what is your family planning essay

Family Planning Essay Sample

Family planning is a crucial thing that every single person on this planet should think about because of the limited number of resources that exist on the earth. If family planning will not be given much attention then there is going to be competition rather we should say tough competition among human beings to grab the maximum resources for their survival.

• Introductory Part on Family Planning Essay
• Main Body Of Family Planning Essay
• Conclusion :- Family Planning Essay

Essay Sample On Family Planning

Introductory Part on Family Planning Essay Planning your family is one of the most important decisions you will make in life. It can be a difficult decision to make, but it is crucial that you plan ahead before having children because this decision will affect your entire life and the lives of those around you. There are many different ways to go about planning for your family, so take some time to think about what would work best for you and your future family. Main Body Of Family Planning Essay Family planning is, therefore, must in such places so that the pressure on the resources of the region can be lowered to a great extent. There are nations like China where the rise of the population has taken a massive range in the country and now the government is trying to have control over the growth of the population. We can see how the population growth of China is in a stagnant state for the past couple of decades. This is because it has taken control of the growth of the population by asking the citizens for better family planning where they cannot reproduce more than one child in their life. Family planning is not only associated with the personal life of a person but at the same time, it is a national issue. It can be associated with the fraction of youth in the population of a country, pressure on the economy and other resources, and competition for survival. If a nation is lacking a young population there is a fair chance that it is going to face severe challenges in the future. This is because when the working population of the country is less than the old one then it is a great concern for the country which can be tackled by the family planning by the citizens by thinking about the growth of the country on a world scale. Various instructions are given by the government of many countries that are concerned with the family planning that citizens are supposed to follow. Buy Customized Essay on Family Planning At Cheapest Price Order Now Must View: Essay Sample On “Adoptive Family Advantages And Disadvantages” Conclusion :- Family Planning Essay Family planning is a very important part of our lives. It’s not just about birth control, it’s also about the emotional and physical well-being of each person in the family. As we know, there are many factors that can affect one or more members of the family including illness, accidents, marriage breakdowns, and work pressures. The truth is that every member has to be considered when making decisions on how often to have children as well as what kind of contraceptive methods will be used. Hire USA Experts for Family Planning Essay Order Now

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What Is Family Planning? 6 Effective Methods And Insights

Alia Siddique

 / 

Table of Contents

• What Is Family Planning 
• Best Family Planning Method 
• What Is Natural Family Planning 
• How Does It Work?  
• What Are Family Planning Services 
• Benefits of Family Planning Services 
• A Word From Mind Family 
• Frequently Asked Questions (FAQs) 

Starting a family requires careful consideration, thoughtful planning and open communication between you and your partner. By learning what is family planning you can pave the way for a secure and promising future for your loved ones.

The practice of family planning, coupled using contraception, plays a pivotal role in safeguarding women’s health, particularly for adolescent girls. Studies show that, family planning serves as a crucial tool in preventing pregnancy-related health risks.

Hence, it is important not only for your children and family but also your own health! So let’s explore what is family planning and how it can help you!

What Is Family Planning

Family planning is a personal journey that allows you to take control of your reproductive choices and shape the course of your life.

It empowers you to make informed decisions about when to start or expand your family, aligning with your unique aspirations and circumstances.

You have a range of options at your disposal , from contraceptives to fertility awareness methods, enabling you to tailor your approach to suit your preferences and health needs.

Read More: Family Planning And Parenthood: Won’t I Just Figure It Out?

This personalized approach to birth control ensures that you can plan for a family that aligns with your goals, promoting not only your well-being but also that of your future children.

However, there have been developments regarding the best family planning method that you can utilize when making the choice of starting a family of your own.

Read More: What Are Family Dynamics? Is Your Family Dynamics Uplifting or Weighing You Down?

Let’s see which is the best family planning method that works for you!

Best Family Planning Method

Choosing the best family planning method is a personal decision that depends on various factors, including lifestyle, health considerations, and individual preferences.

The following are different pregnancy planning methods that can help you make an informed choice:

1. Barrier methods

One of the birth control options offers immediate protection, options like condoms, diaphragms, cervical caps, and contraceptive sponges create a physical barrier to prevent sperm from reaching the egg.

2. Short-acting hormonal methods

Daily, weekly, or monthly choices like birth control pills, the vaginal ring, skin patch and contraceptive injection provide flexibility but require consistent use.

Read More: Link Between Contraceptive Pills And Depression In Women

3. Long-acting hormonal methods

One of the most effective methods for what is family planning is the hormonal method. Opt for convenience with pregnancy planning methods like the copper IUD, hormonal IUDs and the contraceptive implant, offering extended protection without daily maintenance .

Read More: Hormonal Birth Control Affects Brain Activity

4. Sterilization

If you seek a permanent solution, tubal ligation for women and vasectomy for men are irreversible options for long-term contraception.

5. Spermicide or vaginal gel

Birth control for what is family planning also includes nonhormonal alternatives like spermicides or vaginal pH regulator gel provide on-the-spot contraception by immobilizing or inhibiting sperm movement.

6. Natural Family Planning

Understand your body’s natural fertility cues, such as basal body temperature and cervical mucus, to determine fertile days, allowing for pregnancy planning.

Also, there’s emergency contraception like the morning-after pill, which can be used after unprotected sex to prevent pregnancy.

The best method of birth control depends on what suits your life and plans. Talk to a healthcare provider to find what works best for you.

Read More: What Are Family Relationships And Its Importance

However, we recommend a natural family planning approach as an alternate to the medical or chemical options.

What Is Natural Family Planning

Natural family planning, also known as fertility awareness, is a method where a woman keeps track of different signals in her menstrual cycle to understand when she’s most likely to become pregnant.

When followed consistently and correctly, it can be up to 99% effective; however, the effectiveness of planned parenthood decreases if not followed carefully.

This method for what is family planning involves no physical side effects, offering a natural way to plan when you want to get pregnant.

Read More: How Abortion Impacts Mental Health? 5 Self-Help Tips To Cope

To make it work, you need to record daily signals like temperature and cervical fluids for 3 to 6 menstrual cycles to learn the method.

It’s essential to note that factors like illness, stress, and travel can affect the accuracy of your fertility signals. If you decide to have sex during the fertile time, using additional contraception like condoms, diaphragms, or caps is recommended.

Understanding what is natural family planning helps you in pregnancy planning, but combining it with condoms also adds protection against sexually transmitted infections.

Read More: What Is Dysfunctional Family And How To Deal With It

How Does It Work?

Natural family planning involves observing and understanding fertility signs throughout your menstrual cycle to either plan or avoid pregnancy.

If you are considering learning what is natural family planning, it’s crucial to seek guidance from a qualified planned parenthood professional.

Look for family planning services in your local area for proper instruction.

There are three key fertility signals for natural family planning:

• Menstrual cycle length: Keep track of how long your menstrual cycle lasts.
• Body temperature: Take daily readings of your body temperature.
• Cervical secretions (cervical mucus): Note any changes in cervical mucus.

Recording these measures together provides a more accurate understanding of your fertile periods. Additionally, smartphone apps are available to simplify the process and make tracking more accessible.

Remember, the accuracy of natural family planning depends on consistent and correct monitoring , so proper education and guidance are essential for effective use.

If you are considering this method for what is family planning, consult with a qualified professional to ensure you receive accurate instruction. There are family planning services all across the country to help you make this tough decision for your family.

Read More: 10 Devastating Life-Altering Long Term Effects of Premature Birth

But what are family planning services and how can they help? Let’s explore!

What Are Family Planning Services

Family planning services are resources designed to help you make informed decisions about your reproductive health.

Provided by healthcare professionals and organizations, these services support individuals in achieving their desired family size and spacing pregnancies according to your preferences.

You can expect a range of services, including guidance on contraceptive methods such as birth control pills, condoms, intrauterine devices (IUDs), and implants.

Let’s look at the benefits you can expect from what are family planning services!

Benefits of Family Planning Services

Family planning services offer numerous benefits that empower you to make informed decisions about your reproductive health.

By providing education and resources, these services enable you to choose the family size and timing of pregnancies that align with your personal goals.

You can expect the following benefits by applying for family planning services:

1. Reducing Unintended Pregnancies

Access to contraception and family planning services helps you minimize the risk of unintended pregnancies, contributing to better maternal and child health outcomes through well-timed pregnancies.

2. Enhancing Maternal and Child Health

Family planning positively impacts maternal health by reducing the risk of complications associated with closely spaced births . It also contributes to better child health outcomes, promoting healthier birth weights and increased child survival rates.

Read More: Can Menstrual Disorders Change Women’s Brains?

3. Promoting Women’s Empowerment

Family planning supports your empowerment by giving you control over your reproductive choices. This empowerment extends to pursuing education, careers, and personal aspirations, positively influencing your economic and social well-being.

Read More: How Parents Can Empower Their Daughters

4. Preventing STIs

Family planning services include information on safe sex practices and planned parenthood, helping you prevent sexually transmitted infections and promoting overall sexual health.

5. Economic Stability

By helping you plan and space pregnancies, family planning contributes to economic stability. Families can allocate resources effectively, and individuals can pursue educational and career opportunities, leading to improved economic outcomes.

Read More: How to Deal with Family Financial Problems? 10 Life-Saving Tips To Crush Your Financial Struggles

Family planning services are designed to empower you, promote your well-being, and contribute to the health and sustainability of your community by providing planned parenthood.

A Word From Mind Family

Family planning is not just a choice but a personal journey that empowers you to shape the course of your life. With an array of options available for what is family planning, from contraceptives to fertility awareness methods.

Using these methods for what is family planning you can tailor your approach to align with your unique aspirations and health needs. Now, when it comes to picking the best way for you, it’s all about what fits your life. Each method has its perks, so it’s a personal choice.

Learning the ABCs of natural family planning involves understanding your body’s fertility cues and maintaining consistency in monitoring.

However, the effectiveness relies on accurate instruction, emphasizing the importance of seeking guidance from qualified professionals or family planning services.

These services are like your go-to guides. They offer info, support, and contraceptives. It’s all about planning for a future that’s just right for you and for your family!

Frequently Asked Questions (FAQs)

1. what is family planning.

Family planning is a personal journey empowering individuals to make informed decisions about their reproductive choices. It involves a range of options, including contraceptives and fertility awareness methods, allowing individuals to plan and shape the course of their family life.

2. Which is the best family planning method?

The best family planning method is a personal decision influenced by factors such as lifestyle, health considerations, and individual preferences. Options include barrier methods, short-acting hormonal methods, long-acting hormonal methods, sterilization, spermicide or vaginal gel, and natural family planning.

3. What is natural family planning?

Natural family planning, or fertility awareness, involves tracking signals in a woman’s menstrual cycle to understand when she’s most likely to become pregnant. When followed consistently and correctly, it can be up to 99% effective.

4. What are family planning services?

Family planning services are resources provided by healthcare professionals and organizations to help individuals make informed decisions about their reproductive health.

5. What are benefits of family planning services?

Family planning services offer several benefits, including reducing unintended pregnancies and improving maternal and child health outcomes. They empower individuals to make informed choices, promote women’s empowerment, provide information on safe sex practices.

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10 ways family dinners can bring harmony to your home.

In a society that moves rapidly, family dinners are often relegated to secondary status over busy schedules and digital diversions. Nevertheless, these communal meals could be powerful enough to restore and cement familial ties.

Aside from being simply satiating, they provide an invaluable chance for bonding purposes as well as communication. 

This article will highlight ten effective ways in which family dinners can act as healing agents that strengthen relationships, and deepen insight, empathy, and harmony in the family unit.

10 Forgotten Spiritual Truths About Raising Children Every Parent Must Know!

During parenting, we are usually told how to ensure that our children stay happy and healthy. However, sometimes we may fail to remember a very important thing: assisting our children in growing spiritually.

Learning about the spiritual truths about raising children is more than addressing their physical needs and ensuring they excel academically. It implies imparting knowledge to them concerning significant values and beliefs that give them a sense of belonging to something greater than what is ordinary.

This article will discuss ten major spiritual truths about raising children every parent should know. Let’s dive into it and understand how we can be better spiritual parents together.

What Is Spiritual Parenting? 

8 effective ways to deal with toxic family dynamics.

Common perception of family is regarded as love, support, and belonging. 

However, for some people, family dynamics are filled with tension, conflict, and emotional suffering. These can take the form of constant criticism and manipulation to emotional abuse and control.

This guide will cover signs of toxic family dynamics; how they can affect mental health; and what you should do about them – all backed up by useful strategies that work.

