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A journal of peer-reviewed research
March 2016 Pages 33 - 44
Global Trends in Family Planning Programs, 1999–2014
Bernice Kuang,Palladium, Washington, DC
Isabel Brodsky,Palladium, Washington, DC
First published online: June 26, 2016 DOI: https://doi.org/10.1363/42e0316
Since 1972, the Family Planning Effort Index has measured national family planning program activities in developing countries and provided a longitudinal perspective on a standardized set of program characteristics.
In 2014, experts in 90 developing countries assessed national family planning program effort in four main component areas—policies, services, monitoring and evaluation mechanisms, and access to methods—using a standardized questionnaire. Results were compared with previous years' data.
Globally, family planning program effort has progressed in all four main component areas. The service component, historically the weakest, was rated lowest of all components in 2014, at 47% of the maximum effort, despite a marked improvement of 7.6 percentage points since 1999. Policies, generally the strongest component, remained the strongest in 2014, with 55% of the maximum score and a 6.7 percentage-point improvement since 1999. Monitoring and evaluation improved the most, by 7.8 percentage points, from 45% to 53%, while access improved more modestly, by 2.7 points, from 49% to 52%. Family planning efforts were generally strongest in Asia and Oceania and generally weakest in Central Asia and Eastern Europe.
Global family planning programs have improved consistently over the last few decades, although there is room for further development in all regions.
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National family planning programs emerged in the 1960s and are now active in many developing countries throughout the world. These programs vary greatly in effectiveness and coverage. Strong national family planning programs have certain key features, such as provision of a variety of high-quality family planning, counseling and contraceptive options, as well as broad multisectoral governmental and private sector support. Clear national policies help provide structure to family planning programs, which should be sustained by regular monitoring and evaluation, training, supervision, and logistic support. Because services and methods should be accessible to the entire population, effective programs have extensive outreach strategies to serve the general population and targeted approaches to reach underserved populations through mass media programs, social marketing or community-based distribution. Also, successful programs have rights-based quality assurance measures in place to ensure voluntary and well-informed uptake of family planning.1
National family planning programs benefit from regular monitoring to identify both successes and areas in need of development. Since 1972, the Family Planning Effort Index has provided standardized periodic measurements of the strength of national-level family planning programs worldwide. Its measures, categorized into four main component areas—policy context, service provision, monitoring and evaluation, and access to methods—are based on important features of successful programs.2,3 This longitudinal data set spans five decades and serves as the only publicly available international source for analyzing changes in national family planning programs over time. Because the Family Planning Effort Index measures inputs, rather than outcomes, programs are able to use it to determine where greater effort should be expended; also, Family Planning Effort Index scores have often been used by major donors and development partners both to identify program weaknesses and to measure progress over time. Family Planning Effort Index scores have also figured in numerous analyses over the years to investigate program impact separately from socioeconomic changes on contraceptive use and fertility levels and changes.4–6
While the prominence of family planning on the development agenda has risen and fallen over the years, the Family Planning Effort Index has historically been used as a reliable and consistent data source for countries and development agencies. For example, Family Planning Effort Index studies conducted in 1999, 2004 and 2009 were used to monitor national efforts expended to achieve Millennium Development Goals (MDGs) 4 and 5, which focused on reducing maternal and child mortality and improving access to reproductive health care.7
The Sustainable Development Goals8 (SDGs), adopted in 2015 as a follow-up to the MDGs, outline similar maternal and child health priorities for 2030 in SDG 3, which calls for ensuring health and well-being at all ages. Additionally, SDG 3.7 sets the goal of "universal access to sexual and reproductive health care services, including family planning, information and education, and the integration of reproductive health into national strategies and programs."8(p.18) Furthermore, SDG 5 promotes gender equality and empowerment of women and girls; SDG 5.6 reiterates the goal of universal access to sexual and reproductive health and emphasizes the goal of universal access to reproductive rights.
