of international agencies, involved in demographic control projects and major funder of CPAIMC. Initially I focus on how the world started to perceive by overpopulation, especially by the end of World War II and how international agencies engaged themselves in limit the population growth of Third World countries. Then, I analyze the reception of this engagement in Brazil by a series of important social actors, such as economists, Catholic Church and, specially, obstetrics and gynecology doctors. The second chapter addresses the CPAIMC’s operational a financial structure, as well as its collapse. The third chapter deals with the ideological basis that justified the existence of CPAIMC, focusing on the figure of Hélio Aguinaga, its general-director. I finalize the thesis by focusing the opposition movements against CPAIMCs activities and the CPMI in the beginning of the 1990’s that culminated on the creation of the Family Planning Law in 1996.

Despite the increased focus on men in reproductive research, little is known about male involvement in the initial decision/s regarding parenthood (i.e., to become a parent or not) and the subsequent decision-making that may ensue (e.g., choices about timing or spacing of births). In particular, the parenthood decision-making of “White”, heterosexual men from the middle class has been understudied, as indicated in the existing literature. In South Africa, this oversight has been exacerbated by the tendency for researchers to concentrate on “problematic” men, to the exclusion of the “boring, normal case”. I argue that this silence in the literature is a result of the taken for granted nature of parenthood in the “normal” heterosexual life course. In this study, I have turned the spotlight onto the norm of “Whiteness” and heterosexuality by studying those who have previously been overlooked by researchers. I focus on “White” Afrikaans men’s involvement in parenthood decision-making. My aim was to explore how constructions of gender inform male involvement in decision-making, especially within the South African context where social transformation has challenged traditional conceptions of male selfhood giving rise to new and contested masculine identities and new discourses of manhood and fatherhood. In an effort to ensure that women’s voices are not marginalised in the research, as is often the case in studies of men and masculinity, I conducted in-depth, semi-structured interviews about male involvement in decision-making with both “White” Afrikaans women and men. There were 23 participants in total, who all identified as heterosexual and middle-class. The participants were divided into two age cohorts (21 – 30 years and >40 years), which were then differentiated according to gender, reproductive status, and relationship status. Treating the interviews as jointly produced narratives, I analysed them by means of a performativity/performance lens. This dual analytic lens focuses on how particular narrative performances are simultaneously shaped by the interview setting and the broader discursive context. The lens was fashioned by synthesising Butler’s theory of performativity with Taylor’s narrative-discursive method. This synthesis (1) allows for Butler’s notion of “performativity” to be supplemented with that of “performance”; (2) provides a concrete analytical strategy in the form of positioning analysis; and (3) draws attention to both the micro politics of the interview conversation and the operation of power on the macro level, including the possibility of making “gender trouble”. The findings of the study suggest that the participants experienced difficulty narrating about male involvement in parenthood decision-making, owing to the taken for granted nature of parenthood for heterosexual adults. This was evident in participants’ sidelining of issues of “deciding” and “planning” and their alternate construal of childbearing as a non-choice, which, significantly served to bolster hetero-patriarchal norms. A central rhetorical tool for accomplishing these purposes was found in the construction of the “sacralised” child. In discursively manoeuvring around the central problematic, the participants ultimately produced a “silence” in the data that repeats the one in the research literature.