If you want to understand your difficult attachments better or just need someone else to validate what happened during Christmas dinner last year… You’ve come to the right place!

What Are Toxic Family Dynamics? 

7 warning signs of toxic grandparents and how to deal with them.

Multiple reasons can cause toxic relationships between grandparents and grandchildren: for example, stress on the children when around their grandparents or failure to create a safe space for their kids. 

Even though all toxic grandparents may at times make their adult children upset, things become worse if they do not respect limits or let past experiences of parenthood overshadow what should be happening within present-day families.

Drawing on vast life experience, grandmothers and grandfathers may unintentionally undervalue views held by their grown-up sons and daughters whom they think they know better than anybody else since once upon a time they were also parents themselves.

This post w

10 Helpful and Timeless Parenting Advice From The Past!

Traditional parenting is already on the path of modernity. The parenting rules and regulations that trickle down from older generations are no longer being followed by parents, who disagree with them. However, there are timeless parenting advice from the past still resonate. 

In modern parenting, culture and tradition have taken a backseat; instead, social media trends are leading this generation of parents. Although every style has its strengths and weaknesses, those with a grip on traditional values will always matter most.

Here are seven timeless pieces of advice about raising children that I’ve found useful over time — some from my own experience as a parent, others gathered from people who’ve raised smart, successful and caring kids themselves.

8 Positive Qualities of Healthy Modern Families You Should Embrace!

What does modern families need in order to succeed? According to statistics, things don’t look good for the average American household. We’re constantly bombarded with stories of divorce, delinquency, infidelity, “broken homes”… sometimes even physical and emotional abuse.

There are many definitions of happy modern families; however, most sociologists and family therapists can agree upon certain key points that distinguish successful families from unsuccessful ones.

The qualities listed below are among those considered most important for healthy family life by experts. The roster is not intended to be exhaustive or all-inclusive. Many families will lack some of these traits – but they may still serve as useful guides toward which families could stri

10 Characteristics Of A Role Model Parent You Should Know!

In the journey of parenting, there is the role model parent who acts as a guide and inspiration not only to their children but also to society at large. Being real, understanding, and upright creates space for kids to become strong-willed individuals with empathy toward others in the future. 

Let us think about exemplary parenting today in terms of what it means going forward tomorrow. We must therefore endeavor to be such parents as our kids require us to be so that they can pass on love, compassion, and resilience throughout many ages still unborn.

As we travel along this path called being parents from my family end yours; let it be filled with happiness, knowledge, and countless chances for igniting greatness into the hearts of those little ones who call us mom or dad.

Family Planning: Dreams and Realities

How to talk about your plans, and stay loose with what comes..

Posted October 18, 2021 | Reviewed by Devon Frye

• During family planning, preparing a "Plan B" and "Plan C" can help if your first choice (Plan A) doesn’t happen.
• Infertility is one of many common conditions that can be othering. Talking to a doctor about infertility can reduce stigma and secure treatment.
• Families come in all shapes and sizes. There is no wrong way to make a family.

There are few things that create greater expectations than the idea of starting a family. When we think of having or adopting a child for the first time, we all have our own set of expectations of what that will look like for our partners and ourselves. We tend to default to a perfectly smooth process, with a happy and healthy baby and couple at the end of the journey. While this can and most likely will happen for many, there are grittier realities that we must consider and talk about with our partners before we get started.

Make a Plan A, B, and C

It’s not fun and may make someone feel like a wet blanket to consider and envision the “What could go wrong?" scenarios, and that is not the aim of this article. Rather, the goal of having the conversation about the “what if’s” is not to sow fear , but to approach a life-changing event with caution and mental preparedness so that in the event that things do stray from plan A, there is a plan B or plan C waiting in the wings.

For couples whose plan A is to have a child biologically, once you get on the same page that this is the avenue you would like to go down, it is not a bad idea to start the doctor appointments early.

At the end of the day, pregnancy is a medical process and medical knowledge and preparation can only better prepare you for a positive outcome. For couples attempting to have a child biologically, consider going to your OB-GYN when you plan to start trying to get an initial checkup. Most OB-GYNs offer pre-conception counseling and fertility evaluations to couples just getting started to make sure everything is set up for conception.

This is an easy, quick, and painless way to get things started on the right footing.

Why You Should Talk About Timelines

Another thing to discuss with your partner is timelines. Hopefully, you and your partner have already discussed timelines on when to try for a child, but the discussions do not need to end there. Talk with each other about how long you and your partner plan to actively try before seeking fertility help. Getting on the same page about this now will prevent fights in the future when emotions will already be running high.

Infertility and Other Factors

Ask your doctor about fertility and infertility . Infertility (defined as being unable to get pregnant after one year of trying) affects about 6 percent of married women aged 15 to 44 years in the United States. Additionally, 12 percent of women in that same age group have difficulty getting pregnant and carrying the pregnancy to term.

Sadly, these topics are still taboo and not often discussed as normal occurrences for many women. The concept of infertility is still very “othering” for women who experience it, in large part because the media doesn’t normalize it as it should; instead, most media normalizes un-aided pregnancy as normal, leaving many women feeling left out and insecure.

But not only is infertility, miscarriage , and child loss common, but one of the leading causes of it, PCOS, isn’t usually discovered in women until they are trying to conceive and have difficulty conceiving. PCOS, a condition that can lead to fertility issues affects between 6 to 12 percent of women.

For comparison, Toyota cars currently make up around 13 percent of the U.S. car market. The vast majority of people know, see, or own a Toyota. They are far from a niche or an exception in the automotive industry. PCOS is the Toyota of fertility issues and deserves more attention and awareness as an issue that many women face.

Car talk aside—because this is a reality for many many women, in your own relationship, have the conversation with your partner about what your plan would be if you do want children biologically and need help making that happen.

Research Your Options

Set times, and dates, and plans. Do research. What options would you be willing to try? What options would you not be willing to try? Research different areas of family planning such as IVF, IUI, fostering, adoption , surrogacy, etc. (This is another reason that it’s important to talk to your doctor early!)

One couple that had their first child through IVF stated that they wished they had done a workup right at the beginning. They had tried for two years without success, and only then did they go to the doctor, and only then did they find out that IVF would be their best chance at conceiving. Now they are proponents of early screening and fertility checks at the beginning of the journey of trying to have children.

If biological children are not in your family’s plan, then discuss and research your options of fostering, adopting, or surrogacy. What do you and your partner feel comfortable with? What roles do each of you want to take in that process? What are your budgets and timelines?

Remember: You Are Not Alone

If you and your partner run into difficulties in getting pregnant or having a child, there will absolutely be disappointment. No one who plans wants to see that plan changed. Yet if you and your partner have established a framework of how to talk about that disappointment and how to process and feel those feelings while staying actively engaged in your journey, then in the disappointment there will also be sober-mindedness to help to cushion what may be a painful fall.

Ultimately, families come in all shapes and sizes—and just as there is nothing wrong with having a vision of what your ideal family plan will be, there is nothing wrong with finding joy in another outcome. Your family is your family, and the love that will grow in that family is nothing less just because it doesn’t look like someone else’s.

Centers for Disease Control and Prevention (2021). Infertility FAQs. CDC.gov. https://www.cdc.gov/reproductivehealth/infertility/index.htm#:~:text=Ye… .

Centers for Disease Control and Prevention (2021). PCOS (Polycystic Ovary Syndrome) and Diabetes. CDC.gov. https://www.cdc.gov/diabetes/basics/pcos.html

Cox Automotive. (2021). Cox Automotive Analysis: Toyota Quarterly U.S. Market Performance. https://www.coxautoinc.com/market-insights/cox-automotive-analysis-toyo…

Stephanie Cox, MS is a Licensed Mental Health Counselor in Florida specializing in therapy with children, families, and adults with mild to severe mental health and relational issues.

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At any moment, someone’s aggravating behavior or our own bad luck can set us off on an emotional spiral that threatens to derail our entire day. Here’s how we can face our triggers with less reactivity so that we can get on with our lives.

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Family Planning - Essay Samples And Topic Ideas For Free

Family planning involves the ability of individuals and couples to anticipate and attain their desired number of children and the spacing and timing of their births. Essays on family planning could explore the range of family planning methods, the benefits of family planning for individuals, families, and communities, and the barriers to access and utilization of family planning services. Moreover, discussions might delve into the role of governmental and non-governmental organizations in promoting family planning, the impact of cultural and religious beliefs on family planning practices, and the correlation between family planning and socio-economic development. Analyzing case studies of successful family planning initiatives and exploring the challenges in different cultural and regional contexts can provide a nuanced understanding of this crucial health and societal issue. We’ve gathered an extensive assortment of free essay samples on the topic of Family Planning you can find at Papersowl. You can use our samples for inspiration to write your own essay, research paper, or just to explore a new topic for yourself.

Health Care Policy Analysis

Introduction Women’s reproductive rights have been an ongoing issue the United States has dealt with for decades. The main issues surrounding women’s rights, namely the woman’s right to choose, has been debated and politicized, often times with out the actual input from a woman. This policy analysis will examine the relationship between politicizing the reproductive rights of women coupled with the rights of employers to refuse coverage for birth control and the policies surrounding these issues. In 2018, Federal policy […]

An Issue of Women’s Reproductive Rights

We hold these truths to be self-evident: that men and women are created equal (Elizabeth Cady Stanton). In America this has been the basis of what our nation stands for. It is stated that every citizen has the right to equality that shall not be stripped away, in many cases that is not true. Whether man or women you should possess the same rights, but more often than not the women's rights are taken away. There are many instances in […]

Abortion Issue: Saving a Life

Abortion is a topic that is a controversial issues in the United States today. Abortion is the removal of an embryo from the female's uterus resulting to the end of pregnancy (dictionary.com). Weather abortion is legal or not women around the world have tried to end their pregnancies. Women having an abortion are jeporadizing their safety and health by self inducing or seeking illegal product. This procedure is done by a licensed healthcare professional. The procedure is done by a […]

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The Morality of Birth Control

American Educator, birth control activist, sex educator, writer, and nurse Margaret Sanger has written numerous pieces about women empowering. One of her most popular speeches, "The Morality of Birth Control," is intended for women and America as a nation. It is spoken for women that feel like they have no way out of the risks of sex, including pregnancy. It can also be intended for men, in order to be aware of what women go through and that they will […]

Should Birth Control be Free?

Family planning is used by 57 percent of married or in-union women of reproductive age according to a study conducted in 2015 by the United Nations. This displays the impact that contraceptives have worldwide and creates a question of equality within health care, "Is birth control a fundamental right or a privilege?" Even though the use of birth control is increasing, a study by the UN estimates that over 214 million women are not using safe and effective family planning […]

Why we Still Need Feminism

Many people think that with how far we gotten in certain aspects that we no longer need feminism but not all women are blessed with these opportunities, many people forget about women in other countries that aren't as progressive like the United states and Canada. There are still societal issues within the modern age. Many people who feel like feminism is no longer needed forgot about women in other countries, those are the women who need it the most because […]

Abortion and Adoption

Abortion is not as simple as walking into a medical office and having the procedure performed. Although Roe v. Wade made abortion legal in the United States in 1973 women often have to deal with judgment from others including not only protestors but significant others and family members, choosing between abortion and adoption, emotional stress possibly from the reason they are needing an abortion, physical complications, as well as state governments trying to take away their right to have an […]

What would it be Like to Brutally Kill Something that is so Small, Young and so Fragile?