Family Planning 2020 (FP2020) is a global partnership of governments, donors, private organizations, civil society and the research community in support of "the rights of women and girls to decide freely, and for themselves, whether, when and how many children they want to have."9 With its focus on 69 priority countries, FP2020 has also raised the profile of family planning on the development agenda and further highlighted the importance of political engagement, financial support, high-quality rights-based services, and consistent monitoring and evaluation. Thus, the Family Planning Effort Index will be useful as a monitoring tool over the course of FP2020 and toward achievement of the SDGs.
In this article, we summarize the results of the 2014 Family Planning Effort Index, which uses 36 ratings in the four component areas to describe the current landscape of national family planning program efforts in the developing world. Using the longitudinal data set from 1999 onward, we assess the extent of improvement in family planning program effort from national, regional and global perspectives. Our article presents the first full analysis of the 2014 cycle and uses those data, as well as data from the 1999, 2004 and 2009 cycles, to examine trends over the last 15 years.
DATA AND METHODS
The 2014 round of the study used methods very similar to those used in all rounds since 1999. One exception was the use of two implementing agencies, each with separate funding. The United States Agency for International Development–funded Health Policy Project provided support to the Futures Group to conduct the project in anglophone Sub-Saharan Africa; Asia and Oceania; the Middle East and North Africa; and Central Asia and Eastern Europe, excluding the FP2020 priority countries. The Bill and Melinda Gates Foundation supported Track20, implemented by Avenir Health, to conduct the project in the FP2020 priority countries, as well as in francophone and lusophone Sub-Saharan Africa and in Latin America and the Caribbean. All procedures used by the two organizations were identical.
First, we identified a study manager for each country who possessed close familiarity with the national family planning program and who could select respondents knowledgeable about the program. Study managers drew respondents from a variety of backgrounds, including the government, the private sector, academia, nongovernmental organizations and international agencies.
We sought to collect data in developing countries with populations of more than one million that satisfied at least one of the following criteria: an active national family planning program, inclusion in at least one previous study wave or inclusion in the FP2020 priority country list. We defined an active national program as any public-sector activity devoted to the provision of family planning. We attempted to contact experts in 100 countries; ultimately, we collected and analyzed data from 90 countries comprising more than 90% of the population in the developing world. We omitted 10 countries because study managers failed to respond or to identify country experts after repeated attempts. The number of countries represented in 2014 was greater than the number represented in the other cycles examined here (81 in 2009, 82 in 2004 and 87 in 1999).
The study managers each identified 10–15 expert respondents in their country, yielding a total of 1,177 respondents in the 90 countries. Respondents completed a standard questionnaire rating the level of effort expended on 36 features of their country's family planning program. Each feature was rated on a scale of 1 (minimal to no effort) to 10 (highest level of effort). Additional items were included, as had been done in 2009, covering topics not used to calculate the overall Family Planning Effort scores. They focused on family planning program justifications, the emphasis placed on reaching special populations (such as unmarried youth or rural populations) and the perceived quality of the family planning program.
To minimize bias introduced by variability in respondents' areas of knowledge, study managers instructed respondents to skip questions if they were unsure of the answer or did not have the relevant knowledge. Study managers entered data from the questionnaires into a country-level database, and teams from both the Health Policy Project and Track 20 manually reconciled databases against a selection of original questionnaires to verify the accuracy of the data entry; extreme values were checked with study managers.
For a given country, the ratings on each question were averaged across respondents. These ratings were then averaged by component to produce the four component scores; policy context was measured by eight ratings, monitoring and evaluation by three, access by 12 and service provision by 13. The policy context measures the enabling environment, such as support from in-country leaders, the regulatory guidelines for importation or manufacturing of supplies, and budget allocation for family planning activities. The monitoring and evaluation component assesses the extent of data collection and evaluation and the extent to which data are used to improve operations. The access questions focus on the extent to which various methods, method-specific services and safe abortion (regardless of legality) are available to the whole population, while the service questions measure features such as the availability of community-based distribution, the extent to which facilities are adequately staffed, and the extent to which personnel are trained and supervised. The total Family Planning Effort Index score was the average of all 36 ratings. The responses to the additional questions on program justifications and subgroup emphases were not used to calculate component scores or the overall total Family Planning Effort Index (but are available for use by researchers and stakeholders).
