Jordan's 2002 to 2012 Fertility Stall and Parallel USAID Investments in Family Planning: Lessons From an Assessment to Guide Future Programming

Spindler, Esther; Bitar, Nisreen; Solo, J; Menstell, Elizabeth; Shattuck, Dominick

doi:10.9745/ghsp-d-17-00191

Cited by 9 publications

(4 citation statements)

References 10 publications

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“…Jordan has the highest fertility rate decline in the Arab world, with a decline rate reaching 24.3%; apparently due to the fact that it was the rst country in Middle East and North Africa region to exhibit fertility stall from the late of 1990's followed by a resume in declining fertility from 2012 [20,21]. During the fertility stall period, Spindler et al [21] presented the average desired number of children to be around four. At the same period, Rutstein and Shah [22] presented rate of 3.5% and 13.5% for primary infertility and secondary infertility respectivaly among Jordanians.…”

Section: Discussionmentioning

confidence: 99%

“…For comparison of Block-2; The Fertile Crescent Arab Countries block showed most signi cant fertility rate decline for all countries with the exception of Lebanon. Jordan has the highest fertility rate decline in the Arab world, with a decline rate reaching 24.3%; apparently due to the fact that it was the rst country in Middle East and North Africa region to exhibit fertility stall from the late of 1990's followed by a resume in declining fertility from 2012 [20,21]. During the fertility stall period, Spindler et al [21] presented the average desired number of children to be around four.…”

Section: Discussionmentioning

confidence: 99%

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The Epidemiological Declining in the Human Fertility rate in the Arab World for 10 years period 2011-2021

MAHASNEH,

Ebrahim

2024

Preprint

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Background: In recent years, there has been a noticeable global decline in fertility rate, leading to increased attention toward reproductive health and fertility. Understanding fertility trends is crucial for addressing related challenges and maintaining natural balanced fertility rate for the community well-being. Therefore, the aim was to investigate and provide baseline dataset on fertility profiling of the Arab World for the 10 years period between 2011-2021. The Arab World was classified into three regional blocks; Block-1 Arabian Peninsula countries: Bahrain, Kuwait, Saudi Arabia, Oman, Qatar, United Arab Emirates (UAE), Yemen. Block-2 Fertile Crescent Arab countries: Iraq, Jordan, Lebanon, Syria, West Bank and Gaza. Block-3 African Arab countries: Algeria, Comoros, Djibouti, Egypt, Libya, Mauritania, Morocco, Somalia, Sudan, Tunisia. Data on fertility rates for the 10 years period between 2011-2021 were collected from the World Bank for Arab countries. Statistical analysis along with decline in the fertility rates were determined. Results: Fertility rates varied across Arab countries in 2011 and 2021, with notable decline ranging from 24.3% to 3.8%, except for Algeria, with zero decline. Countries that exhibited significant decline were Jordan (24.3%) followed by Iraq (22.2%) then Yemen (19.1%); Whereas, countries that exhibited slight fertility decline were Libya (3.8%), followed by Tunisia (4.5%), Lebanon (4.5%) and Kuwait (4.5%). On another note, lowest fertility rate was observed in UAE as maintained between 1.7% and 1.5% and the highest fertility rate was observed in Somalia as maintained between 7.3% and 6.3% for 2011 and 2021 respectively. Conclusion: The present study reveals the declining-trend in fertility rate across Arab countries, influenced by variable factors. Therefore, we recommend to the Council of the Health Ministries in the Arab-League to focus on investigating the fertility decline as an important parameter for public health in the Arab world to maintain natural balanced fertility rate.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Epidemiological Declining in the Human Fertility rate in the Arab World for 10 years period 2011-2021

MAHASNEH,

Ebrahim

2024

Preprint

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“…In the Middle East and North Africa, the pattern of market share was also similar between and within countries, except for the higher use of non-profit services in Jordan. International organizations have been working in Jordan for several decades through partnerships with the government and direct provision of a full range of modern contraceptives in reproductive health clinics across the country (40)(41)(42). Although our findings are consistent with other studies that documented an overall low share of non-profit services (12), we found differences at regional and country levels.…”

Section: Figurementioning

confidence: 99%

What are the sources of contraceptives for married and unmarried adolescents: Health services or friends? Analysis of 59 low- and middle-income countries