Now you must be think that no one would do it but have you ever heard of abortion? Abortion is an induced termination of pregnancy before the fetus has developed in the womb. The spontaneous abortion is miscarriage but the induced abortion has become a controversial issue, because it involves voluntary decision to terminate the pregnancy. According to WHO statistics, the risk rate for unsafe abortion is 1/270; although according to other sources, it is responsible for at least 8% […]

One to Two Lines: Decoding Birth Control Effectiveness and Choices

Abstract This paper illustrates the different types of contraceptives available to the public. We studied each type of birth control and show the reader which method best suits their needs for protection. Throughout this paper, we cover the pros and cons of each birth control measure to give the reader a comprehensive understanding of each method. This paper discusses contraceptives available for both men and women. STDs, teenage pregnancy, and hormonal imbalances can be common if birth control is used […]

A Minor’s Decision

A Minor’s DecisionIf a minor can make the decision to have sex, then they should be able to be allowed to make their own decision concerning the use of birth control. It is your own body, so only you can decide what happens to it. Even though it’s your child, the parents shouldn’t have a say in whether they want birth control or not because it’s not their decision. A minor can choose to discuss it with their parents if […]

The Necessity of Banning Abortion: Health Risks and Side Effects

According to the World Health Organization, “every year in the world there are an estimated 40-50 million abortions.” A lot of women get abortions because they are way too young to have a baby, think they will not be able to provide for their kid, or they may have been raped. There are so many reasons on why people decide to abort their child, but I personally do not think abortion should be allowed. Women think having abortions is an […]

“The Desire for Parents”

“The desire for parents to be involved in important decisions in their children’s ` lives are understandable, however parental protectiveness could trump a person’s right to her own body and her own future.” (Valenti, 2016). According to Merriam-Webster, abortions are the termination of a pregnancy after accompanied by, resulting in, or closely followed by the death of the embryo or fetus. In most scenarios, women undergo this procedure because they were not financially stable, or experienced sexual harassment in their […]

Overpopulation and Climate Change

In the article Overpopulation and Climate Change Arthur H. Westing tells us that the in 1970, the greenhouse gas emission was beyond the sustainability level of the atmosphere and at that time the worlds population was 3.7 million and today it is 6.9 million. In the mean time emission from fossil fuel increased from 14 billion tons to 29 billion tons. Despite the growing awareness of climate change. In the article, Arthur H. Westing gives us the idea to divide […]

Abortion is an Exceptionally Touchy Issue

Abortion is an exceptionally touchy issue. Numerous individuals are continually discussing whether abortion should be permitted or not. Pro-life and Pro-choice has been a controversial topic since the early 1820s. A few people think fetus removal is extremely terrible and that it should not be permitted by any means. Although I may not personally participate in abortion,I believe that abortion should be a women’s choice with her body because, America is over populated and underfunded, she knows what type of […]

Birth Control in Many Different Forms

According to HHS.gov, every year out of 100 women using birth control, only about 5 to 9 may become pregnant due to not using birth control correctly. Around 1960, the first oral contraceptive known as Enovid, was approved by U.S. Food and Drug Administration (FDA) as a use of contraception. (Thompson). In 1968, the FDA approved intrauterine devices (IUDs). (Thompson). In 1972, the Supreme Court legalized birth control for all citizens of the U.S. (Thompson). In the 1980s, pills with […]

6 Million Americans Looking to Adopt Kids

6 million americans looking to adopt kids out of about 318.6 million that were in the US at the time.There is even a law that is “a guarantee of certain areas or zones of privacy”,and that is written in the US constitution it means we shouldn't make a law that limits a woman's choices it would completely go against the constitution basic principles of life,liberty and the pursuit of happiness,but if your ok with breaking the rule book for our […]

We should not Kill Children

Abortion is killing an embryo while it’s still in its mother's womb. When you have an abortion, it’s just taking the life away from someone who didn’t have a choice. It’s murder, which is against the law. Abortion can even affect the mother later on. Also, so many couples who can’t have a child are just waiting to adopt one. Some people may say that you have a choice if you want to have the child or not. But unless […]

Prevention of Sexually Transmitted Diseases

In my paper, it states that in almost every state within the United States many sexually active teenagers are able to get different types of contraceptives to help protect themselves against many different sexually transmitted diseases and having an unplanned teen pregnancy and they do not need their parent's consent to obtain them. I also state that lawmakers within these states want to take away teens right to protect themselves but imposing laws that teenagers need to get parents consent […]

Why Birth Control is Important: Addressing Teen Pregnancy and STD Rates

The United States ranks first in high teen pregnancy rates and sexually transmitted diseases. Since 2011, 400,000 girls between the age of 15-19 years old have given birth every year (Stanger-Hall, and Hall). So why is nothing being done about it? Why is the government putting these programs that are not helping the statistics go down in place? The Controversy of Abstinence-Only Education While some may argue abstinence-only education is the best way to keep teens and even middle schoolers […]

Teen Pregnancy

Abstract: Teen pregnancy is a growing issue. For one, in some cases, it has become normalized by society to not only engage in sexual acts at a younger age. Even though some individuals may receive scrutiny over their early pregnancy, on a grand scale, it isn’t scrutinized enough. What adds to the complacency over this situation is the fact that teenage pregnancy has tremendously declined from generations prior. With this, the general public feels as if it is not that […]

Blended Families: a Modern Twist on Family Life

Imagine a family tree that looks more like a bush – sprawling, intertwined, and full of surprises. Welcome to the world of blended families, a colorful and complex tapestry of modern family life. Gone are the days when a family was just parents and their biological children. Today, the definition of family has stretched to include step-siblings, half-siblings, stepparents – a whole new crew under one roof, each with their own stories and backgrounds. First off, let’s break down what […]

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Essay about Family: What It Is and How to Nail It

Humans naturally seek belonging within families, finding comfort in knowing someone always cares. Yet, families can also stir up insecurities and mental health struggles.

Family dynamics continue to intrigue researchers across different fields. Every year, new studies explore how these relationships shape our minds and emotions.

In this article, our dissertation service will guide you through writing a family essay. You can also dive into our list of topics for inspiration and explore some standout examples to spark your creativity.

What is Family Essay

A family essay takes a close look at the bonds and experiences within families. It's a common academic assignment, especially in subjects like sociology, psychology, and literature.

So, what's involved exactly? Simply put, it's an exploration of what family signifies to you. You might reflect on cherished family memories or contemplate the portrayal of families in various media.

What sets a family essay apart is its personal touch. It allows you to express your own thoughts and experiences. Moreover, it's versatile – you can analyze family dynamics, reminisce about family customs, or explore other facets of familial life.

If you're feeling uncertain about how to write an essay about family, don't worry; you can explore different perspectives and select topics that resonate with various aspects of family life.

Tips For Writing An Essay On Family Topics

A family essay typically follows a free-form style, unless specified otherwise, and adheres to the classic 5-paragraph structure. As you jot down your thoughts, aim to infuse your essay with inspiration and the essence of creative writing, unless your family essay topics lean towards complexity or science.

Here are some easy-to-follow tips from our essay service experts:

• Focus on a Specific Aspect: Instead of a broad overview, delve into a specific angle that piques your interest, such as exploring how birth order influences sibling dynamics or examining the evolving role of grandparents in modern families.
• Share Personal Anecdotes: Start your family essay introduction with a personal touch by sharing stories from your own experiences. Whether it's about a favorite tradition, a special trip, or a tough time, these stories make your writing more interesting.
• Use Real-life Examples: Illustrate your points with concrete examples or anecdotes. Draw from sources like movies, books, historical events, or personal interviews to bring your ideas to life.
• Explore Cultural Diversity: Consider the diverse array of family structures across different cultures. Compare traditional values, extended family systems, or the unique hurdles faced by multicultural families.
• Take a Stance: Engage with contentious topics such as homeschooling, reproductive technologies, or governmental policies impacting families. Ensure your arguments are supported by solid evidence.
• Delve into Psychology: Explore the psychological underpinnings of family dynamics, touching on concepts like attachment theory, childhood trauma, or patterns of dysfunction within families.
• Emphasize Positivity: Share uplifting stories of families overcoming adversity or discuss strategies for nurturing strong, supportive family bonds.
• Offer Practical Solutions: Wrap up your essay by proposing actionable solutions to common family challenges, such as fostering better communication, achieving work-life balance, or advocating for family-friendly policies.

Family Essay Topics

When it comes to writing, essay topics about family are often considered easier because we're intimately familiar with our own families. The more you understand about your family dynamics, traditions, and experiences, the clearer your ideas become.

If you're feeling uninspired or unsure of where to start, don't worry! Below, we have compiled a list of good family essay topics to help get your creative juices flowing. Whether you're assigned this type of essay or simply want to explore the topic, these suggestions from our history essay writer are tailored to spark your imagination and prompt meaningful reflection on different aspects of family life.

So, take a moment to peruse the list. Choose the essay topics about family that resonate most with you. Then, dive in and start exploring your family's stories, traditions, and connections through your writing.

• Supporting Family Through Tough Times
• Staying Connected with Relatives
• Empathy and Compassion in Family Life
• Strengthening Bonds Through Family Gatherings
• Quality Time with Family: How Vital Is It?
• Navigating Family Relationships Across Generations
• Learning Kindness and Generosity in a Large Family
• Communication in Healthy Family Dynamics
• Forgiveness in Family Conflict Resolution
• Building Trust Among Extended Family
• Defining Family in Today's World
• Understanding Nuclear Family: Various Views and Cultural Differences
• Understanding Family Dynamics: Relationships Within the Family Unit
• What Defines a Family Member?
• Modernizing the Nuclear Family Concept
• Exploring Shared Beliefs Among Family Members
• Evolution of the Concept of Family Love Over Time
• Examining Family Expectations
• Modern Standards and the Idea of an Ideal Family
• Life Experiences and Perceptions of Family Life
• Genetics and Extended Family Connections
• Utilizing Family Trees for Ancestral Links
• The Role of Younger Siblings in Family Dynamics
• Tracing Family History Through Oral Tradition and Genealogy
• Tracing Family Values Through Your Family Tree
• Exploring Your Elder Sister's Legacy in the Family Tree
• Connecting Daily Habits to Family History
• Documenting and Preserving Your Family's Legacy
• Navigating Online Records and DNA Testing for Family History
• Tradition as a Tool for Family Resilience
• Involving Family in Daily Life to Maintain Traditions
• Creating New Traditions for a Small Family
• The Role of Traditions in Family Happiness
• Family Recipes and Bonding at House Parties
• Quality Time: The Secret Tradition for Family Happiness
• The Joy of Cousins Visiting for Christmas
• Including Family in Birthday Celebrations
• Balancing Traditions and Unconditional Love
• Building Family Bonds Through Traditions

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Family Essay Example

For a better grasp of the essay on family, our team of skilled writers has crafted a great example. It looks into the subject matter, allowing you to explore and understand the intricacies involved in creating compelling family essays. So, check out our meticulously crafted sample to discover how to craft essays that are not only well-written but also thought-provoking and impactful.

Final Outlook

In wrapping up, let's remember: a family essay gives students a chance to showcase their academic skills and creativity by sharing personal stories. However, it's important to stick to academic standards when writing about these topics. We hope our list of topics sparked your creativity and got you on your way to a reflective journey. And if you hit a rough patch, you can just ask us to ' do my essay for me ' for top-notch results!

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FAQs on Writing an Essay about Family

Family essays seem like something school children could be assigned at elementary schools, but family is no less important than climate change for our society today, and therefore it is one of the most central research themes.

Below you will find a list of frequently asked questions on family-related topics. Before you conduct research, scroll through them and find out how to write an essay about your family.

How to Write an Essay About Your Family History?

How to write an essay about a family member, how to write an essay about family and roots, how to write an essay about the importance of family.

Daniel Parker

is a seasoned educational writer focusing on scholarship guidance, research papers, and various forms of academic essays including reflective and narrative essays. His expertise also extends to detailed case studies. A scholar with a background in English Literature and Education, Daniel’s work on EssayPro blog aims to support students in achieving academic excellence and securing scholarships. His hobbies include reading classic literature and participating in academic forums.

is an expert in nursing and healthcare, with a strong background in history, law, and literature. Holding advanced degrees in nursing and public health, his analytical approach and comprehensive knowledge help students navigate complex topics. On EssayPro blog, Adam provides insightful articles on everything from historical analysis to the intricacies of healthcare policies. In his downtime, he enjoys historical documentaries and volunteering at local clinics.

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Essay on Family Planning in India for Students and Children

500 words essay on family planning.

Essay on Family Planning in India – India is the first country of the developing nations that initiated a state-supported family planning program. Furthermore, this type of program is a must if you look at the population of a country like India. Also, the statistics show a great rise in the population throughout the decades.

In addition, India is the second-largest population of the world with a population of more than 1.3 billion. Furthermore, national fertility is also quite high and every 20 days the population rise by 1 million people.

Moreover, according to the statistician of the U.N (United Nations), the population of India will exceed the population of China by the year 2028.

Most noteworthy, the Indian government recognized this problem and initiated a family planning measure some time ago to control this problem.

History of Family Planning

Raghunath Dhondo Karve is the person who recognized this problem first place. He also recognizes the need for population control. Furthermore, he publishes a magazine named Samaj Swasthya from 1927 to 1953, in which he debated that the best way to serve the society is by controlling the population through means of contraceptive measure.

Furthermore, Karve urged the Indian government to take initiative and steps to control the population by the control program, an attempt which was stopped by Mahatma Gandhi on the ground that people should practice self-control rather than depending on birth control.

Moreover, by 1951, it has become clear to the Indian government that family planning was becoming increasingly urgent to face the fast-growing population . After that, the government decided to create a state-sponsored family planning program in all the states of the country.