Across all countries, the response rate was 96% for the questionnaire items used to calculate the Family Planning Effort Index and the four component scores; the response rate for the additional questions regarding program justifications and emphases on population subgroups was 98%. Finally, all ratings were calculated as percentages of the maximum score, allowing for easy comparisons between the components and with previous study cycles. Although past experience shows that the scores of the best-performing countries have been only about 80% of this maximum, we have retained the 100% figure for the full perspective and for consistency with past reports.
We calculated both unweighted and weighted scores for each region by averaging the component scores and total Family Planning Effort Index scores for all included countries in the region. The unweighted global average, covering all regions, is the average of all countries' component scores and total Family Planning Effort Index scores. Each country's scores were weighted by its total population size, taken from the United Nations' World Population Prospects 2013 Revision.10 Except for Figure 1, in which both weighted and unweighted scores are presented, analyses of 2014 results present weighted scores, while historical analyses are unweighted because of changing population distributions over time.
This article analyzes trends from study cycles for 1999, 2004, 2009 and 2014. We also use data from 1972–1994 to show trends from the first to the last cycle of the study.
Methodology Changes in 2014
The 2014 iteration of the Family Planning Effort Index differed from previous cycles in two ways. First, in all countries, the Family Planning Effort questionnaire items were followed by the items for the National Composite Index for Family Planning (NCIFP), a collection of FP2020 indicators designed by Track20 to measure specific progress indicators of the FP2020 initiative. The NCIFP measures the enabling environment for family planning, particularly among the 69 FP2020 priority countries; we thus searched for study managers in all 69 FP2020 countries, regardless of whether these countries met the population criteria.
Second, the 2014 cycle of the Family Planning Effort Index included five new items in the access component in addition to the original seven. These were added to reflect the growing importance of newer contraceptive methods and services—specifically IUD removal services, implants, implant removal services, emergency contraceptives and counseling on permanent methods. We included removal and counseling services to measure informed consent and voluntary uptake of family planning. To maintain comparability between survey waves, only the seven original access ratings were used to calculate the access component score and the total Family Planning Effort Index when we compared 2014 with past surveys. In contrast, in cross-sectional analyses of the 2014 survey only, all 12 access ratings were used to calculate both the overall access component score and the total Family Planning Effort Index score.
Adjustments to Maintain Comparability
We adjusted several calculations to improve comparability between survey cycles. First, with the exception of Figure 1, wherever 2014 scores were compared with historical scores, we included only the 54 countries that were included in all four study rounds from 1999 through 2014. (See Appendix 1 for a list of the 54 countries.) In contrast, when 2014 scores were analyzed alone, all 90 countries were included in the calculations.
For Figure 1 only, all countries surveyed in each year were included and, consequently, the count of how many countries figured into the calculations and which countries were assessed differs from cycle to cycle. Also, prior to 1999, a longer form of the questionnaire was used. A simpler form was adopted in 1999 and implemented alongside the longer form to allow for calibration. The average difference between the long and short forms in 1999 lets us adjust subsequent results to produce the full series in Figure 1. This adjustment was applied only in Figure 1 because it encompasses both long-form and short-form results; all other graphs and charts tracking historical patterns focus only on short-form surveys and thus needed no further adjustments.
There are two types of limitations for this research: those common to the methodology, and those particular to this cycle. For the first, the data come from subjective ratings by observers of the national family planning program. The advantage of observer ratings, however, is that estimates emerge for variables for which no objective measures exist, such as the quality of training and supervision or the proportion of the whole population having "ready and easy" access to each contraceptive method.
