User talk:Juliannadrew/sandbox

Proposed Contribution:

I would like to write a new Wikipedia article titled “Family planning in Sub Saharan Africa.” I would cover the current availability and usage of birth control and information on family planning, cultural attitudes toward birth control, and the effects of birth control on the economy and on the health of mothers and children. I think this is a critical topic to add to Wikipedia because more awareness needs to be drawn to the current lack of family planning in Africa and the effects that family planning initiatives would bring to Africa. The “Health” and “Finances” subtopics of the “Birth control” Wikipedia page include graphics that show that Sub Saharan African countries have very high fertility and maternal mortality rates and very low percentages of women using modern birth control methods compared to the rest of the world. Yet, the article only briefly discusses the issue of family planning in developing countries. Of all the regions of the world, the issue of birth control is arguably most important in Africa, yet it is the only continent without a single country represented under the “Policy” subtopic of the “Family planning” page. The current article briefly discusses the effect of birth control on maternal mortality rate and the various financial benefits of birth control, but it lacks detail and reasons why birth control is not readily available, despite the benefits. Maternal and infant mortality rates could be significantly reduced if women only had more knowledge about family planning, access to birth control, and if family planning was more widely accepted by society.

Research:

In an article titled “Estimating the Impact of Birth Control on Fertility Rate in Sub-Saharan Africa” by Ijaiya et al., use of modern birth control methods (MBCM) has been shown to decrease female fertility rate in Sub-Saharan Africa. In a paper titled, “A Cohort Analysis of the Timing of First Birth and Fertility” by Gyimah, women who have their first child at a younger age are less likely to finish school, and will be more limited to low paying career options. Since birth control is not widely available, beginning a family at a young age is additionally correlated with a higher overall fertility rate. This article attributes the higher fertility rates of Sub Saharan African countries compared to other developing countries to “the inter-related factors of early childbearing, high infant mortality, low education and contraceptive use, and persistence of high fertility-sustaining social customs.” According to a study done by Nwachukwu and Obasi titled “Use of Modern Birth Control Methods Among Rural Communities in Imo State, Nigeria,” MBCMs were only used by 30% of respondents and some of the factors identified that prevented use of MBCMs were “perceived negative health reaction, fear of unknown effects, cost, spouse’s disapproval, religious belief and inadequate information.” It also states that men are usually the decision makers on MBCM use, and therefore should be the targeted audience of educational campaigns. Several factors, such as low education level, young age, and living in a rural area contribute significantly to unavailability of family planning information and MBCMs according to “Equity Analysis: Identifying Who Benefits from Family Planning Programs.” There are many benefits to family planning. An article by Baggaley, et al., “The Potential of Medical Abortion to Reduce Maternal Mortality in Africa: What Benefits for Tanzania and Ethiopia?” suggests that increasing access to safe abortion would reduce maternal mortality due to unsafe abortions in Ethiopia and Tanzania. Alvergne, et al. argue in “Fertility, parental investment, and the early adoption of modern contraception in rural Ethiopia” that an increase in usage of MBCMs increases birth spacing which consequently decreases infant mortality, although had no observed effect on overall child mortality, possibly due to a recent overall decrease childhood death rates among both contraception users and nonusers. The article also suggested that another benefit of longer birth intervals due to contraception use is an increase in parental investment and proportion of resources dedicated to each child. According to the Gyimah paper, fertility rates are declining in some African countries, particularly Kenya, Botswana, Zimbabwe, and Ghana. The decrease in fertility rates in Ghana is largely attributed to investment in education that has caused an increase in age at first birth and improved job opportunities for women. I think the topic of “Family planning in Sub Saharan Africa” merits a new wikipedia page because several of the countries listed under the “Policy” subtopic of the “Family planning” page have entire articles about family planning in that country. Since family planning is such an important issue in Africa, I think there is more information that would be beneficial to add to wikipedia than would fit in a subtopic of the family planning article. The only difficulties I anticipate are a slight general lack of information about family planning in the countries in which lack of family planning is a serious problem. I think, however, for the purposes of this article that enough research has been done for me to adequately describe the topic. It is problematic that several of the most relevant articles I found were published in the 1970s and are therefore too outdated to be relevant in describing the current situation. I also want to be careful about making sure the contents of my article remain factual and unbiased and represent all viewpoints equally. This topic would be a valuable contribution to Wikipedia because information on the region of the world where usage of MBCMs is of very significant importance, sub Saharan Africa, is the region that is least well represented on Wikipedia. Providing more information about this topic to the public will increase overall understanding of the issue and hopefully inspire more research and eventual action to help solve this problem.

Proposed Outline:

2. Effects

• Health(includes health of mother and children, prevention of STDs)
• Economic

3. Policy (an overview of family planning policy in sub Saharan African countries)

• Ethiopia
• Ghana
• South Africa
• Tanzania

The first two subtopics would cover general information about family planning in sub Saharan African countries. “Availability” would specifically cite information about current rates of family planning method usage and information on percentage of women interested in using family planning methods. There would be a discussion of the methods of family planning available, such as condoms, abortion, injections, and natural methods, and the effectiveness of each method in the context of mostly rural areas. The various factors, such as education, wealth, living in a rural or urban setting, and age, that can increase and decrease availability and usage of family planning methods would also be included here. I would further discuss what prevents women from using birth control, such as misinformation about birth control methods, religious beliefs, societal views, and pressure to not use family planning methods from spouses. The “Health” subtopic would be a discussion of the effects of birth control on both women and their offspring. The “Economic” subtopic would be a fairly brief overview of the current effect of family planning on the economies of African countries. It would also include a brief summary of the potential economic impact of increased family planning. The “Methods to increase awareness and availability” would document information on the successes and failures of various public health initiatives that aimed to increase family planning. Many of the articles I read provided suggestions of how to best increase knowledge and availability of family planning based on factors that they found contributed to the current lack of family planning. I would briefly summarize a few of the most well-researched idea proposals. Finally, the policy section would describe the general government policies relating to birth control and abortion. I also chose four countries to focus on that are well-represented in scholarly articles and have high maternal and infant mortality rates and low rates of MBCM usage (with the exception of South Africa, which has relatively low mortality rates, but has been exceptionally well studied and written about). I would cover all government initiated attempts to increase and decrease fertility rates. The current “Family planning” entry in Wikipedia includes a subtopic of birth control and subtopics for various countries. None, however, of the subtopic countries are in Africa. Additionally, the original “Family planning” article is fairly brief and does not include enough information about birth control distribution in Africa. The “Birth control” article includes an appropriate amount of information on various birth control devices, but includes only a very small section on contraception use in developing countries (under subtopic “Health”). I would add a link to my new page on birth control in sub Saharan Africa from the outline of the already existing “Family planning” page and from the “Effects” and “Prevalence” subtopics on the “Birth control” page. I would also add links to both articles from my new page. Since this is a very broad topic, I will suggest that my work be continued by other Wikipedians, especially in increasing the number of countries covered in the “Family Planning” article’s “Policy” subtopic.

References

• Alvergne, A., Lawson, D. W., Clarke, P. M.R., Gurmu, E. and Mace, R. (2013), Fertility, parental investment, and the early adoption of modern contraception in rural ethiopia. Am. J. Hum. Biol., 25: 107–115. doi: 10.1002/ajhb.22348

• Baggaley, R. F., Burgin, J., & Campbell, O. R. (2010). The Potential of Medical Abortion to Reduce Maternal Mortality in Africa: What Benefits for Tanzania and Ethiopia?. Plos ONE, 5(10), 1-9. doi:10.1371/journal.pone.0013260

• Clelana, J. G., Ndugwa, R. P., & Zulu, E. M. (2011). Family planning in sub-Saharan Africa: progress or stagnation?. Bulletin Of The World Health Organization, 89(2), 137-143. doi:10.2471/BLT.10.077925

• Creanga, A. A., Gillespie, D., Karklins, S., & Tsui, A. O. (2011). Low use of contraception among poor women in Africa: an equity issue. Bulletin Of The World Health Organization, 89(4), 258-266. doi:10.2471/BLT.10.083329

• Cordero-Coma, J., & Breen, R. (2012). HIV Prevention and Social Desirability: Husband-Wife Discrepancies in Reports of Condom Use. Journal Of Marriage And Family, 74(3), 601-613.

• Gyimah, Stephen Obeng. A Cohort Analysis of the Timing of First Birth and Fertility in Ghana. Population Research and Policy Review , Vol. 22, No. 3 (Jun., 2003), pp. 251-266

• Hoque, M., Ghuman, S., & Medeiros, R. (2012). Knowledge, Practices, and Attitudes of Emergency Contraception among Female University Students in KwaZulu-Natal, South Africa. Plos ONE, 7(9), 1-7. doi:10.1371/journal.pone.0046346

• Mantell, J. E., Correale, J., Adams-Skinner, J., & Stein, Z. A. (2011). Conflicts between conservative Christian institutions and secular groups in sub-Saharan Africa: Ideological discourses on sexualities, reproduction and HIV/AIDS. Global Public Health, 6192-209. doi:10.1080/17441692.2011.604039

• MAYHEW, S., OSEI, I., & BAJOS, N. (2013). PROVIDER ATTITUDES TO EMERGENCY CONTRACEPTION IN GHANA AND BURKINA FASO. Population (16342941), 68(1), 115-140. doi:10.3917/pope.1301.0115

• MAYHEW, S., OSEI, I., & BAJOS, N. (2013). Sexuality, Contraception, Unplanned Pregnancies and Abortion in West Africa and Morocco: The ECAF Survey. Population (16342941), 68(1), 7-14. doi:10.3917/pope.1301.0007

• Moultrie, T. A., Sayi, T. S., & Timæus, I. M. (2012). Birth intervals, postponement, and fertility decline in Africa: A new type of transition?. Population Studies, 66(3), 241-258. doi:10.1080/00324728.2012.701660

• Nwachukwu, Ike and O. O. Obasi. (2008) Use of Modern Birth Control Methods among Rural Communities in Imo State, Nigeria. African Journal of Reproductive Health / La Revue Africaine de la Santé Reproductive , Vol. 12, No. 1 (Apr., 2008), pp. 101-108

• Ortayli, N., & Malarcher, S. (2010). Equity Analysis: Identifying Who Benefits from Family Planning Programs. Studies In Family Planning, 41(2), 101-108.

• Stephenson, R., Baschieri, A., Clements, S., Hennink, M., & Madise, N. (2007). Contextual Influences on Modern Contraceptive Use in Sub-Saharan Africa. American Journal Of Public Health, 97(7), 1233-1240. doi:10.2105/AJPH.2005.071522

• Vincent, L. (2012). Shaking a hornets' nest: pitfalls of abortion counselling in a secular constitutional order – a view from South Africa. Culture, Health & Sexuality, 14(2), 125-138. doi:10.1080/13691058.2011.627469