In addition, the government put a five-year plan into place; these plans focus on the economic restructuring and growth of the country. But, I 1971 the Prime Minister of India put a forced sterilization policy into place in the country.

However, the program was meant to sterile only those who have two or more children. But, the program ended up sterilizing many unmarried and people who politically opposed the regime.

Moreover, by the time the new government came into power the damage has been already done and people started to see family planning with hatred. That’s why the government shifts its focus from men to a birth control method for women.

Family Planning in Recent Years

The measure to control the birth control method for women not unsuccessful. Furthermore, from 1965 to 2009, the use of contraceptives in women increased from 13 percent to 48 percent. In addition, the fertility rate also goes down from 5.7 percent to 2.4 during the year 1966 to 2012.

Moreover, many states adopted policies that prohibit a person who has more than two children to apply for a government job.

To sum it up, India has come a long way in practicing birth control but still has a long way to go. Moreover, most of the women are aware of the birth control measure, but they cite difficulty in getting access to these measures.

Also, the traditional mindset of most of the Indians related to children also doesn’t help either. Besides, the decreased fertility rate has gone down but it isn’t enough to control the population explosion.

However, India needs to more than just birth control to stop this problem.

FAQs about Essay on Family Planning in India

Q.1 Name the person who first recognizes the importance of birth control in India. A.1 Raghunath Dhondo Karve is the person who recognizes this problem. He also published it in his magazine.

Q.2 What is birth control? A.2 Birth control is a practice by which the birth rate of children is controlled.

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How to plan an essay: Essay Planning

• What's in this guide
• Essay Planning
• Additional resources

How to plan an essay

Essay planning is an important step in academic essay writing.

Proper planning helps you write your essay faster, and focus more on the exact question.  As you draft and write your essay, record any changes on the plan as well as in the essay itself, so they develop side by side.

One way to start planning an essay is with a ‘box plan’.

First, decide how many stages you want in your argument – how many important points do you want to make? Then, divide a box into an introduction + one paragraph for each stage + a conclusion.

Next, figure out how many words per paragraph you'll need.

Usually, the introduction and conclusion are each about 10% of the word count. This leaves about 80% of the word count for the body - for your real argument. Find how many words that is, and divide it by the number of body paragraphs you want. That tells you about how many words each paragraph can have.

Remember, each body paragraph discusses one main point, so make sure each paragraph's long enough to discuss the point properly (flexible, but usually at least 150 words).

For example, say the assignment is

Fill in the table as follows:

Next, record each paragraph's main argument, as either a heading or  topic sentence (a sentence to start that paragraph, to immediately make its point clear).

Finally, use dot points to list useful information or ideas from your research notes for each paragraph. Remember to include references so you can connect each point to your reading.

The other useful document for essay planning is the marking rubric .

This indicates what the lecturer is looking for, and helps you make sure all the necessary elements are there.

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What works in family planning interventions: A systematic review of the evidence

Lisa mwaikambo.

1 Center for Communication Programs, Johns Hopkins University Bloomberg School of Public Health

Ilene S. Speizer

2 Carolina Population Center and Department of Maternal and Child Health, University of North Carolina at Chapel Hill Gillings School of Global Public Health

Anna Schurmann

3 Sukshema Project, Karnataka Health Promotion Trust/Intrahealth

Gwen Morgan

4 African Population and Health Research Center, Nairobi, Kenya

Fariyal Fikree

5 Independent Consultant, Global Health, Washington DC

This study presents findings from a systematic review of evaluations of family planning interventions published between 1995 and 2008. Studies that used an experimental or quasi-experimental design or had another way to attribute program exposure to observed changes in fertility or family planning outcomes at the individual or population levels were included and ranked by strength of evidence. A total of 63 studies were found that met the inclusion criteria. The findings from this review are summarized in tabular format by the type of intervention (classified as supply-side or demand-side). About two-thirds of the studies found were on demand generation type-programs. Findings from all programs revealed significant improvements in knowledge, attitudes, discussion, and intentions. Program impacts on contraceptive use and use of family planning services were less consistently found and less than half of the studies that measured fertility or pregnancy-related outcomes found an impact. Based on the review findings, we identify promising programmatic approaches and propose directions for future evaluation research of family planning interventions.

By the early 1970s, international efforts to reduce rapid population growth in the developing world were well advanced. The vast majority of countries adopted voluntary family planning programs, which in most cases were part of their maternal and child health or primary health care systems ( Sinding 2007 ). A golden era of family planning from 1970 to 1990—during which a reproductive revolution occurred in every region of the world except sub-Saharan Africa—was underway ( Donaldson 1990 ; Donaldson and Tsui 1990 ).

Between the mid-1960s and the mid-1990s, average fertility in the developing world, including China, fell from around six children per woman over her reproductive lifetime to around three, a 50 percent decline. During the same period, the prevalence of contraceptive use among women increased from less than 10 percent to nearly 60 percent, but the rise was uneven ( Sinding 2007 ).

Despite decades of research on the subject, considerable uncertainty exists about the processes and factors that motivate couples to limit their family size; this is related to variations in the adoption of birth control in different societies at different times ( Bongaart et al. 1990 ). There is general agreement that socioeconomic development and organized family planning programs both play significant roles in bringing about changes in reproductive behavior; however identifying independent effects of family planning programs proves more difficult (see United Nations 1979 , 1986 , and Lloyd and Ross 1989 for a review of this work).

Lapham and Mauldin (1985) showed that it is the combination of improved socioeconomic conditions and greater family planning program effort that leads to the strongest associations with increased use of contraception. These findings were used to demonstrate to economic and social development policymakers that consideration of ways to initiate or improve family planning delivery systems should be an integral part of any development strategy.

Family planning programs have varied widely in their emphasis on demand generation activities and supply-side activities such as increasing contraceptive method choice and using varying service delivery approaches. Despite such differences in their characteristics, Bongaarts, Mauldin, and Phillips (1990) outline certain key issues that are relevant for strengthening program performance in a variety of settings:

• Passive clinical approaches are less successful than programs that make services available to couples in their villages and home.
• The quality of services is a crucial but often neglected element of programs; this entails choice among a number of methods, to be well informed about alternative methods, to have competent and caring providers of services, to have follow-up exchanges with knowledgeable program staff.
• No single formula for program design suits all needs. It is imperative to develop culturally appropriate, sensitive approaches and monitor and adjust programs as a result of lessons learned.
• Political support for family planning is often critical to establishing strong program effort.

The Matlab Project from rural Bangladesh exemplifies the importance and ultimate success of taking into account all of the above mentioned issues. It is one of the most well-documented experimental projects on family planning in developing countries as a result of the Demographic Surveillance System (DSS) developed by the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B). The experimental design of Matlab has allowed researchers to examine the differences between the special services invested in the treatment areas against the standard government services provided in the comparison areas. These areas are similar culturally and socioeconomically allowing researchers to conclude that the Matlab Project has succeeded in raising contraceptive prevalence and reducing child mortality substantially even in an environment that is economically and socially unfavorable to these developments ( Nag 1992 ).

The longitudinal, experimental study design of Matlab has allowed researchers to study a variety of inputs and outcomes as a result of the interventions. The very nature of the study design allows researchers to draw conclusions on cause and effect. Unfortunately, this is not always the case in public health research. Although randomized controlled trials are the gold standard, a number of real-world issues are encountered that often prevent the use of randomized trials in public health research; these include feasibility and ethical concerns among others. Randomized controlled trials are “primarily a vehicle for evaluating biomedical interventions, rather than strategies to change human behavior. Altering the norms and behaviors of social groups can sometimes take considerable time….” ( Global HIV Prevention Working Group, 2008 ).

From the available evidence that varies in strength, Bongaarts, Mauldin, and Phillips (1990) estimated that without the effects of family planning programs in the 1970s-1980s, fertility in developing countries would have been 5.4 births per women during 1980 to 1985 rather than the actual 4.2. These program effects reflect the buildup of program strength over the preceding years. Ironically, this success, in combination with increased attention to the AIDS epidemic, has led to reduced funding for contraceptive research and most importantly, investment in family planning services in the mid-1990s ( UN Population Fund 2005 ). And, despite the positive effects that family planning programs have had, in much of the developing world and particularly in sub-Saharan Africa, fertility remains well above the level observed in the developed world, where women average about two births.

INTRODUCTION

Worldwide, there is a large and empirically verified demand for family planning services to space or limit childbearing. Currently, about 201 million women have an unmet need for modern contraception ( PRB 2008 ), that is, they are sexually active, they want to delay or stop childbearing, and are not using a modern method of contraception. Notably, more than 80 million mistimed or unwanted pregnancies (unintended pregnancies) occur each year worldwide, contributing to high rates of induced abortions, maternal morbidity and mortality, and infant mortality ( Cleland et al. 2006 ). Furthermore, family planning has been found to be an essential approach for countries to achieve their Millennium Development Goals (MDGs), particularly goals four and five for improved child and maternal health outcomes ( Cleland et al. 2006 ; Potts and Fotso 2007 ; Allen 2007 ; Moreland 2006 ). Family planning is a cost-effective public health and development intervention. The cost of averting unwanted births is miniscule compared to the costs to the family and country of unwanted births ( Cleland et al. 2006 ). Few public health interventions are as effective as family planning programs at reducing the mortality and morbidity of mothers and infants and have such a breadth of positive impacts ( Cleland et al. 2006 ; Bongaarts et al. 2009 ).

In the 1970s-1980s, family planning programs were on the rise, leading to important impacts on increasing voluntary family planning use and reducing fertility in many parts of the world. During this same period, numerous family planning program evaluations were undertaken to demonstrate the impact of demand generation and service delivery improvements on contraceptive use and fertility-related outcomes ( Bauman, Viadro, Tsui 1994 ; Samara, Buckner, Tsui 1996 ; Cuca and Pierce 1977 ). Evaluations undertaken in this period included small-scale evaluation efforts to test novel service delivery approaches as well as evaluations of community- and national-level mass media, community-based delivery, and policy change initiatives ( Samara, Buckner, Tsui 1996 ). The family planning evaluations used varying study designs, especially in terms of the outcomes measured, the assumptions required, and the strength of the conclusions ( Bertrand, Magnani, Rutenberg 1996 ). The more rigorous family planning evaluations used randomized experiments (experimental designs), quasi-experiments, and multilevel regression methods. Notably, examining the period through the end of 1992, Bauman (1997) found sixteen family planning evaluations that were considered to be randomized experiments (i.e., random assignment of individuals or groups). Thus, while many authors at the time acknowledged the difficulties in undertaking randomized experiments of family planning programs ( Cuca and Pierce 1977 ), Bauman’s analysis demonstrated that this was not impossible. That said, even the most widely recognized family planning evaluation, the Matlab study mentioned above, did not randomly assign participating villages; a strong advantage of Matlab, however, was the use of longitudinal data and multivariate analyses to demonstrate program impacts.

Although significant gains have been made since the 1970s, the potential benefits of family planning programs have not been realized for millions of women ( Cleland et al. 2006 ). To revitalize political will and funding for a new era in the promotion of family planning and reproductive health (FP/RH) services, robust evidence-based strategies must continue to demonstrate research-driven best practices and outline the logistics of implementation. A recent report by the Center for Global Development (CGD) Evaluation Gap Working Group concluded that missed opportunities for the collection and analysis of program impacts have led to continued funding of ineffective and inefficient programs ( William 2006 ). Impact evaluation studies are imperative in providing critical evidence to decision makers on how to effectively spend scarce resources. As a result, the objective of this review is to provide an update on family planning program effectiveness since 1994 when there was less attention and funding for family planning programs. In particular, we a) synthesize recent research on family planning program effectiveness, focusing on experimental and quasi-experimental impact evaluation studies; b) discuss program approaches that are successful (and those that are less successful); c) identify gaps in family planning evaluation research; and d) recommend future research and evaluation directions.

METHODOLOGY

We undertook a systematic search of journal databases for peer-reviewed articles as well as a companion search of gray literature through funder clearinghouse websites, project websites, and correspondence. In addition, we utilized a ‘snowball’ sampling approach through searching the reference lists of identified articles. The search strategy included word combinations that incorporated evaluation or outcomes with the following terms: family planning, contraceptive use, child spacing, fertility, unmet need, maternal health, quality of care, private sector family planning services, adolescent pregnancy, unintended pregnancy, abortion, cost effectiveness, male involvement, breastfeeding and lactational amenorrhea method (LAM), and family planning/reproductive health policy.

