Women's socioeconomic position and contraceptive behavior in Togo

Few studies have examined empirically the influence of women's position on contraceptive behavior in sub-Saharan Africa. Using data from the 1988 Togo Demographic and Health Survey, this article explores the linkages between various indicators of women's position and spousal communication about family planning and contraceptive use. The results highlight the importance to their contraceptive behavior of women's economic power and individual control over choice of partner. The likelihood of spousal communication about family planning and modern contraceptive use is significantly higher among women who exercised complete control over selection of partner than among those with arranged marriages. Women who work for cash are significantly more likely than those who do not to communicate with their spouses about family planning, particularly if they participate in rotating credit or savings schemes. Such participation also increases significantly the likelihood of ever using traditional and modern methods of contraception.

The integration of family planning and childhood immunization services in Togo

Improvements in the constellation of services in the African context are largely addressed through attaining better measures of service integration, which can be achieved through improved referral across categories of health programs. The use of an unobtrusive referral message that linked family planning and the Expanded Program of Immunizations (EPI) services was tested in an operations research study in Togo. The introduction of the referral message was accompanied by an 18-percent increase in awareness of available family planning services and an increase in the average monthly number of new family planning clients of 54 percent. These positive results indicate that the use of referral can have a significant and dramatic impact on family planning services in a relatively short time. In Togo, no evidence existed of a negative impact on EPI services, and a majority of the EPI providers reported satisfaction with the effect of the referral message at the close of the study.

Sex education promotes safer behavior

I started having sexual relations at 10 with a girl at the same school who was almost my age. We did not have anything to protect against pregnancy or diseases. I did not know about contraceptive methods then. I learned about these methods in a sex education program. It helped me control myself and show my school buddies what to do to avoid sexually transmitted diseases and pregnancies. After the training, I lost my shame about things that would have seemed forbidden before. I am no longer afraid to express myself about sexuality, a subject that was taboo during my childhood. I learned about family planning centers through the training too. At one clinic, it is easy to get condoms because the person who serves there is young and we can trust him. With older people, one is not so at ease asking for condoms. Before that, I got condoms at the pharmacy, but I did not get them myself. I asked someone who is a little older and could buy them without fear to get them. Someone as young as me is not well thought of in pharmacies, and one fears running into family members or friend of the family. A year ago when I used a condom, the girl thought I wanted to humiliate her. Another time, I had some condoms but I did not use them because I did not have enough courage to propose that. With another girl, I asked her the first day of her period to find out if she was fertile or not. That was a little difficult for me. Now that I have been in training, I found out that it is normal to use a condom and it is good to protect oneself against disease. I may be that I am the one who carries the disease. It's also good to protect against pregnancy, because I go out with girls my age. Now when I am with a girl, I propose using a condom, I try to convince her, and if she refuses, I don't have sex with her. So I'm no longer afraid of pregnancy or disease.

On the intrinsic force of convergence to stability

"Observed populations differ greatly in the speed with which they approach the stable form, but what determines rates of convergence is not fully understood.... Here we examine the trajectory to stability, derive a mathematical expression for the force of convergence, and provide an approximate relationship in terms of the mean and variance of the stable net maternity function." Trajectories for Japan, Togo, and the United States are used as illustrations. (SUMMARY IN FRE)

Crossovers that link populations with the same vital rates

"In this paper, we consider crossovers of demographic density distributions from...populations that have the same fertility and mortality rates. We focus on observed populations and their associated stationary and stable models, and on proportional distributions of persons, births, deaths and reproductive values.... Three different populations were selected to represent a range of demographic behavior. Those populations are Japan 1963, a low mortality, low fertility population; Togo 1961, a high mortality, high fertility population; and the United States 1919-1921, a population whose fertility and mortality are intermediate."

[Status of women and rural-urban migration in Benin: from decision to integration]

Factors affecting the decision to migrate among women in countries around the Gulf of Benin are examined. Using data for Togo, the author notes that "rural-urban migration can be a component of women's status. Women are now better educated, even in rural Africa, and better integrated into the modern way of life, and it is likely that they will be more and more engaged in rural to urban migration in the...future. But...they need to be better skilled and/or have financial capital. Therefore, instead of implementing policies to avoid migration, policy makers must develop comprehensive strategies taking this migration dimension into account, in order to improve women's status." (SUMMARY IN ENG AND SPA)

The Quality Assurance Project: introducing quality improvement to primary health care in less developed countries

Persistently excessive morbidity and mortality rates in less developed countries (LDCs) served by primary health care systems suggest that the quality of services is inadequate. The PRICOR project, sponsored by the United States Agency for International Development, has designed and implemented methods for quality assessment and problem solving in LDC health systems. After developing comprehensive lists of essential activities and tasks, similar to practice parameters, for seven child survival interventions, PRICOR supported comprehensive quality assessment studies in twelve LDC countries. The studies, yielding over 6000 observations of health worker-client encounters, indicated highly prevalent, serious program deficiencies in areas including diagnosis, treatment, patient education and supervision. To facilitate corrective action, PRICOR assisted managers in conducting operations research to resolve priority problems revealed by the assessments. The recently initiated Quality Assurance Project is building on PRICOR techniques in designing and implementing sustainable continuous quality improvement programs for LDC health systems.

Increase in family benefits, 1987

As of January 1987, family benefits in Togo were increased from CFAF 1000 to CFAF 1250 per month per child.