An additional limitation is that because the cycles are about five years apart, the respondents differ to some degree from one cycle to the next. Also, some countries included in one cycle are omitted in the next cycle, for a variety of reasons. The latter is addressed in the results with time trends only for countries included in all cycles of interest. Balanced against these limitations are the advantages of a standard set of effort measures for most developing countries, obtained at approximately the same point in time, at reasonable cost, with trends for each of the ratings.
The second set of limitations for this particular cycle includes changes in the questionnaire—specifically, adding items for the access component. On average, however, comparisons of the two versions showed little difference in the results. Perhaps a more important change was that the Family Planning Effort Index questions were followed by the NCIFP questions. This was not done in previous years and may have increased respondent fatigue (although there was no evidence of elevated nonresponse rates).
Trends in Global Scores
The weighted and unweighted global Family Planning Effort Index score (the mean Family Planning Effort Index score across all countries, weighted by country population) rose dramatically between 1972 and 1990 (Figure 1). The weighted scores stabilized during the 1990s, while the unweighted scores continued to rise. In the 2000s, the weighted scores declined slightly and then stabilized after 2010, while the unweighted scores continued to edge upward between 2000 and 2014. Both weighted and unweighted Family Planning Effort Index scores increased slightly in the last five years. The difference in trajectory between the unweighted and weighted averages suggests that family planning programs are increasing their strength of effort at the country level and that countries adopting new programs have started off strong, but that improvements in smaller countries may be offset by stagnancy or limited improvements in larger countries.* For example, while scores for smaller countries such as Nicaragua and Benin improved by more than 15 percentage points between 2009 and 2014, scores for more populous countries like China and Indonesia have decreased steadily over time, with a 5–6 percentage-point decline in the last five years (not shown). Furthermore, although there has been both long- and short-term improvement, the highest global scores are still less than 70% of the maximum possible score, indicating space for further growth.
We also looked separately at the global mean Family Planning Effort Index total and component scores for all study cycles conducted since the short-form questionnaire was adopted in 1999 (Figure 2). For this analysis, we included only the 54 countries that were included in all four survey cycles. We also calculated the 2014 access score with the original set of contraceptive methods and service items only. Most program components improved consistently between 1999 and 2014. The total Family Planning Effort Index score improved by more than six percentage points, from 45% to 51%, demonstrating steady improvement in programs established 15 or more years ago. The monitoring and evaluation component scores saw the largest growth, with a 7.8 percentage-point improvement, followed by services and policies at 7.6 and 6.7, respectively. Finally, access also improved, but by only 2.7 percentage points. This pattern persisted when the 12-item access measure was used in the 2014 total Family Planning Effort Index score and in the access component score, although the degree of improvement was attenuated for both scores (not shown).
Trends in Regional Scores
•Total scores. We looked at historical trends by region, again among only the 54 countries that were included in the last four survey cycles. We found that although the global average had improved steadily for family planning programs, differences between regions persisted both in overall program strength and in level of change over time (Table 1). For example, while the Middle East and North Africa and Asia and Oceania had the highest total Family Planning Effort Index scores in 2014 (55% and 58%, respectively), the absolute increase in their scores (five and four percentage points, respectively) between 1999 and 2014 was much lower than in other regions. During that period, total scores in Latin America and the Caribbean and in Central Asia and Eastern Europe improved by more than 10 percentage points each and in francophone and lusophone Sub-Saharan Africa by approximately nine points. Anglophone Sub-Saharan Africa has had a U-shaped pattern of progress and its score in 2014 was lower than its score in 1999.
•Policy scores. In 2014, Asia and Oceania had the highest policy score (64%), while francophone and lusophone Sub-Saharan Africa had the lowest score (48%). In the last five years, policy effort increased notably in Asia and Oceania (five percentage points), with dramatic strides made in the Philippines, Myanmar and Bangladesh (not shown). Over the same period, the policy score in anglophone Sub-Saharan Africa improved by nearly four percentage points, while that score declined in francophone and lusophone Sub-Saharan Africa by approximately the same amount. Although the policy score for the Middle East and North Africa had risen by six points between 1999 and 2004 (to 64%), it dropped back to 59% by 2014. The score for Central Asia and Eastern Europe improved by less than one percentage point over the period between the last two surveys.