The inclusion criteria for the review focused on studies of family planning interventions that took place in developing countries, assessed changes in outcomes that are directly attributable to a program (causality), and included the following family planning outcomes of interest: use of family planning services, knowledge and/or attitudes about family planning, discussions around family planning, intentions to use family planning, contraceptive use, unmet need, total fertility rate, unintended pregnancies, and abortion. These outcomes were selected as they provide both short-term and longer term perspectives of family planning program achievements. While the long-term outcomes (fertility, unintended pregnancies, and abortion) are the most important, few evaluations have a long enough follow-up period to observe changes at this level. Thus, using the short-term outcomes provides an understanding of whether programs are on track for achieving their intended impacts; a program that is unable to affect short-term outcomes is unlikely to have long-term impacts. The systematic search covered published and unpublished papers from 1995 to 2008.

Studies identified were categorized based on their study methodology as experimental designs, quasi-experimental designs, and non-experimental designs. Studies that included experimental designs, that is, the groups or individuals were randomly assigned and quasi-experimental designs with non-random assignment to groups were included in this review. Most of these studies used a pre-test and post-test study design or a panel/longitudinal design. A small number of included studies used a post-test only design with an appropriately defined comparison group. Finally, a few of the included studies were non-experimental and thus did not include a comparison group but were able to attribute changes in outcomes to program exposure through multivariate analyses.

The studies included in this review meet the above criteria; however, they still vary widely in strength of design and robustness of the findings. For this reason, we further ranked the studies by the methodological quality, creating a rating scale based on the strength of the research design, scope of the study (i.e., ability to generalize results), and the control of confounders and selection bias. As a result, three categories of strength of evidence emerged:

• High – This includes randomized cluster designs that included details on the randomization process and where necessary, controlled for differences in the small number of groups randomized. Also included in this category are studies that randomized individual-level participants; many of these often first randomized sites and then randomized participants within sites. A small number of studies met the high quality criteria by using a longitudinal design with a low loss to follow-up, a long follow-up period, and a comparison group (e.g., Matlab and Navrongo); most of these studies also controlled for differences in groups.
• Medium – Most of the studies in this category used a pre-post test with comparison group design that had a follow-up period of at least six months. All of the studies in this category controlled for possible selection bias between the groups through multivariate analyses. This category also included longitudinal studies without a control group and with low loss to follow-up as well as a small number of studies that used a randomized cluster design but either did not provide details on the randomization process and/or did not control for differences between the small number of intervention and control groups;
• Low – These studies were quasi-experimental designs that often included a pre-post test control group design with no control for differences between the groups and/or a very short follow-up period (e.g., <6 months). Also in this category are the post-test only comparison group design studies and the longitudinal studies with high loss to follow-up and no comparison group.

Two individuals (the first two authors) independently assessed the studies for inclusion and rated the studies according to the inclusion criteria and above rating scale. The majority of the studies in this review fall into the medium strength of evidence category.

No attempt was made to conduct a meta-analysis and reanalyze the data from the studies, as is done in the Cochrane Collaboration. As noted in the Cochrane Handbook for Systematic Reviews of Interventions , “Public health and health promotion interventions are broadly-defined activities that are evaluated using a wide variety of approaches and study designs. For some questions, the best available evidence may be from non-randomized studies” ( Armstrong R et al., 2008 ). Thus merging study designs and observations from multiple studies would not provide useful information to summarize the varying types of family planning program activities.

Search results (as of August 2009) yielded 225 studies that consisted of a family planning intervention. Of these, 63 studies met the above methodological criteria for rigor of evaluation. A number of studies were excluded due to their lack of multivariate analysis with non-randomized study designs, focus on reproductive health outcomes other than the family planning outcomes of interest (e.g., HIV prevention programs and youth programs focusing on delayed sexual debut and condom use), or being strictly operations research (e.g., feasibility and acceptability studies) that did not go on to examine population-based family planning and fertility outcomes. Notably, many of the operations research studies were undertaken as part of the FRONTIERS Project led by the Population Council and can be found on the Frontiers Legacy website ( http://www.popcouncil.org/publications/FRONTIERSLegacy/index.asp ).

In numerous cases, the interventions consist of various activities using both demand- and supply-side strategies. However, for this review, we have categorized each intervention study as predominantly demand or predominately supply. Forty-two of the included articles are classified as demand-side interventions, while the remaining twenty-one are classified as supply-side interventions. Within the demand generation activities, we further classified programs as mass media, interpersonal communication, and development approaches. The development approaches that included conditional cash transfer programs and a savings and credit program tended to be the most integrated in terms of demand- and supply-side strategies and four out of five of them had high quality evidence (see details below). Among the supply-side interventions, we further classified programs into access, quality, and cost approaches. The one cost approach identified (a voucher program) had features of both a supply-side and a demand generation activity and was classified in the low quality of evidence category.

Among the 63 studies included, the strength of the evidence varies widely. In particular, among the 42 studies that were in the demand category, 7 were of low quality, 27 were of medium quality, and 8 were considered to be of high quality (see Table 1 for citations by category). Half of the high quality studies were of studies and interventions classified as development approaches - conditional cash transfer programs and a savings and credit program ( Stecklov et al. 2007 ; Steele et al. 2001 ). Among the remaining high quality demand programs, two were interpersonal communication programs with an instructor/facilitator ( Cabezon et al. 2005 ; Walker et al. 2006 ) and two were community-level interpersonal communication programs ( Lou et al. 2004 ; Ross et al. 2007 ). Among the programs in the supply-side interventions, 8 were considered low quality, 7 were considered medium quality, and 6 were considered high quality. Among those supply-side programs of high quality, three are access/community outreach programs that were undertaken in large demographic surveillance sites (Bangladesh and Ghana), permitting long-term follow-up of a longitudinal sample ( Rahman et al. 2001 , Sinha 2005 , Debpuur et al. 2002 ). The three others were quality of care/integrated service programs ( Bashour et al. 2008 ; Bolam et al. 1998 ; Xiaoming et al. 2000 ), two of which were able to randomize individuals at the clinic level. Notably, the remaining demand-side and supply-side interventions were of medium or low quality but still met the inclusion criteria of being quasi-experimental designs (or having another way to attribute program exposure to outcomes).

Strength of Evidence of Included Family Planning Evaluation Studies by Type of Intervention and Strength of Evidence

Table 2 summarizes the findings of the 63 rigorously evaluated studies included in this review. Generally speaking, the available evidence over the last 15 years suggests that family planning programs have positively impacted individuals’ family planning knowledge, attitudes, discussion, intentions, and to a smaller degree, contraceptive use. Seventy-five percent of the studies that measured contraceptive use as an outcome reported positive findings for increased contraceptive use or reduced unmet need, while the outcomes of knowledge, attitudes, discussion, and intentions were more commonly found to be significant. Increased service use and changes in fertility-related outcomes were less consistently evident. All of the supply-side interventions that measured fertility outcomes (4 studies - Rahman et al. 2001 ; Sinha 2005 ; Debpuur et al. 2002 ; Sherwood-Fabre et al. 2002 ) were positive and significant, revealing either a decrease in fertility rates, reduced unintended pregnancies, or a decrease in abortion rates, while only 2 ( Askew et al. 2004 (sites A & C); Cabezon et al. 2005 ) out of 9 demand-side intervention studies ( Rogers et al. 1999 ; Vernon et al. 2004 ; Mathur et al. 2004 ; Stecklov et al. 2007 (included as 3 separate studies – Honduras, Nicaragua, and Mexico); Signorini et al. unpublished, PAA 2009) that measured fertility-related outcomes revealed statistically significant, positive findings on this outcome.

Evaluation Studies of Family Planning Interventions on Knowledge, Attitudes and Behaviors

As shown in Table 3 , the majority of the evaluation studies reported on interventions that took place in Africa (n=25 studies), while 21 studies reported on data from Asia, 14 studies from the Americas, 2 study from Eurasia, and 2 studies from the Middle East. 1

Regional Distribution of Studies

To facilitate synthesis and presentation, studies are presented based on their categorization as demand-side or supply-side interventions below. More detailed summaries of the intervention type, program description, research design/analytic methods, and results may be found in the Appendix .

Research on Effectiveness of Demand-side Interventions

No significant difference 0; significant desirable difference +; significant undesirable difference - RCT=randomized cluster trial; PS-C=panel study with comparison group; PS=panel study; RCS-C=repeat cross-sectional study with comparison group; PT-C=posttest only with comparison group

The next three sections outline specific demand-side approaches that the articles from our review broadly fall within – mass media, interpersonal communication, and development approaches. The subsequent three sections divide the supply-side studies from our review into the three broad supply-side categories – access, quality of care, and cost. The article concludes with a discussion of gaps and directions for future evaluation research.

Demand-side approaches

The central goals of family planning demand-side interventions include changing women’s, men’s, and couples’ knowledge and attitudes about family planning methods, increasing their knowledge of sources of contraceptives, and increasing their use of family planning to meet their fertility desires ( Salem et al. 2008 ). As an intervention, mass media through the radio, television, or print media is an appealing strategy for the promotion of family planning because of its potential reach and ability to address often culturally taboo issues in an entertaining way. The use of media to deliver primarily social development messages has been employed in family planning (FP) and reproductive health (RH) programs for over five decades ( Salem et al. 2008 ). As FP/RH programs have grown and evolved so have the communication approaches. These approaches are referred to by many names such as entertainment-education (EE); edutainment; information, education, and communication (IEC); and behavior change communication (BCC), to name a few ( Salem et al. 2008 ).

Nine articles ( Rogers et al. 1999 ; Kincaid 2000a ; Meekers et al. 1997 ; Meekers et al. 1998 ; Van Rossem et al. 1999a ; Van Rossem et al. 1999b ; Kim et al. 2001 ; Magnani et al. 2000a ; Sood et al. 2004 ) evaluating the impact of mass media interventions that met our inclusion criteria for rigorous evaluation were found in the literature search. Often, in the case of mass media interventions, evaluations must use creative methods to compare those exposed to the intervention to those not exposed given that the programs tend to be full coverage programs. In cases where a comparison group is not feasible, researchers sometimes divide the sample into groups based on exposure to the various components of the intervention. Comparing the groups based on exposure experience or extent of exposure, controlling for background differences, provides researchers with an opportunity to measure dose response effects on the fertility or family planning outcomes of interest ( Kincaid 2000a ; Magnani et al. 2000a ; Sood et al. 2004 ). Given these methodological challenges with evaluating mass media approaches, all but one of these studies were considered to be of medium quality; this last study was considered of lower quality because it used a post-test only comparison group design ( Sood et al., 2004 ).

Of the nine mass media intervention evaluations we reviewed, results usually focused on short-term outcomes such as changes in knowledge, attitudes, beliefs, and discussion patterns either between partners or between parents and their children. Few behavioral outcomes were measured. However, when behavioral outcomes such as contraceptive use were measured among the study population, results were positive ( Rogers et al. 1999 ; Kincaid 2000a ). Most positive behavioral results emerged from studies where mass media was combined with other intervention components, such as social marketing ( Meekers et al. 1998 ; Van Rossem et al. 1999a ; Van Rossem et al. 1999b ) or interpersonal communication interventions ( Kim et al. 2001 ; Magnani et al. 2000a ; Sood et al. 2004 ).

In Tanzania, Rogers and colleagues (1999) , which was considered to be a medium quality study, measured married women’s use of contraceptives as a result of exposure to an entertainment-education radio soap opera, “Twende na Wakati” (Let’s Go with the Times). The authors used a quasi-experimental design since the soap opera was broadcasted on seven mainland stations of Radio Tanzania and not on the eighth station covering the Dodoma area. While the seven stations were broadcasting the soap opera twice a week, the Dodoma area station was broadcasting locally produced programs at the same time. Consequently, it was able to serve as the comparison site. In addition to triangulating a number of different data sources, the authors used a repeat cross-sectional design, in which they surveyed individuals in the same 35 wards in two regions of the Dodoma comparison area and seven regions in the treatment area at one-year intervals from 1993 to 1997. The authors found that all statistical tests supported a significant effect of exposure to “Twende na Wakati” from 1993 to 1995 on married women’s use of contraceptives. As a result of the positive findings from the 1993-1995 analysis, Radio Tanzania began broadcasting the soap opera in the Dodoma area. The authors found this statistically significant effect between exposure to the soap opera and contraceptive use of married women replicated in the Dodoma comparison area from 1995 to 1997.

