NOTE TO EDITORS/REPORTERS/PRODUCERS: The June 2001 issue of International Family Planning Perspectives, a quarterly, peer-reviewed journal of The Alan Guttmacher Institute, features several new studies examining contraceptive use and the provision of family planning services:

Low levels of contraceptive use among Nigerian adolescents might be a result of perceived risks related to the use of birth control methods, according to findings reported in "Why Nigerian Adolescents Seek Abortion Rather than Contraception: Evidence from Focus-Group Discussions." Researchers Valentine O. Otoide, Frank Oronsaye and Friday E. Okonofua found that sexually active Nigerian youths are generally misinformed about the risks associated with modern methods of contraception, especially the possibility of infertility. As a result, many teenagers reject contraceptive use and rely on induced abortion instead. Many participants in focus groups conducted by the authors in a major Nigerian city perceive the adverse effects of modern contraception on fertility to be continuous and prolonged, while they view abortion as an immediate solution to an unplanned pregnancy-and, therefore, one that would have a limited negative impact on future fertility. Induced abortion in Nigeria is the largest contributor to maternal mortality, however, and accounts for 20,000 of the 50,000 maternal deaths that occur each year. Abortion is illegal in Nigeria unless a woman's life is threatened by the pregnancy. Most abortions are of poor quality and unsafe.

With Nigerians marrying later and increasingly having premarital sex, this study concludes that young people need education about contraceptives and their side effects in relation to unsafe abortion in order to prevent a dramatic rise in the prevalence of unsafe abortion.

SHIFT TOWARD CLINIC-BASED FAMILY PLANNING SERVICES IN BANGLADESH SUCCESSFUL

A recent shift away from door-to-door delivery of family planning services in Bangladesh and toward site-based distribution has not discouraged women from seeking services, according to findings reported in "Consequences of the Shift from Domiciliary Distribution to Site-Based Family Planning Services in Bangladesh." The analysis, by Subrata Routh, Ali Ashraf, John Stoeckel and Barkat-e-Khuda, showed that while the proportion of women obtaining their supplies at home from fieldworkers has declined, the proportion obtaining supplies from pharmacies, shops or clinics has increased. This finding shows that Bangladeshi women are committed to continuing family planning efforts, contrary to the initial hypothesis of the researchers. After two decades of door-to-door service, the national family planning program is shifting its emphasis to a clinic-based approach for service provision. This new strategy for delivering family planning services comes as a result of estimated growth in the number of couples of reproductive age from 27 million in 1995 to 40 million in 2005-a number that fieldworkers will be unable to handle effectively. In addition, the findings indicate that the move to fixed-site facilities and clinics will provide a broader range of reproductive health services and better serve women's reproductive needs, as well as improve the financial sustainability of the program.

FAMILY PLANNING LINKED TO POSTABORTION CARE DECREASES REPEAT ABORTIONS IN TURKEY

Providing family planning services to Turkish women seeking abortions has led to an increase in the use of effective contraceptives and a significant decrease in the number of repeat abortions, according to "Bridging the Gap: Integrating Family Planning with Abortion Services in Turkey." The analysis, by Pinar Senlet, Levent Cagatay, Julide Ergin and Jill Mathis, examines a pilot program funded by the United States Agency for International Development (USAID) that began in one hospital in 1991, and has now been implemented in all major public and private facilities providing abortion in Turkey.

The authors note that despite a successful, progressive family planning program in Turkey, women have not had adequate access to modern contraceptives, which has resulted in their relying on repeat abortion rather than long-term modern contraceptive methods to limit their family size. Prior to the establishment of the new postabortion family planning program, women rarely left an abortion provider facility with the contraceptives and information necessary to prevent another unplanned pregnancy. In the first year of this pilot program, however, the proportion of clients who left the hospital after their abortion with a modern contraceptive method (particularly an IUD or tubal sterilization) rose from 65% to 97%. That proportion remained steady from 1992 through 1998, the last year for which data are available. This article shows that the postabortion family planning program contributed to a decline in abortion in Turkey, both by increasing contraceptive use overall and by shifting the method mix toward more effective methods and away from repeat abortion.

Other articles featured in this issue are

• "Timing of First Intercourse Among Malian Adolescents: Implications for Contraceptive Use," by Mouhamadou Gueye, Sarah Castle and Mamadou Kani Konat&aacute,

• "Monitoring Quality of Care in Family Planning Programs: A Comparison of Observations and Client Exit Interviews," by Ruth E. Bessinger and Jane T. Bertrand, and

• "Female Circumcision in Sudan: Future Prospects and Strategies for Eradication," by M. Mazharul Islam and M. Mosleh Uddin.