Bakgrund: Ugandas snabba befolkningsökning som följd av låg användning av familjeplanering leder till ohälsa, ojämlika könsnormer samt minskade möjligheter till hållbar utveckling. Tidigare forskning har påvisat ugandiska mäns motstånd till familjeplanering, men en nyanserad och gedigen kunskap kring de faktorer som leder till motståndet saknas. Syfte: Syftet med denna litteraturstudie var att få en fördjupad förståelse kring de faktorer som påverkar ugandiska mäns involvering i familjeplanering. Metod: En systematisk litteraturstudie har genomförts på sex vetenskapliga artiklar publicerade mellan 2010-2017. Samtliga artiklar uppsöktes i databaserna PubMed samt Scopus och behandlade studier med kvalitativ metod och ugandisk kontext. Med en induktiv ansats bearbetades artiklarna sedermera med kvalitativ innehållsanalys. Resultat: Ugandiska mäns involvering i familjeplanering påverkas av sociokulturella normer vilka kan härledas till vedertagna traditioner och samhällsstrukturer, inklusive normer som förespråkar ett högt familjeideal samt könsmaktsordning. Männens deltagande påverkas även av en omfattande misstro och kunskapsbrist, vilket enligt resultatet beror på bristande struktur och service inom hälso- och sjukvården. Resultatet visar vidare att samtliga faktorer både leder till och delvis är resultatet av ojämlika könsnormer. Destruktiva strukturer och normer som innebär ojämlika livsvillkor för kvinnor är därmed en avgörande faktor för den låga familjeplaneringen och således den ökande befolkningsmängden i Uganda. Slutsats: Genom att sammanställa och analysera vetenskapliga studier vilka undersökt faktorer som påverkar ugandiska mäns involvering i familjeplanering har en fördjupad samt nyanserad förståelse vuxit fram. En kunskap som tillsammans med den socioekologiska modellen SEM och till den kopplade kommunikationsstrategin C4D har möjlighet att bidra till evidensbaserade folkhälsointerventioner för ökad användning av modern familjeplanering i Uganda och liknande kontexter. / Background: Uganda's rapid population growth due to low use of family planning leads to ill-health, unequal gender norms and reduced opportunities for sustainable development. Earlier research has shown that Ugandan men's resistance to family planning is crucial, but a nuanced and solid knowledge of the factors that lead to resistance is lacking. Purpose: The purpose with this literature review was to gain a deeper understanding of the factors that affect Ugandan men's involvement in family planning. Method: A systematic literature study has been conducted on six scientific articles published between 2010-2017. All articles were searched in the PubMed and Scopus databases and treated studies with qualitative method and Ugandan context. With an inductive approach, the articles were subsequently processed with qualitative content analysis. Results: Ugandan men's involvement in family planning is influenced by socio-cultural norms, which can be derived from established traditions and social structures, including norms advocating a high family ideal well as gender power relations. Men's participation is also affected by an extensive mistrust and lack of knowledge, which, according to the result, is due to lack of structure and service in the health care sector. The result further shows that all factors both lead to and, in part, are the result of unequal gender norms. Destructive structures and norms that impose unequal living conditions for women are thus a decisive factor in the low family planning and thus the increasing population in Uganda. Conclusion: By compiling and analyzing studies which has investigated factors affecting the involvement of Ugandan men in family planning, a deeper and nuanced understanding has emerged. Along with the Social Ecological Model SEM and the connected communication strategy C4D this knowledge has the ability to contribute to evidence-based public health interventions for increased use of modern family planning in Uganda and in similar contexts.

Contraceptive use has far-reaching social and health benefits for women in low and middle-income countries. While socioeconomic factors are known to be associated with contraceptive use, few studies on this topic have focused specifically on young women, whose reproductive health is a target of the Sustainable Development Goals and the Family Planning 2020 agenda. This study used the Kenya Demographic and Health Survey to examine the association between three social determinants (wealth, education, and residence) and two contraceptive outcomes (modern method use and long-acting reversible contraceptive [LARC] use) in women ages 15-24 in 2008-09 (n=3,211 women) and 2014 (n=4,982 women). Results showed increases in the prevalence of modern method use and of LARC use. Low wealth was associated with non-use of LARC methods, and the same wealth pattern emerged for all modern method use between the two timepoints. An education gradient was observed for both outcomes. This study provides some evidence that the urban-rural gap is closing for contraception; however, rural residence continues to be a strong predictor of non-use of LARC methods. Results indicate that continued work is needed to ensure equitable progress in contraceptive use and method choice to contribute to improved reproductive health for young Kenyan women.