Interpersonal communication

Interpersonal communication approaches including one-on-one discussions, small-group sessions, and facilitator-led curriculum-based programs are another demand-side strategy used to influence knowledge, attitudes, intentions, and behaviors related to FP and RH. Interpersonal communication interventions take place in varying settings including schools, workplaces, and the community. These interventions are often facilitated by peers, teachers, or expert trainers. Twenty-eight articles using interpersonal communication approaches met our inclusion criteria. Of these articles, 11 reported on peer-led interventions ( Agha et al. 2004 ; Magnani et al. 2000b ; Brieger et al. 2001 ; Speizer et al. 2001 ; Cartagena et al. 2006 ; Askew et al. 2004 ; Diop et al. 2004 ; Vernon et al. 2004 ; Bhuiya et al. 2004 ; Mathur et al. 2004 ; Ozcebe et al. 2003 ); 12 were instructor/facilitator-led ( Cabezon et al. 2005 ; Eggleston et al. 2000 ; Magnani 2001 ; Mbizvo et al. 1997 ; Murray et al. 2000 ; Martiniuk et al. 2003 ; Mba et al. 2007; Rusakaniko et al. 1997 ; Shuey et al. 1999 ; Stanton et al. 1998; Walker et al. 2006 ; FOCUS/CARE International - Cambodia 2000 ); and, 5 were community-based ( Levitt-Dayal et al. 2001 ; Erulkar et al. 2004 ; Lou et al. 2004 ; Tu et al. 2008 ; Ross et al. 2007 ).

Within these categories, the overwhelming majority were of medium quality with the exception of two of the peer-led interventions that were lower quality ( Cartagena et al. 2006 ; Ozcebe et al. 2003 ); two of the instructor/facilitator led that were of high quality ( Cabezon et al. 2005 ; Walker et al. 2006 ); two of the instructor/facilitator led of low quality (Mba et al. 2007; Shuey et al. 1999 ); two of the community-based that were high quality ( Lou et al. 2004 ; Ross et al. 2007 ); and one of the community-based that was low quality ( Levitt-Dayal et al. 2001 ). Notably, none of the articles compared the different types of facilitators to help inform whether one approach is more effective than another. However, Table 2 reveals that the peer-led and adult-led intervention studies had similar outcomes.

The interpersonal communication interventions almost exclusively targeted adolescents and young adults (the age range included 10 year olds to 26 year olds), and the evaluations all included short-term outcomes (knowledge, attitudes, and beliefs) and only a few included behavioral outcomes (contraceptive use and unintended pregnancies). Most studies (86% - 18 studies out of 21) reported improved knowledge and attitudes, while about two-thirds of the studies (12 studies out of 19) measuring family planning use found a positive effect ( Magnani et al. 2000b ; Brieger et al. 2001 ; Speizer et al. 2001 ; Askew et al. 2004 ; Murray et al. 2000 ; Stanton et al. 1998; Walker et al. 2006 ; Levitt-Dayal et al. 2001 ; Erulkar et al. 2004 ; Lou et al. 2004 ; Tu et al. 2008 ; Ross et al. 2007 ) and half of those measuring fertility outcomes (2 studies out of 4) led to declining fertility ( Askew et al. 2004 ; Cabezon et al. 2005 ).

Askew and colleagues (2004) compared three intervention sites in the Western Providence of Kenya. Interventions to create a supportive environment at the community level and strengthen the health system’s ability to meet the reproductive health information and service needs of adolescents were introduced into Site A locations. Site B locations consisted of the same intervention activities as in Site A plus an in-school life-skills and development curriculum and parent sensitization, so that the additional effect of educating school children on reproductive health issues could be assessed. Site C locations were identified as comparison sites, where no interventions were introduced. This was considered to be a medium quality study. For most socio-demographic characteristics, there were no differences, between the sites nor between baseline and endline cross-sectional characteristics. Where differences did occur for a characteristic, it was taken into account in the analysis and interpretation of the findings. This indicates that any differences in measures of the key indicators found between baseline and endline are most likely due to the influence of the interventions themselves. Among the never married girls living in Site B there was no change over time in terms of experiencing pregnancy, with about one quarter of sexually active girls reporting a pregnancy. In intervention Site A and the comparison site, however, large and significant reductions in pregnancy were reported over time. This may be a result of the fact that approval of contraception and condom use improved in the comparison site and in Site A but not in Site B. This finding is particularly interesting because Site B, which offered exposure to the largest number of program components, had the least effect.

Alternatively, Cabezon and colleagues (2005) , in their high quality study, found that a school-based intervention taught by teachers had a protective effect in preventing unintended pregnancies. Three cohorts of first year high school students were enrolled in a randomized control trial in which some students received no intervention and other students received the TeenSTAR abstinence-centered sex education program which consisted of 14 units taught over a school year. The cohorts represent the years 1996, 1997, and 1998; the 1996 cohort did not experience any intervention program. No interventions were received by any of the cohorts during their second, third, or fourth years. All cohorts were followed up for four years; pregnancy rates were recorded and subsequently contrasted in the intervention and control groups. Pregnancy rates for the intervention and control groups at four year follow-up in the 1997 cohort were 3.3% and 18.9%, respectively; while pregnancy rates for the intervention and control groups at four year follow-up in the 1998 cohort were 4.4% and 22.6%, respectively. The pregnancy rate for the 1996 cohort that was not exposed to the program was 14.7%. The differences between intervention and control group by cohort were statistically significant demonstrating an impact of the TeenSTAR program using a high quality study design.

Development approaches

The development approaches, which included four conditional cash transfer programs and a savings and credit program, all focused on intermediate and long-term behavioral outcome indicators, such as contraceptive use and fertility. Four out of five of these studies were of high quality ( Stecklov et al. 2007 – counting for three studies; Steele et al., 2001 ) and the remaining one was of medium quality (Signorini et al. unpublished, PAA 2009). In the case of Stecklov and Signorini, they used population-level secondary data for the evaluation. In particular, by relying on large, nationally representative surveys that are infrequently available, the authors were able to examine longer-term outcomes than what is usually available immediately following the intervention activities. Stecklov and colleagues (2007) explored the possible association between conditional cash transfer (CCT) programs in three Latin American countries (Mexico, Nicaragua, and Honduras) and fertility. The authors compared three sets of panel data from experimental CCT programs in these countries to assess the impact of these programs on childbearing. Each program first identified a set of communities eligible for the program and then randomly assigned them into control and treatment groups. The treatment groups were provided payments conditional on the household’s behavior, such as enrolling children into public schools, getting regular check-ups at the doctor’s office, and receiving vaccinations.

Findings, based on difference-in-difference models, show that the program in Honduras, which inadvertently created large incentives for childbearing, may have raised fertility by between 2 and 4 percentage points. The Honduras program created incentives by establishing different targeting and eligibility criteria and transfer amounts. For example, the Honduras’ Family Allowance Program (PRAF, after its Spanish acronym) allowed parents to join or obtain increased benefits by bearing children after the program had begun ( Stecklov et al. 2007 ). The CCT programs in the two other countries, Mexico and Nicaragua, did not have the same unintended incentives for childbearing; however, they also did not have a net impact on fertility ( Stecklov et al. 2007 ). The data were more positive when examining contraceptive use, where it was measured. The data from the PROGRESA program in Mexico revealed significant increases in contraceptive use, while the Nicaragua data illustrated an increase, albeit one that was not significant. Similarly, an evaluation of a similar conditional cash transfer project in Brazil, called Bolsa Familia Program, was found to have no impact on the fertility of program beneficiaries (Signorini et al. unpublished, PAA 2009).

Likewise, evidence from a high quality evaluation of a Save the Children USA program examining the characteristics of women who choose to join a women’s savings or a credit group in rural Bangladesh and the impact of their participation on contraceptive use revealed mixed results ( Steele et al. 2001 ). The credit approach required more stringent criteria for membership based on credit worthiness, an admission fee, and there were individual and group expenses for meeting rooms. In addition, the group funds were managed by a credit officer who collects weekly savings and loan payments to deposit at a government bank. The savings groups were more autonomous than the credit groups, and set their own rules with regard to frequency of meetings, savings contributions by members, size of group, and how group savings were managed. To evaluate the impact of the credit program, the authors compared credit members with eligible nonmembers in the same village communities. The savings group members were compared with eligible nonmembers in the same village communities as well as in village communities in which the savings program was not introduced. The use of a longitudinal design for this evaluation controlled for two types of endogeneity that often threatens evaluation research: self selection and non-random program placement ( Steele et al. 2001 ). Increased contraceptive use was found among participants of the credit program but not among participants of the savings group.

Supply-side approaches

The overarching strategy of successful supply-side family planning programs is to make contraceptive methods as accessible as possible to clients in a good quality, reliable fashion. This includes offering a wide range of affordable contraceptive methods, making services widely accessible through multiple service delivery channels, making sure potential clients know about services, following evidence-based technical guidelines that promote access and quality, and providing client-centered services ( Richey et al. 2008 ). These types of supply-side interventions ensure that women and couples are able to effectively use family planning when the need arises. Understanding which supply side interventions lead to increased contraceptive use and reductions in unmet need and unintended pregnancy is important for making recommendations to program managers and policy makers on how to expend finite resources. Much of the research to date on supply-side interventions has been undertaken through operations research that has generally focused on outcomes such as improved service quality, increased client satisfaction, and increased service use. Fewer recent evaluation studies of supply-side strategies examine whether changes in family planning availability, accessibility, quality, and costs lead to increased contraceptive use and reduced unintended pregnancy at the population level. The studies that we sought for this assessment of rigorous evaluations did just this; they examined the impact of supply-side activities on fertility and family planning outcomes. In total, we found twenty-one articles that evaluated the population-level impact of supply-side interventions.

Nine studies focusing on issues of accessibility met our inclusion criteria; three of these (two with medium quality and one with low quality) evaluated the impact of fractional social franchising programs ( Agha et al. 2007 , Hennink and Clements 2005 , Babalola et al. 2001 ) and six focused on community-based distribution or outreach programs (high quality: Rahman et al. 2001 , Sinha 2005 , Debpuur et al. 2002 ; medium quality: Phillips et al. 1996 ; low quality: Douthwaite et al. 2005 , Kincaid 2000b ). Social franchising typically entails the creation of networks of private medical practitioners (doctors, nurses, midwives, pharmacists) that offer a standard set of services at lower costs under a shared brand name. Franchise members are offered training, commodity advertising, inter-franchise referrals, a branding that shows high-quality standards, and other benefits. Fractional social franchises are businesses that add a franchised service or product to the existing operations ( LaVake 2003 ). Among the three studies that used this approach, one with medium quality and one with low quality ( Hennink and Clements 2005 ; Babalola et al. 2001 ) had a significant effect on family planning outcomes in the intended direction, while the Agha et al. 2007 article found a marginally significant effect on current use of family planning (p=.067). None measured an effect on fertility-related outcomes. Similarly, those that examined knowledge, attitudes, and intentions also demonstrated positive effects. One study, however, that examined whether fractional social franchising leads to increased service use in Nepal failed to show the hypothesized effect and showed only a marginally significant effect for contraceptive use ( Agha et al. 2007 ). This may be a result of the fact that clients had other sources of reproductive health services available to them that they felt comfortable using; 10-12% of the population in the intervention district went to a medical store/pharmacy for reproductive health services. In addition, the project was implemented for less than a year ( Agha et al. 2007 ).

Hennick and Clements (2005) found that the introduction of new family planning clinics in urban Pakistan resulted in increased knowledge of family planning methods, distinct effects on contraceptive uptake, and decline in unmet need. However, the impacts were different by provinces, which represent different cultural contexts. The new clinics in Sargodha and Gujranwala in the Punjab province contributed to a significant decline in unmet need for family planning; most of this change was comprised of a decline in unmet need for limiting births. In the more culturally conservative cities of Hyderabad and Shikarpur in the Sindh province, the operation of the new clinics led to no reduction in overall unmet need but led to increases in the demand for family planning. This study highlights the importance of taking into account the socio-cultural context of the study location.

Among the six community outreach/distribution studies, positive findings were found for all outcomes measured, including three studies that measured fertility related outcomes. The three studies that measured fertility outcomes were all of high quality and used longitudinal study designs – Matlab and Maternal and Child Health-FP Extension projects in Bangladesh ( Rahman et al. 2001 ; Sinha 2005 ) and Navrongo project in Ghana ( Debpuur et al. 2002 ) over long follow-up periods. This reflects the fact that it is often difficult to report on changes in fertility-related outcomes in the absence of datasets that cover a long period of time. In addition, the Matlab and Maternal and Child Health-FP Extention and Navrongo projects include a combination of demand- and supply-side activities, which may explain the positive FP and fertility outcomes.