•Service scores. Nearly all regions increased their service scores between 1999 and 2014. Asia and Oceania had the highest service score in 2014 (55%), while Central Asia and Eastern Europe had the lowest score (43%), down almost three percentage points in the last five years. In the last five years, the region with the greatest improvement was anglophone Sub-Saharan Africa, whose score increased by nearly four percentage points (to 46%); however, the region's service score has not yet returned to its 1999 level (47%), following a marked decrease between 1999 and 2004. In contrast, francophone and lusophone Sub-Saharan Africa improved by only 0.5 percentage points in the last five years but by nearly 10 percentage points since 1999.
•Monitoring and evaluation scores. Monitoring and evaluation saw substantial improvements in most regions between 1999 and 2009, and either stability or modest improvements in the five years between 2009 and 2014. Although anglophone Sub-Saharan Africa has not improved consistently, it did experience the strongest five-year improvement (three percentage points), recovering to almost 50% in 2014 after a decline of nearly six percentage points between 1999 and 2004. The Middle East and North Africa region had the highest monitoring and evaluation score in 2014 (60%), similar to its score in the previous survey and largely attributable to a very high score in Morocco (not shown).
•Access scores. Scores measuring access to contraceptive methods increased, albeit slowly, between 1999 and 2014. Asia and Oceania scored the highest in this area in 2014, with 59%, while francophone and lusophone Sub-Saharan Africa scored lowest at 44%. Progress in Asia and Oceania in the last five years was particularly strong, with every single country except Nepal reporting greater access (not shown); however, the 2014 regional access score for Asia and Oceania was not much higher than its 1999 score (58%). Other regions also reported fairly steady improvements in access over the last five years, with most experiencing a 2–3 percentage-point increase in their score.
Current Landscape
The 2014 global picture of family planning program efforts, including all 90 countries surveyed in 2014, weighted by country population and with new contraceptive methods included in the access component, shows that the policy component was rated the highest (62%), followed by access (57%), monitoring and evaluation (54%), and services (53%—Table 2). However, when we look at component areas by region, the pattern of which program components ranked highest varied somewhat. For all regions except Central Asia and Eastern Europe, the policy component was rated as either the strongest or second-strongest component. In most regions, access was also the strongest or second-strongest, with the exceptions of the Middle East and North Africa and francophone and lusophone Sub-Saharan Africa, where monitoring and evaluation emerged as the strongest component (57% and 53%, respectively).
Asia and Oceania was the highest rated region in total program effort (60%) and also in the policies (67%), services (57%) and access components (60%). Programs that received lower scores were generally in less-populous countries, such as Afghanistan, Papua New Guinea and Timor-Leste (see Appendix 1 for country-level results). Although China and India could potentially have dominated regional trends because of their large populations, they were often rated on opposite sides of the regional average and tended to offset each other (not shown). The total Family Planning Effort Index score and the component scores were weakest, with the exception of access, in Central Asia and Eastern Europe (32–47%). Russia, the most populous and thus most influential country in Central Asia and Eastern Europe, performed particularly poorly in the policies, services, and monitoring and evaluation areas, which depressed the regional average for these components (not shown).
The monitoring and evaluation component was ranked highest in the Middle East and North Africa (57%) and was rated fairly evenly across countries, with the exception of very high scores in Morocco and Tunisia and a very poor score in Libya, which had little effect on the average because of its small population (not shown). The access component was weakest in francophone and lusophone Sub-Saharan Africa (44%); this was heavily influenced by a low access score in the Democratic Republic of the Congo, the most populous country in the region.