Made available in DSpace on 2016-08-18T18:55:09Z (GMT). No. of bitstreams: 1 ANA TERESA SILVA DE FREITAS.pdf: 1178355 bytes, checksum: 2cc1f3fe4a7befdd41edec36faf309af (MD5) Previous issue date: 2009-04-27 / Family Planning through the Federal Constitution of 1988. Prospects for a democratic politics of family planning that includes a plurality of family models and the possibilities of implementation of planning legislation, for these families, through the Constitution of 1988. It presents the historical trajectory of the families in Brazil and of family planning, to contextualize them in the social area, starting the journey of building concept of family planning and their horizons of re-drafting. Projects is the development of normative categories such as family and family planning in Brazil, to considerate the possibility of extracting the argument that the Federal Constitution of 1988, in its regulations for family planning. Builds up in front of the argument, the concept of plural family planning and barriers to their achievement. The structures of the Federal Law no. 9263/96, the National Policy for Sexual and Reproductive Rights, in areas of family planning, and legislative perspectives on the chosen topic (anonymous childbirth; pension paid to the mother the benefit of the child created as a result of rape, and family planning in prisons), is questioning their positions to allow pluralism and diversity of families and social change. / Planejamento Familiar a partir da Constituição Federal de 1988. Perspectivas de uma política de planejamento familiar democrática que contemple a pluralidade de modelos familiares e as possibilidades legislativas de implementação desse planejamento, para essas famílias, a partir da Constituição Federal de 1988. Apresenta-se o percurso histórico das famílias no Brasil e do planejamento familiar, para contextualizá-los no espaço social, iniciando o percurso de construção conceitual do planejamento familiar e os seus horizontes de re-elaboração. Projeta-se a construção normativa das categorias família e planejamento familiar no Brasil, para serem analisadas as possibilidades de argumentação que se extraem da Constituição Federal de 1988, em sua normatividade, para o planejamento familiar. Constrói-se, diante da argumentação, o conceito plural de planejamento familiar e os entraves para a sua realização. Examinam-se os paradigmas da Lei Federal nº. 9.263/96, da Política Nacional de Direitos Sexuais e Reprodutivos, nos eixos do planejamento familiar, e das perspectivas legislativas escolhidas sobre o tema (parto anônimo; pensão paga à mãe em benefício do filho gerado em decorrência de estupro; e planejamento familiar em presídios), questionando-se suas posturas a possibilitar o pluralismo e a diversidade de famílias e as transformações sociais.

Cette thèse porte sur le rapport entre la fécondité et la religion. Dans une approchesociodémographique, cet ouvrage propose une analyse sur les comportements et les attitudes descouples catholiques face à la planification familiale. Nous nous proposons d’expliquer comment cescouples concilient leur foi avec la nécessité de contrôler les naissances, puis la manière dont ilsjustifient leur dépendance ou désobéissance à la doctrine et, enfin, nous montrerons comment lesnouvelles attitudes coexistent avec les modèles traditionnels. Par ailleurs, étant donné que le Mexiqueest un pays qui appartient à l’ensemble d’un contexte culturel traditionnel dont les principalescaractéristiques garantissent la prévalence des rapports inégalitaires de sexe et de dominationmasculine, il nous a paru important d’inclure dans notre recherche une perspective de genre. / This thesis focuses on the relationship between fertility and religion. In a demographic approach, thisthesis provides an analysis on the behavior and attitudes of Catholic couples face of family planning. Itproposes to explain how they reconcile their faith with the need for birth control and how they justifytheir dependence or disobedience to the doctrine. Finally, one of our main objectives is to recognizethe procedures by which new attitudes coexist with traditional models. Moreover, given that Mexico isa country that belongs to the set of a traditional cultural context in which its main characteristicsguarantee the prevalence of unequal relations of sex and male domination, it was considered importantto include in our research a gender perspective. / Esta tesis se centra en la relación entre la fecundidad y la religión. Desde una perspectivasociodemográfica, este trabajo ofrece un análisis sobre el comportamiento y las actitudes de las parejascatólicas frente a la planificación familiar. Lo que se propone es explicar cómo estas personas logranconciliar su fe con la necesidad de controlar la natalidad y la manera con qué justifican su conformidado su desobediencia a la doctrina. Finalmente, uno de nuestros principales objetivos es el de reconocerlos procedimientos por los cuales las nuevas actitudes coexisten con los modelos tradicionales. Porotro lado, dado que México es un país que pertenece al conjunto de un contexto tradicional en el quesus principales características garantizan la desigualdad de sexos y la dominación masculina, seconsideró importante incluir en nuestra investigación, una perspectiva de género.