These long follow-up periods also provided the time necessary to compare different intervention approaches on the outcomes of interest. For example, Debpuur and colleagues (2002) examined approaches to mobilizing Ghana’s Ministry of Health outreach program and compared this with mobilizing traditional community-based organizations as well as mobilizing both sectors simultaneously. Their study had four arms: a comparison site with no intervention, a nurse outreach only site, a traditional community organization (zurugelu) site, and a combined zurugelu plus nurse outreach site. They found that contraceptive use remained the same when analyzing the effects of the approaches separately. However, when examining the combined zurugelu plus nurse outreach approach, they found that contraceptive use increased significantly and fertility decreased significantly.

Quality of care

Programs that seek to improve quality of services often focus on the various components of quality as defined by Bruce (1990) in her seminal article. These include choice of methods, information given to users, technical competence, interpersonal relations, follow-up or continuity mechanisms, and appropriate constellation of services. Quality is inconsistently defined across different studies, and between different stakeholders. This makes it difficult to draw larger conclusions about studies that seek to improve family planning service quality.

Eleven articles to improve quality of care met the inclusion criteria for this review. One article of lower quality focused on increased method options ( Khan et al. 2004 - introducing emergency contraceptive pills into the method mix); another of lower quality focused on client provider interactions ( Nawar et al. 2004 ). Nine reported on various quality improvement approaches (high quality: Bashour et al. 2008 , Bolam et al. 1998 , Xiaoming et al. 2000 ; medium quality: Khan et al. 2008 , Kunene et al. 2004 , Sherwood-Fabre et al. 2002 , Sanogo et a. 2003 ; low quality: Varkey et al. 2004 , Speizer et al. 2004 ).

Studies that sought to improve quality were not consistently successful; six studies ( Sanogo et a. 2003 ; Xiaoming et al. 2000 ; Speizer et al. 2004 ; Bolam et al. 1998 ; Khan et al. 2008 ; Varkey et a. 2004 ) out of ten revealed a significant increase in contraceptive use. Five of the seven integrated service delivery studies focused on postpartum contraceptive use ( Bashour et al. 2008 ; Bolam et al. 1998 ; Khan et al. 2008 ; Kunene et al. 2004 ; Varkey et al. 2004 ), and of these, three reported significant results ( Bolam et al. 1998 ; Khan et al. 2008 ; Varkey et a. 2004 ). The one integrated service delivery study that provided family planning to post-abortion clients in Russia ( Sherwood-Fabre et al. 2002 ) found a reduction in abortion rates but no corresponding increase in contraceptive use. The authors explained that this situation may be a result of the fact that the intervention was unevenly implemented; the survey indicated that there were many missed opportunities to reinforce and personalize the family planning information that women received. In addition, it was found that there was an increase in the proportion of unintended pregnancies that resulted in live births during the study period; this affected the abortion rates ( Sherwood-Fabre et al. 2002 ). Finally, one study investigated the impact of integrating an HIV prevention intervention into a well-established family planning network of services in China. The authors found that at 12-months follow-up, significantly more respondents from the experimental sites were using condoms as their main contraceptive method (p<.05) ( Xiaoming et al. 2000 ) as compared to in the comparison sites.

The feasibility of male involvement in antenatal care (ANC) counseling sessions and the effectiveness of their involvement in postpartum contraceptive use was evaluated by two studies – one of medium quality from South Africa ( Kunene et al. 2004 ) and one of lower quality from India ( Varkey et al. 2004 ). In KwaZulu-Natal, South Africa, the study team matched facilities by size and rural/urban status and then randomly assigned six clinics as the intervention sites and six as the comparison sites. Implementing joint couple counseling was challenging for this program because the population being served was mostly unmarried. One-third of the couples invited attended the joint counseling sessions, and communication among them was reported to improve with male partners more likely to provide support in the event of pregnancy complications; however, postpartum family planning use and overall risk behavior did not change ( Kunene 2004 ). The other study that examined male involvement had positive effects; however, did not randomly assign sites or control for differences between the groups ( Varkey et al. 2004 ).

The issue of cost of family planning methods is often discussed as both a supply-side and demand-side issue. From the supply-side perspective, the direct cost of a family planning method is seen as a barrier to use. From the demand-side perspective, many family planning programmers and advocates have pointed out that there are many indirect costs associated with access to family planning, such as large, unofficial payments to staff and long waiting times to see service providers; each of these affects demand ( Ensor and Cooper 2004 ).

Only one article evaluating a cost-based intervention was found that met our inclusion criteria. Although Meuwissen and colleagues (2006) used a quasi-experimental design to evaluate the impact of a competitive voucher pilot program on adolescents’ use of sexual and reproductive health care (SRHC) services and contraceptives in urban Managua, Nicaragua, the authors used a post-test only design so the study design is considered lower quality. Self-administered questionnaires were distributed randomly among female adolescents 3 to 15 months after the vouchers had been distributed in their area. The voucher receivers were considered the intervention group to be compared at a group level with the control group, the non voucher receivers. Voucher receivers demonstrated significantly higher use of SRHC services and knowledge of contraceptives and sexually transmitted infections compared with non-receivers. There was no change in overall contraceptive use between the two groups – receivers and non-receivers. However, effects were modified by place of survey – school versus neighborhood. Focus group discussions and interviews with adolescents during the intervention suggest that the factors that contributed to the success of the voucher program were the removal of practical obstacles (e.g., financial, the need to make an appointment, the lack of information on clinic location, and opening times) plus the guarantee of confidential access to a service provider of their choice. These results reveal the interplay between demand-side and supply-side barriers.

The available evidence on the effectiveness of family planning interventions in developing countries over the last fourteen years reveals a positive picture with no one size fits all approach. Both demand- and supply-side interventions led to improvements in knowledge, attitudes, discussion of family planning and sexuality, and intentions to use family planning. Results were less consistent in terms of effects on fertility and family planning outcomes.

The examination of mass media interventions illustrated positive results on contraceptive use and/or unmet need, while the wealth of interpersonal communication interventions less consistently demonstrated these effects. A notable example is the quasi-experimental study by Rogers and colleagues (1999) that showed a significant effect of exposure to an entertainment-education radio soap opera on contraceptive use by married women, which led to the scale-up of the program nationwide throughout Tanzania.

Only two ( Askew et al. 2004 ; Cabezon et al. 2005 ) out of the four studies from the interpersonal communications category that measured fertility related outcomes found significant reductions in unintended pregnancies. For example, Askew and colleagues (2004) found differential effects by exposure arm such that those with the greatest exposure had the least fertility and family planning impacts. Askew and colleagues acknowledged that their multi-sectoral approach reached adolescents with reproductive health information; however, they cautioned that the findings need to be interpreted with care in light of the fact that the community-based intervention was more intensively implemented in varying sites. They also pointed to the fact that the teachers who implemented the school-based intervention were more comfortable with providing the abstinence messages than the safer sex messages to their students. These challenges are representative of similar challenges experienced by all programs working with adolescents on issues of sexual and reproductive health.

Contrary to Askew’s findings, Cabezon and colleagues (2005) revealed a protective effect in preventing unintended pregnancies from a school-based intervention taught by teachers. The authors reported that the success of their teacher-led program was due to the accurate and comprehensive information provided and the focus on developing assertiveness and negotiation skills. The authors also acknowledged that the implementation of the program over an academic year was ideal and found the teachers to be effective implementers of the program. This example along with the example provided by Askew highlights the importance of the program facilitators’ comfort with the subject matter and their commitment to the program.

Once demand for contraceptive use is achieved, it is imperative that the supply is readily available and accessible. Our review found that supply-side interventions that addressed access to family planning led to positive effects on family planning use, whereas improved quality less consistently showed positive effects on family planning behaviors. Notably, few studies measured fertility-related outcomes such as reduced unintended pregnancies and abortions; however, the supply-side intervention studies that did measure fertility showed the most consistent and positive findings, generally using the strongest study designs ( Khan et al. 2008 ; Debpuur et al. 2002 ; Rahman et al. 2001 ; Sherwood-Fabre et al. 2002 ).

It is also notable that even in some places where the findings were positive; results were not necessarily consistent across different locations or target groups. For example, the voucher program in urban Nicaragua found different effects among school-going youth and youth who participated from community-based sites ( Meuwissen et al. 2006 ). Hennick and Clements (2005) reported differential changes in unmet need as a result of introducing new family planning clinics in two culturally distinct provinces of Pakistan. Debpuur and colleagues (2002) found a significant increase in contraceptive use and decrease in fertility when they examined the combined approach of two different community-based outreach interventions in contrast to when they analyzed the effects of the interventions separately.

Although the findings presented in this review categorized studies as demand-side and supply-side interventions, a small number of studies explicitly included a multi-component approach, such as undertaking mass media and interpersonal communication ( Kim et al. 2001 ; Magnani et al. 2000a ; Sood et al. 2004 ), mass media and social marketing ( Meekers et al. 1998 ; Van Rossem et al. 1999a ; Van Rossem et al. 1999b ), fractional social franchising with strong media promotional presence ( Agha et al. 2007 ; Babalola et al. 2001 ), and fractional social franchising and community-based outreach ( Hennick and Clements 2005 ). These studies generally found positive family planning outcomes and, when measured, positive fertility outcomes as well. The importance of multi-component programs has been demonstrated in other reviews that have examined rigorous evaluations of adolescent reproductive health programs ( Speizer et al. 2003 ; Ross et al. 2006).

It is also worth noting where the evidence was weak or non-existent in this review. While male involvement programs are becoming increasingly important in the international family planning arena, there is limited evidence on the effectiveness of this approach on population-based fertility and family planning outcomes. A small number of operations research studies have been undertaken and reveal that approaches to increase male involvement in prenatal and postpartum care lead to increased attendance at these critical events; these studies with medium to low quality of quasi-experimental design, however, have shown mixed results in regards to behavioral outcomes such as contraceptive use and unintended pregnancies ( Kunene et al. 2004 ; Varkey et al. 2004 ).

In addition to the limited evidence provided on evaluations of male involvement programs, only one study of lower quality ( Meuwissen et al. 2006 ) was found that examined the effect of a voucher program on increased contraceptive use behaviors; this is an important gap because voucher programs are an increasingly popular approach in public health programming. Several developing countries, with international donor support, are considering or in the process of implementing a voucher program (examples include India, Tanzania, Uganda, Kenya and Bangladesh) ( Arur et al. 2009 ). However, more research is needed to inform the design and expansion of voucher programs throughout the developing world. Important areas for further voucher studies include: impact evaluations, cost and cost-effectiveness studies, and the effect of using technology to simplify implementation and reduce overhead costs. Vouchers are a relatively untested approach in low-income countries. Although results from these early experiences are positive, there is a clear need for rigorous research that can conclusively establish that voucher programs can increase coverage and use of FP/RH and other health services among underserved target populations ( Arur et al. 2009 ).

Limitations

There are a number of limitations to this type of systematic review. First, depending on the level of depth provided in each study, it is not always possible to extrapolate the features of each intervention and the corresponding evidence as to which components were the most effective. Second, most studies of multi-component programs examined overall program effects and did not separate out the effects of the different components. Third, the majority of studies considered were written in English although the authors also reviewed studies in French. Fourth, as expected for the outcomes of interest, most of the studies were based on self-reported sexual and health-seeking behaviors; previous studies have demonstrated potential biases of self-reported behaviors ( Curtis and Sutherland 2004 ). Fifth, service utilization statistics were included but only as a complement to individual level data; this limited the inclusion of most of the operations research studies. Sixth, there is likely to be a publication bias with this type of review whereby studies with positive findings are more likely to be published (and found) whereas studies with non-significant or negative findings are unavailable. Finally, given the diversity in study methods and implementation strategies, it was not possible to do a formal meta-analysis that joins the samples and compares the odds ratios. Therefore, a limitation of this study is that while all studies included met the experimental or quasi-experimental (or another form of attribution) criteria, there was still variability across the rigor of the studies. We have categorized the identified studies into three quality categories: low, medium, and high to help clarify these types of distinctions across the multiple approaches. Where appropriate, we have identified which findings come from those studies with a higher study quality (e.g., are from a randomized cluster design and/or use longitudinal data with a comparison group to determine attribution).

Conclusions

In spite of limited funding for family planning programs during the period 1995 to 2008, this systematic review reveals that both demand- and supply-side interventions that have been rigorously evaluated have been found to be generally successful in increasing knowledge, attitudes, beliefs, and discussions around family planning as well as increasing contraceptive use. These impacts are often a result of programs that have taken into account the importance of various approaches to reaching women and couples with family planning products and services, providing quality information and service delivery, addressing cultural norms and barriers to contraceptive use, and seeking community support.