Effect of Adding Items to the Access Component
In the decades during which the Family Planning Effort Index has been studied, the range of available family planning methods has expanded to include new choices, and interest in the quality of method-specific services has increased. We added five items to the original seven items in the access component to reflect these shifts. However, to maintain longitudinal consistency, we calculated the access component with all 12 items ("New measure") and also with the original seven items only ("Original measure"). We looked at the impact of the additional five items both globally and by region and found that the additions did not make a substantial difference in the access component score (Table 3).
A closer look at regional differences shows that Asia and Oceania's access average was the only one that declined notably when the new items were included (64% with original items vs. 60% with the additional items), which is in line with the observation of limited family planning effort progress in recent years in that region. Although the family planning programs in Asia and Oceania have historically been strong, improvements in recent years have been modest, possibly because of the higher baseline. Sri Lanka and Papua New Guinea were two clear exceptions to the Asia and Oceania pattern and were markedly stronger at providing the full range of new access features than the original group of items (not shown).
In contrast, nearly all other regions were slightly stronger in access efforts when assessed using the new access component than when using the original one. However, analysis at the country level revealed interesting patterns. First, the Middle East and North Africa region showed an increase of 1.1 percentage points in access when the new items were included. However, this was affected by the dramatic increase reported in Iran—the second most populous country in the region—of nearly eight percentage points; almost every other Middle Eastern and North African country reported a decline (not shown).
The access score for the francophone and lusophone region of Sub-Saharan Africa was one percentage point higher when the expanded access component was used; however, this was largely because of a 4.9 percentage-point increase in access in the Democratic Republic of the Congo, the most populous country in the region. In contrast, in anglophone Sub-Saharan Africa, approximately two-thirds of countries in the region scored higher under the new access measure than under the original access measure. Namibia and Eritrea were two clear exceptions, showing a decline of about six percentage points each; however, this had little impact on the regional averages because both countries have small populations. South Africa was a similar exception, with a decline of three percentage points (not shown).
The results for Eastern Europe and Central Asia and for Latin America and the Caribbean were more evenly distributed across countries. Approximately half of countries' scores decreased when all 12 items were included, while scores for the other half increased.
Regional Scores for Additional Questions
Despite not being used to calculate the overall Family Planning Effort Index scores, the questions on program justifications, the emphasis programs put on special populations and the perceived quality of the country's family planning program add context to the Index scores and how they might be improved. They also shed light on how programs differ, country to country and region to region.
Globally, the most frequently cited justifications for national family planning programs were to improve women's health and avoid unwanted births, both scoring 76% of the maximum scores (Table 4). This finding was similar to past results.11 Reducing unmarried adolescent childbearing was the lowest global priority at 52%, although this was heavily influenced by especially low ratings in Asia and Oceania (49%) and the Middle East and North Africa (25%), where nonmarital childbearing remains highly taboo. Reducing population growth was strikingly unimportant in Central Asia and Eastern Europe, where it scored at just 11%—nearly 40 percentage points lower than the next lowest region, francophone and lusophone Sub-Saharan Africa. The two regions least concerned with reducing population growth also occupy opposite ends of the fertility spectrum (not shown). At the global level, reducing population growth was rated at 69%, in large part because of high scores in the populous Asia and Oceania region.
The population subgroup receiving the strongest emphasis was rural residents, with a global score of 69%. Asia and Oceania scored rural residents as the subgroup receiving the strongest emphasis (75%), while Central Asia and Eastern Europe identified this group as receiving the least emphasis (38%), prioritizing unmarried youth, postpartum and postabortion women higher (42–56%). Globally, at 40%, unmarried youth were seen as the least emphasized subgroup, attributable in part to low scores in Asia and Oceania (39%) and the Middle East and North Africa (20%). In contrast, the score for unmarried youth in Latin America and the Caribbean was 61%. This may reflect the relative social acceptability of sexual activity among Latin American youth, in contrast to, say, abortion; for instance, with a score of approximately 50%, postabortion women were seen as the least emphasized special population in Latin America and the Caribbean, ranking more than 10 percentage points lower than every other special population (61–64%).