<div> <div> <div> <p>The following study used a liberal feminist lens to address a gap in the literature on contraceptive method use and romantic relationships by examining the association between contraceptive method use and both relationship satisfaction and balance of power. Specifically, it surveyed married women between the ages of 20-49 using either oral contraceptives (OCs) or natural family planning (NFP). Relationship satisfaction was measured using the Couple Satisfaction Index (CSI-4). Balance of power in the relationship was measured using the Relationship Balance Assessment (RBA). It was hypothesized that women using NFP would report higher relationship satisfaction and greater balance of power than women using OCs. Instead, results of the multiple regression analyses indicated that women using NFP experienced significantly lower rates of balance of power in their relationship. There was no significant difference in relationship satisfaction between groups. Additionally, control variables of religious importance and number of children were found to be associated with balance of power. Controls of age and religious importance were found to be associated with relationship satisfaction. Clinical implications, strengths and limitations, and future directions for research were discussed. </p> </div> </div> </div>

Magister Philosophiae - MPhil / One of the population structures associated with demographic dividend is “demographic transition”, which is a shift from high fertility and mortality to low fertility and mortality. It is understood that low dependency ratio (shows that there are relatively more adults of working age who can support the young and the old of the populace) is one major factor in achieving a successful demographic dividend (DD) (Esther, 2013). DD refers to the fast-economic growth that is achieved by a country when there are dependency ratios. This definition means that the proportion of people of working age group (15-64) is higher, compared to those of ages lower than 15 and above 64 years (Statistics SA, 2017). In addition, having a large proportion of working age people does not necessarily guarantee a successful demographic dividend. There are certain conditions to support a successful DD. According to Dewald Van Rensburg, 2017, South Africa is almost done with the achievement of demographic transition. These does not guarantee a successful demographic dividend. This study will therefore look at socio-economic conditions in support of a demographic dividend, because most of the working age people are still not employed, therefore are not productive enough to contribute to the economic growth. Socio economic conditions include (favorable labor market, economic growth, good governance, education and training, health care, family planning and gender equity) (StatsSA, 2017). These conditions if well-established will lead to a reduction of unemployment and therefore result in more labor resources becoming available to devote to production. Since many people entering working age find it difficult to get employment. Statistics South Africa shows that 38.2% of youth were unemployed in the first quarter of 2018 (Statistic South Africa, 2018), this study will have a close look at South African youth unemployment in relation to the demographic characteristics such as gender, population group, marital status, geography type and province of residence.

This study operationalized the five dimensions of health care access in the context of contraceptive service provision and used this framework to examine access to contraceptive care at health department (HD) (Title X funded) and federally qualified health center (FQHC) (primarily non-Title X funded) clinics in South Carolina and Alabama. A cross-sectional survey was conducted in 2017/18 that assessed clinic-level characteristics, policies, and practices related to contraceptive provision. Provision of different contraceptive methods was examined between clinic types. Survey items were mapped to the dimensions of access and internal consistency for each scale was tested with Cronbach's alpha. Scores of access were developed and differences by clinic type were evaluated with an independent t-test. The overall response rate was 68.3% and the sample included 235 clinics. HDs (96.9%) were significantly more likely to provide IUDs and/or Impants on-site than FQHCs (37.4%) (P < 0.0001). Scales with the highest consistency were Availability: Clinical Policy (24 items) (alpha = 0.892) and Acceptability (43 items) (alpha = 0.834). HDs had higher access scores than FQHCs for the Availability: Clinical Policy scale (0.58, 95% CL 0.55, 0.61) vs (0.29, 95% CL 0.25, 0.33) and Affordability: Administrative Policy scale (0.86, 95% CL 0.83, 0.90) vs (0.47, 95% CL 0.41, 0.53). FQHCs had higher access scores than HDs for Affordability: Insurance Policy (0.78, 95% CL 0.72, 0.84) vs (0.56, 95% CL 0.53, 0.59). These findings highlight strengths and gaps in contraceptive care access. Future studies must examine the impact of each dimension of access on clinic-level contraceptive utilization.