That said, a number of gaps and directions for future research have also been identified. In particular, there is a need to undertake evaluations of broader development approaches and supply-side interventions measuring population-level outcomes (beyond operations research) and their long-term impacts on family planning and fertility. Likewise, there is a need for more research around the impact of male involvement, integrated services, public-private partnerships, and voucher programs, especially in light of the recent push and funding for these approaches. There is also a need for information on the effectiveness and cost-effectiveness of alternative implementation approaches for both demand and supply-side interventions. For example, there are gaps in our understanding of the impact of a peer-led versus instructor or facilitator led program as well as gaps in the understanding of intervention costs and the comparison of costs for alternative implementation approaches.

Most evaluations are of small-scale interventions and implemented over relatively brief periods of time (often a pilot test). There is little evidence on the long-term behavioral effects of the interventions that would provide us the evidence required to make decisions about scale-up or replication. The strongest evidence to support reaching long-term fertility measures comes from long-standing longitudinal studies, such as Maternal and Child Health-FP Extension projects in Bangladesh ( Rahman et al. 2001 ; Sinha 2005 ) and the Navrongo project in Ghana ( Debpuur et al. 2002 ). This reflects the need for long-term follow-up in measuring and observing such changes in fertility-related outcomes. A number of Demographic Surveillance Systems coordinated through the INDEPTH network ( http://www.indepth-ishare.org/ ) are now currently available and could possibly serve as data for these types of long-term evaluations of existing models in varying sites.

Furthermore, lacking in most studies is an assessment of the differential impact of interventions across target audiences. For example, it is important to consider the impacts of programs on the populations most in need of services, such as high risk subgroups, migrants, and the urban poor, to name a few. The examination of differential impacts by subgroups was rarely examined within the studies found. More specific information on the actual beneficiaries of interventions is still needed by policy makers wishing to target scarce resources to those most in need. The study by Hennick and colleagues (2005) highlights the importance of not only understanding the cultural backgrounds of the various populations that are being studied, which helps in explaining the different results in unmet need and where these two distinct populations are in terms of acceptance and intentions to use family planning methods, but also the importance of looking at the socio-demographic characteristics of beneficiaries. They found that women who live outside of the catchment areas are often married with four or more children and are of low socioeconomic status. They also found that young (aged 16-19), poor women who are separated or unmarried were seeking services from outside the catchment areas. These findings reveal that women who are poor were willing to travel some distance to obtain services for which they pay fees.

The findings of this review reveal that all of the intervention approaches have some benefit at least on short-term outcomes. The main program approaches that led to increases in contraceptive use included development approaches and supply-side interventions. Whether the other approaches did not have an effect or did not measure one is a different issue. Notably, only a small number of studies had an impact on fertility outcomes; most of these were high quality studies of supply-side approaches working in supportive, long-term settings using multi-component, integrated programs. As interventions are designed, it is imperative that planning goes into monitoring and evaluating the activities, so that programs can be refined and lessons learned can be shared widely. Particular attention needs to be paid to undertaking rigorous impact evaluations that can attribute program activities to changes in outcomes of interest. Randomized controlled trials will not be feasible for most FP program activities; thus evaluators need to identify alternative study designs (quasi-experimental; longitudinal) that are appropriate for the varying settings where programs are being implemented ( Victora, Habicht, and Bryce, 2004 ). This attention to rigor of family planning evaluations will increase accountability, improve program decision making, and in the end, improve maternal and infant health outcomes.

Research on Effectiveness of Supply-side Interventions

Acknowledgments

This work was made possible with support from the Bill & Melinda Gates Foundation for the Measurement, Learning & Evaluation (MLE) Project for the Urban Reproductive Health Initiative. The authors’ views expressed in this publication do not necessarily reflect the views of the donor, the Bill & Melinda Gates Foundation.

A previous version of this paper was presented in October, 2009 at the International Conference on Urban Health in Nairobi, Kenya and in November, 2009 at the International Conference on Family Planning: Research and Best Practices in Kampala, Uganda. At the time this work was undertaken, LM, AS, and FF were part of the MLE project team.

1 The total does not equal 63 studies because the Brieger 2001 article reports on data from Nigeria and Ghana.

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Everything you need to know to plan your family summer getaway to Great Wolf Lodge

Great Wolf Lodge can be a great family getaway with their indoor waterpark, restaurants, arcade and more.

Here's everything you need to know about visiting Great Wold Lodge.

How many Great Wolf Lodge locations?

There are 23 Great Wolf Lodge Locations, seven of them in the Midwest. You can view the full list of locations at greatwolf.com .

How far is Great Wolf Lodge from Indy?

The closest Great Wolf Lodge locations to Indianapolis are listed below, by closest driving distance.

Need a break? Play the USA TODAY Daily Crossword Puzzle.

• Cincinnati/Mason, Ohio: 130 miles, approx. 2.5 hours*
• Chicago/Gurnee, Illinois: 230 miles, approx. 3.5 hours
• Sandusky, Ohio: 270 miles, approx. four hours
• Wisconsin Dells, Wisconsin: 370 miles, approx. 5.5 hours
• Traverse City, Michigan: 400 miles, approx. six hours

*All links below lead to the Mason location, but it can easily be switched at the top left corner of the webpage.

Waterpark passes for Great Wolf

If you're interested in heading to Great Wolf for just the day instead of staying on site, Day Passes are available for the indoor waterpark for either the full day (open to close) or half the day (4 p.m. to close).

For more information on all the waterpark attractions and deals, visit their website .

Staying at Great Wolf

If you're planning to stay on-site while visiting Great Woolf Lodge, they have standard suites , themed ones and premium suites .

It is important to note when booking your stay, the price per night includes the waterpark fee for each member of your family. Prices vary depending on what suite and what date you choose.

To start planning your stay, you can head to greatwolf.com/mason/plan .

Dining options at Great Wolf Lodge

There are several dining options on-site at Great Wolf, there's even one that doesn't even require leaving the waterpark called Buckets .

There's Hungry As A Wolf (pizza and pasta), Grizzly Rob's Bar (waterpark bar), Loose Moose (buffet open for breakfast and dinner) and the Lodge Wood Fired Grill .

At their branded restaurants, Great Wolf prioritizes allergy accomodations.

"At Great Wolf Lodge, our chefs are passionate about preparing culinary options to accommodate the food allergies and dietary restrictions of our guests," the website reads ." We are more than happy to assist with your dietary needs, and encourage you to speak directly with our chef so your meal can be prepared safely."

There are also grab-and-go options like Freshwoods Market for snacks and Wood's End Creamery for desserts.

There's also a Dunkin' located in the lodge so you can get your caffeine and donut fix.

What else is there to do at Great Wolf Lodge?

Besides the indoor waterpark, Great Wolf has their Northern Lights Arcade , Glow Golf , Ten Paw Alley , Oliver's Mining Sluice , an on-site Build-A-Bear Workshop and a few different interactive quest games, called MagiQuest.

MagiQuest takes you on an interactive adventure seeking out items throughout the resort to complete quests. Once you complete MagiQuest, there is also ShadowQuest and Compass Quest , for more missions to complete.

To participate in these quests, there are additional costs to purchase a wand, play the game, accessories and more. The good news is that your wand will remember where you left off, so on your next visit you're able to purchase more game time to pick up right where you left off.

To get the most out of these attractions, you can buy a separate pass to give you access to several of the attractions mentioned above. There are three pass options: the Wolf Pass, Paw Pass and Pup Pass.

You can view all the activities, as well as what's included on each pass at greatwolf.com/mason/waterpark-attractions/attractions .

Katie Wiseman is a trending news intern at IndyStar. Contact her at [email protected]. Follow her on Twitter @itskatiewiseman .

More From Forbes

The essential role of genuine insurance in financial planning.

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Gianluca Sidoti is an Independent Financial Advisor, Founder of TraDetector and Managing Partner at Citadines Capital SCF.

In today's financial landscape, marked by a proliferation of complex products often cloaked in attractive packaging, the essential nature and purpose of insurance can be overshadowed. As an independent financial advisor, I have consistently observed the pivotal role that properly chosen insurance coverage plays in comprehensive financial planning.

It serves as a protective barrier, shielding individuals and families from the unpredictable yet inevitable challenges that life can present. This protective role is in stark contrast to the numerous financial offerings marketed by banks, which frequently blur the lines between investment and insurance under the guise of enhanced benefits.

True insurance products, such as life insurance and accident/health/disability insurance, are fundamentally designed not as vehicles for investment but as crucial safety nets. These products are intended to preserve your existing quality of life and provide financial security for your dependents, not to generate additional wealth. They operate on the principle of risk management—mitigating the financial impact of adverse events that could otherwise alter your life's trajectory dramatically. This differentiation is vital. While investment products aim to grow wealth with an acceptance of risk, genuine insurance stands as a bulwark against risk, offering a buffer that helps maintain stability in turbulent times.

In my practice, I advocate for the strategic use of insurance as a cornerstone of sound financial planning. It is about ensuring continuity when faced with disruptions—whether it's the death of a breadwinner, a debilitating illness or a disabling accident. These are not mere hypotheticals but real risks that every financial plan must address. Therefore, selecting the right insurance coverage is not merely an administrative decision; it is a foundational one, essential for any robust financial strategy aimed at long-term resilience and security. This approach ensures that when life does take unexpected turns, the financial well-being of you and your family remains intact and protected.

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Baby reindeer piers morgan seeks richard gadd for interview after real martha segment, tyson fury vs oleksandr usyk results winner scorecard and reaction, life insurance: a safety net for your loved ones.

Life insurance is perhaps the most straightforward yet profound form of financial protection you can provide for your family. It's not about investment returns or saving on taxes; it's about ensuring that your loved ones can maintain their lifestyle and meet future financial goals even if you're no longer there to provide support.

Consider the case of a client of ours who is a father of two young children and the primary earner in his family. He secured a term life insurance policy that would cover his family's living expenses, the children's education costs and his wife’s transition back into the workforce, should anything happen to him. Tragically, he passed away unexpectedly, but the life insurance policy allowed his family to remain financially stable and cope with the loss without the added burden of immediate financial hardship.

This example underscores life insurance's critical role: It isn't about benefiting the insured but protecting the insured's family, ensuring that tragedy doesn't bring financial ruin.

Accident, Health And Disability Insurance: Protecting Your Standard Of Living

While life insurance supports your family after your death, accident, health and disability insurance protect your quality of life and financial independence in case of severe illness or injury. These types of insurance are important as they cover medical bills, provide income when you're unable to work and help maintain your standard of living.

Take another client of mine who was a freelance graphic designer. Her ability to work was directly tied to her physical health. When she was diagnosed with a severe illness that prevented her from working for several months, her health insurance covered her medical treatments and her disability insurance provided a monthly income during her recovery period. Without these protections, she would have faced not only health challenges but potentially crippling financial consequences.

The Misconception Of Bundled Financial Products

Unfortunately, the true essence of insurance is often clouded by financial institutions that bundle these products with investment components, such as unit-linked insurance plans (ULIPs) or investment-linked policies. These products typically come with higher premiums, and a part of the premium goes into investment funds, which can be volatile and provide uncertain returns.

As an advisor, I caution my clients against conflating insurance with investment. The primary purpose of insurance should always be protection. When clients seek both protection and investment, I often recommend keeping these needs separate. Consider opting for a straightforward term insurance policy for protection and consider separate investment avenues like mutual funds or stocks for growth.

Choosing The Right Insurance

Selecting the right type of insurance involves assessing your personal financial situation and understanding the different products available. Here are a few tips to guide you:

• Assess Your Needs : Determine what you need to protect. Is it your family's future, your income or both?

• Understand The Terms : Read the fine print. Know what is covered and what is not. Pay special attention to any exclusions.

• Compare Products : Not all insurance products are created equal. Compare different policies to find the one that best suits your needs without unnecessary extras that inflate costs.

• Consult An Independent Advisor : An independent advisor can offer unbiased advice without being tied to specific products or sales targets.

The Bottom Line

Insurance can be a key component of your financial plan, providing a safety net that protects you and your family from life's uncertainties. By considering genuine insurance products focused on protection rather than investment, and by seeking the guidance of an independent financial advisor, you can work to safeguard your financial health, and your family's. In my opinion, in the complex world of finance, keeping insurance pure is a great strategy to protect the things that matter most.

The information provided here is not investment, tax or financial advice. You should consult with a licensed professional for advice concerning your specific situation.

Forbes Finance Council is an invitation-only organization for executives in successful accounting, financial planning and wealth management firms. Do I qualify?

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