The final item on the questionnaire asked respondents to rank overall family planning service quality in their country. Globally, the average score was 55%, and regional scores were distributed fairly closely around this number, with Latin America and the Caribbean and Asia and Oceania scoring the highest (57% each). (These two regions also had the highest total Family Planning Effort scores.) Anglophone Sub-Saharan Africa scored the lowest in family planning service quality (52%).
Family planning programs exist around the world; some have been in place for decades and have been strengthened over time, while others still receive low ratings. However, in the last five years, family planning program efforts have increased, from both a country-by-country perspective and a per-capita perspective, as evidenced by unweighted and weighted scores, respectively. Globally, each program component also gained in strength in the last five years, with the largest strides being made in access, followed by improved efforts in the policy area. Adequate access is necessary for the adoption of family planning; thus, the increase in access strength favors family planning uptake. Further development in monitoring and evaluation and in services, such as absence of financial incentives, provision of method removal services and regular supervision and training, will ensure that uptake is voluntary and occurs within the context of a rights-based approach. Justifications for family planning programs as assessed here have varied over the years, but most programs today focus on improving health among women and children, and enabling women to avoid unwanted births.
Although the 2014 Family Planning Effort Index demonstrates consistent global progress in family planning program effort in all four main component areas, the highest scores are still far from the maximum, and indicate areas for further improvement at both the country and regional levels. Furthermore, the quality of family planning programs was consistently rated at around 50% of the maximum by all regions, demonstrating that the in-country experts feel there is room for further growth.
Although improvements in family planning program effort have been steady, unmet need is still high in many developing countries,12,13 which is indicative of gaps in access, services or policies that neither the public nor the private sector has addressed. Survey data continue to show that substantial proportions of births are still too closely spaced, are of birth orders greater than three or are occurring among adolescents—all of which are linked to adverse maternal and child outcomes.14–16 As a result of insufficient family planning access, poor family planning services or negative sociopolitical environments, mistimed and unwanted births continue to occur, exacerbating unmet need. Greatly improved family planning access, services and policies may lower unmet need by decreasing barriers to family planning uptake, and may also increase the demand for contraception.9,17 In any case, addressing unmet need and preventing unwanted pregnancies and births will relieve pressure on the health, economic and social sectors, leading to positive ramifications at the household, community and national levels.
There are many pathways through which national and subnational governments can improve their family planning programs and address the policy, service, monitoring and evaluation, access and uptake gaps. Governments can continue to improve the policy and access environment for family planning by removing bottlenecks in the supply chain, such as facilitating importation or local manufacture of contraceptives, and also by improving the enabling environment for private-sector provision of services and supplies. Additionally, governments can issue statements in support of family planning from prominent leaders, and can allow unrestricted family planning advertisements in the media. Programs can better reach those most vulnerable and in need by making a comprehensive range of methods and services easily accessible to all women—unmarried women, adolescents, migrant women, mobile populations, and poor and rural women. These efforts can use such traditional channels as public clinics or outreach via fieldworkers, as well as more innovative outreach methods, such as mobile health (e.g., mobile clinics or health services supported by mobile phones) or social franchising. In an increasingly urban world, channels for reaching mobile or hard-to-reach populations, urban youth or the urban poor will need to adapt to serve the women who have the least access and independent agency, but may be the most in need. And finally, as more and more births are attended by professional birth attendants, postpartum opportunities should be leveraged as a crucial point of contact for counseling women on their family planning needs, in both public and private facilities.
With the 2014 wave of the Family Planning Effort Index, up-to-date national and regional data are now available in the public domain, enabling policymakers, program planners and family planning researchers to further investigate program strengths and weaknesses, renew commitments from stakeholders and set priorities for future improvements. Lessons can also be drawn for policy and program improvements and for adjustments to the changing contexts in which the programs work, including decentralization, integration, funding reversals and attention to special populations. Finally, with longitudinal monitoring mechanisms such as the Family Planning Effort Index, governments, nongovernmental organizations and international agencies are equipped to more effectively allocate resources, identify shortfalls and devise country-customized approaches to improving family planning programs.
