Evaluation of an integrated services program to prevent subsequent pregnancy and birth among urban teen mothers.

This article details the evaluation of a clinical services program for teen mothers in the District of Columbia. The program's primary objectives are to prevent unintended subsequent pregnancy and to promote contraceptive utilization. We calculated contraceptive utilization at 6, 12, 18, and 24 months after delivery, as well as occurrence of subsequent pregnancy and birth. Nearly seven in ten (69.5%) teen mothers used contraception at 24 months after delivery, and 57.1% of contraceptive users elected long-acting reversible contraception. In the 24-month follow-up period, 19.3% experienced at least one subsequent pregnancy and 8.0% experienced a subsequent birth. These results suggest that an integrated clinical services model may contribute to sustained contraceptive use and may prove beneficial in preventing subsequent teen pregnancy and birth.

Management of non-marital fertility in two South African communities.

In this analysis, we draw on qualitative data to examine the management of non-marital fertility among young women in two rural, Black communities situated in different provinces of South Africa: KwaZulu-Natal and Mpumalanga. While the two communities share a history of economic and social disadvantage and limited access to the labour market, there are, nonetheless, distinctive features that are evident in the management of non-marital fertility. We show that young women in both communities aspire to an ideal ordering of events that places finishing education before getting married and having children, but this is not easily attained. However, there are important differences in the ways young women and their families respond to union formation and childbearing that often occurs outside of a recognised union. In Hlabisa, KwaZulu-Natal, formal processes for legitimising non-marital pregnancies through union recognition are still in place whereas, in Agincourt, Mpumalanga, more emphasis is placed on securing support and paternal recognition for the child rather than on cementing the union between the young woman and her partner. We also find that the older generation in Agincourt at times views education as a threat to marriage while this is not common in Hlabisa. Our findings have important implications for intervention programmes that often treat Black communities as homogeneous wholes.

"How can I gain skills if I don't practice?" The dynamics of prohibitive silence against pre-marital pregnancy and sex in Zimbabwe.

Young people face sexual and reproductive health (SRH) problems including Human immunodeficiency virus (HIV) and Acquired immunodeficiency syndrome (AIDS). It is critical to continue documenting their situation including the contexts they live in. As part of a larger study that explored perspectives of men to SRH and more specifically abortion and contraceptive use, 546 pupils (51% female; age range 9-25 years) from a rural area in Zimbabwe were invited to write anonymously questions about growing up or other questions they could not ask adults for fear or shame. The pupils were included following descriptions by adults of the violence that is unleashed on unmarried young people who engaged in sex, used contraceptives, or simply suggested doing so. The questions by the young people pointed to living in a context of prohibitive silence; their sexuality was silenced and denied. As a consequence they had poor knowledge and their fears and internal conflicts around sexuality and pregnancy were not addressed. Current action suggests concerted effort at the policy level to deal with young people's SRH in Zimbabwe. It nevertheless remains necessary, as a way to provide support to these efforts, to continue examining what lessons can be drawn from the past, and how the past continues to reflect in and shape present dynamics and relations. There is also need to look more critically at life skill education, which has previously been described as having failed to address adequately the practical needs of young people. Life skill education in Zimbabwe has rarely been systematically evaluated. A fuller understanding is also needed of the different factors co-existing in contemporary African societies and how they have been and continue to be constituted within history, and the implications to the promotion of adolescent SRH.

Predicting adolescent risk behaviors based on an ecological framework and assets.

OBJECTIVES: To examine the relationship between an aggregate risk score (smoking, drinking, and number of sex partners) and measures of youth assets in a sample of 3439 youth aged 14-18 years. METHODS: Linear regression models for African American and white males and females predicted an aggregate risk score. RESULTS: After adjustments, the youth asset most predictive of risk was self/peer values regarding risk behaviors. Perceived school support was also predictive. CONCLUSIONS: Taking an ecological approach to the measurement of adolescent health behaviors contributes to our understanding of these risk behaviors.

Michigan hospitals build stronger families.

Each year in the United States, about one in three babies is born to an unwed mother. The United States Department of Health and Human Services is trying to stop the rise in illegitimate births with an attractive incentive offered to the five states that show the largest decrease in out-of-wedlock births. Michigan is a leader in the fight--winning the award both times it has been given out.

A developmental approach to prevention research: configural antecedents of early parenthood.

A developmental framework emphasizing the combined impact of correlated constraints within and without the individual was applied to a prospective longitudinal study of early parenthood. The purpose was to use a person-approach to the analysis of longitudinal data to clarify risk for early parenthood and to generate hypotheses about potentially useful intervention strategies. Respondents were 475 youth who were assessed annually from seventh grade through the end of high school and, again, at ages 20 and 24. The risk patterns associated with parenthood were the same for both sexes. Individuals with a middle-school configuration of low socioeconomic status, high aggression, low academic skills, low popularity, and prior grade failure were most likely to become parents by early adulthood. Risk for early parenthood increased substantially for respondents who dropped out of school early, regardless of their initial risk status.

Implementation of section 403(a)(2) of Social Security Act; bonus to reward decrease in illegitimacy ratio. Administration for Children and Families, HHS. Final rule.

The Administration for Children and Families is issuing a final rule describing how we will award a bonus to those States that experience the largest decreases in out-of-wedlock childbearing and also reduce their abortion rates. The total amount of the bonus will be up to $100 million in each of fiscal years 1999 through 2002, and the award for each eligible State in a given year will be $25 million or less. This incentive provision is a part of the welfare reform block grant program enacted in 1996--the Temporary Assistance for Needy Families, or TANF, program.