Objetivo: Estimar la asociación entre la participación del hombre en la planificación familiar (PF) y la concordancia en el número de hijos por la pareja. Materiales y métodos: Se utilizaron los datos de la Encuesta Demográfica y de Salud Familiar (ENDES 2019), de acuerdo con los criterios de inclusión (mujeres en edad fértil en unión, no gestantes, uso métodos anticonceptivos El análisis consideró un diseño muestral complejo y se utilizaron los factores de ponderación y expansión correspondientes para recomponer la estructura poblacional de referencia. Se usaron modelos lineales generalizados (GLM) de la familia Poisson. Las variables con valor de p <0.1 en el análisis bivariado fueron incluidas en el análisis multivariado. Se reportaron los Razón de Prevalencia crudas y ajustadas (RP) con intervalos de confianza al 95%, considerándose un valor de p < 0,05 como estadísticamente significativo. Resultados: El 39.5% de las encuestadas se encuentran entre los 30 a 39 años. Aproximadamente el 77.3 % de ellas residen en el área urbana. Respecto al nivel educativo, el 43.1% de las encuestadas cuentan con secundaria completa. Además, el 65.6 % estaban conviviendo y un 34.4% estaban casadas. El 96.4% refieren que los cónyuges aprobaron el uso de PF y que el 76.9% de las parejas habían decidido juntos el uso de contraceptivos. Se realizó el modelo de regresión crudo y ajustado. Se encontró que las parejas que concordaron en el número de hijos tuvieron un 43% (p<0.001) más de probabilidad de decidir juntos el uso de un método anticonceptivo respecto a su contraparte. Conclusiones: Existe la asociación entre la concordancia de la pareja en el número de hijos y la participación del hombre en la planificación familiar. Se requiere mantener el fortalecimiento de las estrategias realizadas por el Ministerio de Salud, además de fomentar la PF con un enfoque holístico. / Objective: To estimate the association between the participation of men in family planning (FP) and the concordance in the number of children by the couple. Materials and methods: Data from the Demographic and Family Health Survey (ENDES 2019) were used, according to the inclusion criteria (women of childbearing age in union, non-pregnant women, use of contraceptive methods). The analysis considered a complex sample design and the factors used were of weighting and expansion to recompose the reference population structure. Generalized Linear Models (GLM) of the Poisson family were used. Variables with a p value <0.1 in the bivariate analysis were included in the multivariate analysis. Ratio of Crude and adjusted prevalence (PR) with 95% confidence intervals, considering a value of p < 0.05 as statistically significant. Results: 39.5% of the respondents are between 30 and 39 years old. Approximately 77.3% of them reside in the urban area. Regarding the educational level, 43.1% of the respondents have completed high school. In addition, 65.6% were living together and 34.4% were married. 96.4% reported that the spouses approved the use of FP and that 76.9% of the couples had decided together to use contraceptives. The raw and adjusted regression model was performed. It was found that couples who agreed on the number of children were 43% (p<0.001) more likely to decide together to use a contraceptive method than their counterparts. Conclusions: There is an association between the couple's concordance in the number of children and the man's participation in family planning. It is necessary to maintain the strengthening of the strategies carried out by the Ministry of Health, in addition to promoting FP with a holistic approach. / Tesis