The spread of health services and fertility transition
The spread of health services and fertility transition
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DOI：
10.1353/dem.2007.0041
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发表时间：
2007-11-01
期刊：
影响因子：
3.5
通讯作者：
Ghimire, Dirgha J.
中科院分区：
文献类型：
--
作者：
Brauner-Otto, Sarah R.;Axinn, William G.;Ghimire, Dirgha J.
我们使用详细的措施，随着时间的推移，社会变化，增加各种医疗服务的可用性，和夫妇的生育行为，以文件的独立影响，医疗服务的生育限制。我们的调查集中在尼泊尔农村的一个环境中，经历了从1945年几乎不使用节育到1995年广泛使用节育来限制生育的过渡。保健服务许多不同方面的变化提供了评价其对使用避孕药具限制生育的独立影响的手段。研究结果表明，计划生育以及妇幼保健服务对终止生育率有独立的影响。例如，提供儿童免疫服务提高了避孕药具的使用率，以限制生育率，而不依赖计划生育服务。此外，新的基于地理信息系统的措施也使其能够测试服务空间分布的许多替代模式。这些测试表明，所有卫生服务提供者的复杂的，地理上定义的措施优于更简单的措施。这些结果提供了有关孕产妇和儿童健康服务的后果以及这些服务在形成生育率转变方面的重要性的新信息。
We use detailed measures of social change over time, increased availability of various health services, and couples 'fertility behaviors to document the independent effects of health services on fiertility limitation. Our investigation focuses on a setting in rural Nepal that experienced a transition from virtually no use of birth control in 1945 to the widespread use of birth control by 1995 to limit fertility. Changes in the availability of many different dimensions of health services provide the means to evaluate their independent influences on contraceptive use to limit childbearing. Findings show that family planning as well as maternal and child health services have independent effects on the rate of ending childbearing. For example, the provision of child immunization services increases the rate of contraceptive use to limit fertility independently of family planning services. Additionally, new Geographic Information System (GIS)-based measures also allow its to test many alternative models of the spatial distribution of services. These tests reveal that complex, geographically defined measures of all health service providers outperform more simple measures. These results provide new information about the consequences of maternal and child health services and the importance of these services in shaping fertility transitions.