The results suggest that method and provider choice are strongly linked, and recent efforts to increase access to long-term methods among young women may be restricted by where they seek care. Interventions to increase adolescents' access to a range of FP methods and quality counseling should target providers frequently used by young people, including limited-capacity providers in the private sector.

Schoon, I; Lyons-Amos, M (2017) A socio-ecological model of agency: The role of structure and agency in shaping education and employment transitions in England. Longitudinal Schoon, Lyons-AmosA socio-ecological model of agency: The role of structure and agency in shaping education and employment transitions in England 36

Although the transition from education to work has been a topic of much research, there is still lack of understanding regarding experiences of recent cohorts of young people. Moreover, much of the debate has focused on the polarization of youth transitions, at the neglect of a large group of young people who fall outside this dualism. This paper introduces a diverse pathways view offering a more comprehensive understanding of changing youth transitions and examines how transitions are shaped by interactions between structure and individual agency. The study is based on data from the British Household Panel Study (BHPS) and the UK Household Longitudinal Study (UK-HLS) using sequence analysis to identify transition patterns among cohorts born in 1980-84 and 1985-1989. Five distinct clusters could be identified, differentiating between those who participate in extended education, two pathways dominated by continuous employment, either directly after completing compulsory schooling at age 16 or after some further education, and two pathways characterized by exclusion from the labor market (either through prolonged experience of unemployment or inactivity). Both structural and agency variables are associated with variations in transition patterns, pointing to the need of conceptualizing the role of the agent as well as that of structures and resources for a better understanding of the processes underlying the selection into different pathways.

ObjectivesOut-of-pocket (OOP) payment for modern contraception is an understudied component of healthcare financing in countries like Kenya, where wealth gradients in met need have prompted efforts to expand access to free contraception. This study aims to examine whether, among public sector providers, the poor are more likely to receive free contraception and to compare how OOP payment for injectables and implants—two popular methods—differs by public/private provider type and user’s sociodemographic characteristics.Design, setting and participantsSecondary analyses of nationally representative, cross-sectional household data from the 2014 Kenya Demographic and Health Survey. Respondents were women of reproductive age (15–49 years). The sample comprised 5717 current modern contraception users, including 2691 injectable and 1073 implant users with non-missing expenditure values.Main outcomeRespondent’s self-reported source and payment to obtain their current modern contraceptive method.MethodsWe used multivariable logistic regression to examine predictors of free public sector contraception and compared average expenditure for injectable and implant. Quintile ratios examined progressivity of non-zero expenditure by wealth.ResultsHalf of public sector users reported free contraception; this varied considerably by method and region. Users of implants, condoms, pills and intrauterine devices were all more likely to report receiving their method for free (p<0.001) compared with injectable users. The poorest were as likely to pay for contraception as the wealthiest users at public providers (OR: 1.10, 95% CI: 0.64 to 1.91). Across all providers, among users with non-zero expenditure, injectable and implant users reported a mean OOP payment of Kenyan shillings (KES) 80 (US$0.91), 95% CI: KES 78 to 82 and KES 378 (US$4.31), 95% CI: KES 327 to 429, respectively. In the public sector, expenditure was pro-poor for injectable users yet weakly pro-rich for implant users.ConclusionsMore attention is needed to targeting subsidies to the poorest and ensuring government facilities are equipped to cope with lost user fee revenue.

Reforestation of riparian zones is increasingly practiced in many regions for purposes of biodiversity conservation, bank stabilisation, and improvement in water quality. This is in spite of the actual benefits of reforestation for recovering underlying soil properties and function remaining poorly understood. Here we compare remnant riparian rainforest, pasture and reforestation plantings aged 2–20 years in an Australian subtropical catchment on ferrosols to determine the extent to which reforestation restores key soil properties. Of the nine soil attributes measured (total nitrogen, nitrate and ammonium concentrations, net nitrification and ammonification rates, organic carbon, bulk density, fine root biomass and water infiltration rates), only infiltration rates were significantly lower in pasture than remnant riparian rainforest. Within reforestation plantings, bulk density decreased up to 1.4-fold and infiltration rates increased up to 60-fold with time post-reforestation. Our results suggest that the main outcome of belowground processes of early reforestation is the recovery of the soils' physical structure, with potential beneficial ecosystem services including reduced runoff, erosion and associated sediment and nutrient loads in waterways. We also demonstrate differential impacts of two commonly planted tree species on a subset of soil properties suggesting that preferential planting of select species could accelerate progress on specific restoration objectives.

Background: Improving maternal health is a major development goal, with ambitious targets set for high-mortality countries like Bangladesh. Following a steep decline in the maternal mortality ratio over the past decade in Bangladesh, progress has plateaued at 196/100,000 live births. A voucher scheme was initiated in 2007 to reduce financial, geographical and institutional barriers to access for the poorest.Objective: The current paper reports the effect of vouchers on the use of continuum of maternal care.Methods: Cross-sectional surveys were carried out in the Chattogram and Sylhet divisions of Bangladesh in 2017 among 2400 women with children aged 0–23 months. Using Cluster analysis utilisation groups for antenatal care, facility delivery and postnatal care were formed. Clusters were regressed on voucher receipt to identify the underlying relationship between voucher receipt and utilisation of care while controlling for possible confounders.Results: Four clusters with varying levels of utilisation were identified. A significantly higher proportion of voucher-recipients belonged to the high-utilisation cluster compared to non-voucher recipients (43.5% vs. 15.4%). For the poor voucher recipients, the probability of belonging to the high-utilisation cluster was higher compared to poor non-voucher recipients (33.3% vs. 6.8%) and the probability of being in the low-utilisation cluster was lower than poor non-voucher recipients (13.3% vs. 55.4%).Conclusion: The voucher programme enhanced uptake of the complete continuum of maternal care and the benefits extended to the most vulnerable women. However, a lack of continued transition through the continuum of maternal care was identified. This insight can assist in designing effective interventions to prevent intermittent or interrupted care-seeking. Programmes that improve access to quality healthcare in pregnancy, childbirth and the postnatal period can have wide-ranging benefits. A coherent continuum-based approach to understanding maternal care-seeking behaviour is thus expected to have a greater impact on maternal, newborn and child health outcomes.

Postabortion contraceptive use is low in Nepal. Postabortion family-planning counseling and related services should be strengthened with systematic monitoring and follow-up interventions.

CPC centre for population changeImproving our understanding of the key drivers and implications of population change Longitudinal methods for life course research: A comparison of sequence analysis, latent class growth models, and multistate event history models for studying partnership transitions ABSTRACT This paper compares and contrasts three methods that are useful for life course researchers; the more widely used sequence analysis, the promising but less often applied latent class growth models, and multistate event history models. The strengths and weaknesses of each method are highlighted by applying them to the same empirical problem. Using data from the Norwegian Generations and Gender Survey, changes in the partnership status of women born between 1955 and 1964 are modelled, with education as the primary covariate of interest. We show that latent class growth models and multistate event history models are a useful addition to life course researchers' methodological toolkit and that these methods can address certain research questions better than the more commonly applied sequence analysis or simple event history analysis.