Scribd Logo
Upload

Welcome to Scribd!

  • 45 views

    Creative Commons Attribution-Noncommercial-Sharealike License

    Uploaded by

    sysv
    session

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Creative Commons Attribution-Noncommercial-Sharealike License

    Uploaded by

    sysv
    45 views7 pages
    session

    Original Title

    session2.1notes

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    session

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    45 views7 pages

    Creative Commons Attribution-Noncommercial-Sharealike License

    Uploaded by

    sysv
    session

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 7

    This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike License.

    Your use of this


    material constitutes acceptance of that license and the conditions of use of materials on this site.

    Copyright 2006, The Johns Hopkins University and W. Henry Mosley. All rights reserved. Use of these materials
    permitted only in accordance with license rights granted. Materials provided AS IS; no representations or
    warranties provided. User assumes all responsibility for use, and all liability related thereto, and must independently
    review all materials for accuracy and efficacy. May contain materials owned by others. User is responsible for
    obtaining permissions for use from third parties as needed.

    PFHS 380.665 FAMILY PLANNING POLICIES AND PROGRAMS


    Intermediate Fertility Variables
    A Framework for Fertility Analysis and Program Planning
    W. Henry Mosley
    A.

    B.

    Definitions:
    1.

    natural fertility

    2.

    proximate determinants

    Intermediate Fertility Variables:


    1.

    Kingsley Davis and Judith Blake framework (1956)

    2.

    Variables used in reproductive models


    a.

    proportion of females married

    b.

    contraception

    c.

    induced abortion

    d.

    postpartum infecundability

    e.

    frequency of intercourse

    f.

    spontaneous intrauterine mortality

    g.

    permanent sterility

    C.

    Relative Importance of the Intermediate Variables

    D.

    The Bongaarts Model

    E.

    Applications of the proximate determinants model


    1. decomposition of determinants of fertility for policy/program analysis
    (Beijing case study)

    2. setting goals and allocating resources for programs (SPECTRUM


    computer model)

    References
    Required Reading:
    Stover, J. Revising the proximate determinants framework of fertility.
    What have we learned in the past 20 years? Studies in Family
    Planning 29,3: 255267, 1998.
    Recommended Readings:
    Bongaarts J. The fertility-inhibiting effects of the intermediate fertility variables.
    Studies in Family Planning 13(6/7):179-189, 1982.
    Bongaarts J. A simple method for estimating the contraceptive prevalence required
    to reach a fertility target. Studies in Family Planning 15(4):184-190, 1984.
    Bongaarts J, Frank O, Lesthaeghe R. The proximate determinants of fertility in
    Sub-Saharan Africa. Population and Development Review 10(3):511-537,
    1984.
    Davis K, Blake J. Social structure and fertility, an analytic framework. Economic
    Development and Cultural Change 4:211-23, 1956.
    Wang S-X, Chen Y-D, Chen CHC, Rochat R, Chow LP, Rider R. Proximate
    determinants of fertility and policy implications in Beijing. Studies in Family
    Planning 18(4):222-228, 1987

    Figure 1- Intermediate Variables Affecting Fertility*


    I. Factors affecting exposure to intercourse
    A.

    Those governing the formation and dissolution of unions in the reproductive period
    1.

    Age of entry into sexual unions

    2.

    Permanent celibacy; proportion of women never entering sexual unions

    3.

    Amount of reproductive period spent after or between unions


    a.
    b.

    B.

    When unions are broken by divorce, separation or desertion


    When unions are broken by death of husband

    Those governing the exposure to intercourse within unions


    4.

    Voluntary abstinence

    5.

    Involuntary abstinence (from impotence, illness, and unavoidable but temporary


    separations

    6.

    Coital frequency (excluding periods of abstinence)

    II. Factors affecting exposure to conception


    7.

    Fecundity or infecundity, as affected by involuntary causes

    8.

    Use or non-use of contraception


    a.
    b.

    9.

    By mechanical and chemical means


    By other means

    Fecundity or infecundity, as affected by voluntary causes (sterilization, subincision,


    medical treatment, etc.)

    III. Factors affecting gestation and successful parturition


    10.

    Foetal mortality from involuntary causes

    11.

    Foetal mortality from voluntary causes

    * Source:

    Kingsley Davis and Judith Blake. Social Structure and Fertility: An Analytic
    Framework, Economic Development and Cultural Change 4:211-35, 1956.

    The BongaartsModel
    TFR = TF x Cm x Cc x Ca x Ci
    where: TFR = Total Fertility Rate
    TF = Total natural Fertility rate
    Cm = index of non-marriage
    Cc = index of contraception
    Ca = index of induced abortion
    Ci = index of lactational infecundability
    The value of each index ranges between 0 and 1; the lower the index value, the
    greater the inhibiting effect of the variable. Each of these indices can be estimated
    from survey data to assess the relative contribution of each of these proximate
    determinants to the level of fertility.
    Index of Non-Marriage
    This index (Cm) expresses the effect of non-marriage in terms of reduction in fertility
    per woman. By definition the index of non-marriage is the ratio between the total
    fertility rate (TFR) and the total marital fertility rate (TM). That is:
    Cm = TFR/TM
    The proportion of women of reproductive age who are married can be used as an
    approximation of Cm. That is:
    Cm ~ MWRA/WRA

    Index of Contraception
    The index of contraception varies inversely with prevalence and use effectiveness of
    contraception practiced by couples. The index of contraception is calculated
    according to the following formula:
    Cc = 1 - (1.08 x u x e)
    Where: u = the overall proportion of married women currently
    practicing contraception
    e = the weighted average of contraceptive use
    effectiveness using the proportions of current
    contraceptive users of each method as weights
    1.08 is a sterility correction factor
    Index of Induced Abortion
    Computation of the index of induced abortion requires first the estimation of the agespecific induced abortion rates from which one can calculate the total abortion rate
    (TA). The total abortion rate is then used to estimate the total number of births
    averted per woman (A) as follows:
    A = b x TA
    = .4(1 + u) x TA
    where:

    b = births averted per induced abortion


    0.4 is an estimate of births averted per induced
    abortion in the absence of contraception
    u = the prevalence of contraception

    After the total number of births averted per woman (A) is estimated, the index of
    induced abortion is calculated as:
    Ca = TFR/(TFR + A)

    Index of Lactational Infecundability


    The effect of lactational infecundability on fertility operates entirely through
    modification of the birth interval. The equation to estimate the index of
    infecundability is as follows:
    Ci = 20.0/(18.5 + i)
    where:

    (18.5 + i) is the average birth interval with lactation


    i = average duration of postpartum infecundability

    This equation implies that 20 months is the birth interval in the absence of lactational
    infecundability, allowing 7.5 months as waiting time to conception, 2 months to
    account for spontaneous fetal wastage, 9 months for term gestation, and 1.5 months
    for infecundability without lactation.
    Estimation of Total Fertility
    The total fertility rate is estimated from the indices according to the Bongaarts
    model:
    TFR = 15.3 x Cm x Cc x Ca x Ci
    15.3 is an average estimate of TF that Bongaarts has derived based on data from
    multiple studies. It is generally used for this analysis unless there is specific data
    from the population under study to derive a better estimate, which is not usually the
    case.

    You might also like