Hellwig

Barros²

2023

Front. Public Health

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BackgroundDespite the efforts to promote universal coverage for family planning, inequalities are still high in several countries. Our aim was to identify which sources of contraceptives women mostly rely on in low- and middle-income countries (LMICs). We also explored the different sources according to age and marital status.MethodsWe used data from national health surveys carried out in 59 LMICs since 2010. Among all sexually active women at reproductive age, we explored inequalities in demand for family planning satisfied by modern methods (mDFPS) and in the source of modern contraceptives according to women's age, classified as: 15–19, 20–34, or 35–49 years of age. Among adolescents, mDFPS and source of method were explored by marital status, classified as married or in union and not married nor in a union.ResultsmDFPS was lower among adolescents than among adult women in 28 of the 59 countries. The lowest levels of mDFPS among adolescents were identified in Albania (6.1%) and Chad (8.2%). According to adolescents' marital status, the pattern of inequalities in mDFPS varied widely between regions, with married and unmarried adolescents showing similar levels of coverage in Latin America and the Caribbean, higher coverage among unmarried adolescents in Africa, and lower coverage among unmarried adolescents in Asia. Public and private health services were the main sources, with a lower share of the public sector among adolescents in almost all countries. The proportion of adolescents who obtained their contraceptives in the public sector was lower among unmarried girls than married ones in 31 of the 38 countries with data. Friends or relatives were a more significant source of contraceptives among unmarried compared to married adolescents in all regions.ConclusionsOur findings indicate lower levels of mDFPS and lower use of the public sector by adolescents, especially unmarried girls. More attention is needed to provide high-quality and affordable family planning services for adolescents, especially for those who are not married.

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“…Utilization patterns of modern family planning methods (MFPMs) are crucial in evaluating the overall coverage and success of family planning programs and services. Jordan has achieved great success in improving access to, provision of, and use of family planning methods and services [1], particularly between 1990 and 2012, when the contraceptive prevalence rate (CPR) increased from 40% to 61%, with the modern CPR increasing from 27% to 42% and the traditional CPR increasing from 13% to 19% [2]. Following this increase in CPR, the total fertility rate (TFR)-inversely related with CPR [3]-declined from an average of 5.6 children per woman in 1990 to 3.5 in 2012 but with a long fertility stall between 2002 and 2012 [2].…”

Section: Introductionmentioning

confidence: 99%

The Impact of Behavioral Economics-Based Counseling and Mobile Phone Text Educational and Reminder Messages on the Use of Modern Family Planning in Jordan: A Cluster Randomized Controlled Trial

et al. 2023

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Background: Favorable attitudes toward modern family planning methods (MFPMs) among Jordanian and Syrian women do not always translate into behavioral changes, and the availability and cost of MFPMs do not appear to be related to either prior stalls in fertility rates in Jordan or to the current and likely temporary decline in fertility rates. This study aimed to determine whether behavioral economics (BE)-based family planning interventions influence the use of any family planning method, MFPMs use, continuation of MFPMs use, and pregnancy rates among women in Jordan. The BE-based family planning interventions included personalized text messaging and augmented counseling based on framing and identity-priming BE principles, with their effects tested over a 9-month period in the postpartum period following the birth of a child. Methods: A parallel-group cluster randomized controlled trial was conducted to compare two interventions, augmented counseling based on framing and identity-priming BE principles and personalized mobile phone text messages reminders, aiming to improve the utilization of MFPMs among postpartum women over status quo family planning services in comprehensive health centers in the north of Jordan. Results: In total, 1032 participated in the study: 295 women in the control group; 326 women in Intervention Group 1, which received only augmented counseling; and 411 women in intervention Group 2, which received augmented counseling and monthly text messages. The rates of using MFPMs in the counseling group and the counseling and messages group 3 months (54.7% and 57.1%, respectively), 6 months (50.0% and 51.7%, respectively), and 9 months (49.5% and 52.0%, respectively) were significantly higher than the rates among women in the control group (40.6% at 3 months, 37.6% at 6 months, and 34.3% at 9 months). Overall, 26.8% of women in the control group, 42.1% of women in the counseling-only group, and 45.2% of women in the counseling and messages group used MFPMs continuously for all 9 months. At 9 months, the pregnancy rate was significantly much higher in the control group (13.7%) compared to women in the counseling-only group (7.0%) and to women in the counseling and messages group (7.4%). Conclusions: Simple BE-based interventions can be effective methods for enhancing the use of MFPMs and maintaining the anticipated decline in Jordan’s total fertility rate.

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Jordan's 2002 to 2012 Fertility Stall and Parallel USAID Investments in Family Planning: Lessons From an Assessment to Guide Future Programming

Cited by 9 publications

References 10 publications

The Epidemiological Declining in the Human Fertility rate in the Arab World for 10 years period 2011-2021

The Epidemiological Declining in the Human Fertility rate in the Arab World for 10 years period 2011-2021

What are the sources of contraceptives for married and unmarried adolescents: Health services or friends? Analysis of 59 low- and middle-income countries

The Impact of Behavioral Economics-Based Counseling and Mobile Phone Text Educational and Reminder Messages on the Use of Modern Family Planning in Jordan: A Cluster Randomized Controlled Trial

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