*Unweighted scores reflect family planning program status from a country-by-country perspective, while weighted scores speak to family planning program strength from a per-capita perspective.
1. Hardee K et al., Voluntary, human rights-based family planning: a conceptual framework, Studies in Family Planning, 2014, 45(1):1–18.
2. Lapham RJ and Mauldin WP, National family planning programs: review and evaluation, Studies in Family Planning, 1972, 3(3):29–52.
3. Ross JA and Stover J, The Family Planning Program Effort Index: 1999 cycle, International Family Planning Perspectives, 2001, 27(3):119–129.
4. Lapham RJ and Mauldin WP, Family planning program effort and birthrate decline in developing countries, International Family Planning Perspectives, 1984, 10(4):109–118.
5. Lapham RJ and Mauldin WP, Contraceptive prevalence: the influence of organized family planning programs, Studies in Family Planning, 1985, 16(3):117–137.
6. Jain AK and Ross JA, Fertility differences among developing countries: Are they still related to family planning program efforts and social settings? International Perspectives on Sexual and Reproductive Health, 2012, 38(1):15–22.
7. Cates W, Jr., et al., Global development. Family planning and the Millennium Development Goals, Science, 2010, 329(5999):1603.
8. United Nations (UN), Transforming Our World: The 2030 Agenda for Sustainable Development, New York: UN, 2015.
9. Family Planning 2020, Family Planning 2020, 2015, http://www.familyplanning2020.org.
10. UN, Department of Economic and Social Affairs, Population Division, World Population Prospects: The 2013 Revision, 2013, http://esa.un.org/unpd/wpp/.
11. Ross J and Smith E, Trends in national family planning programs, 1999, 2004 and 2009, International Perspectives on Sexual and Reproductive Health, 2011, 37(3):125–133.
12. Cleland J, Harbison S and Shah IH, Unmet need for contraception: issues and challenges, Studies in Family Planning, 2014, 45(2):105–122.
13. Bongaarts J, The impact of family planning programs on unmet need and demand for contraception, Studies in Family Planning, 2014, 45(2):247–262.
14. The Alan Guttmacher Institute (AGI), Family planning can reduce high infant mortality levels, Issues in Brief, New York: AGI, 2002, http://www.guttmacher.org/pubs/ib_2-02.html.
15. Rutstein SO, Further evidence of the effects of preceding birth intervals on neonatal, infant and under-five-years mortality and nutritional status in developing countries: evidence from the Demographic and Health Surveys, DHS Working Papers, Calverton, MD, USA: Macro International, 2008, No. 41.
16. Ahmed S et al., Maternal deaths averted by contraceptive use: an analysis of 172 countries, Lancet, 2012, 380(9837):111–125.
17. Madsen EL, Kuang B and Ross J, Tracking changes in states of contraceptive use over time in sub-Saharan Africa through cohort and period analyses, Journal of Biosocial Science, 2015, 47(3):329–344.
Bernice Kuang is demographer and Isabel Brodsky is technical advisor, both at Palladium, Washington, DC.
The authors thank John Ross for his review and useful suggestions. This study was funded by the Bill and Melinda Gates Foundation and the United States Agency for International Development (USAID) through the Health Policy Project under Co-operative Agreement No. AID-OAA-A-10–00067. The views expressed are those of the authors and do not necessarily represent the views of USAID or the United States government.
The views expressed in this publication do not necessarily reflect those of the Guttmacher Institute.
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Kenya's Masai Mara National Reserve is the ultimate ballooning destination. The landscape is stunning and free, and the abundant wildlife can make for spectacular viewings from above. As this is a wilderness area contiguous with the Serengeti National Park of Tanzania, with free-ranging wildlife that is not fenced in, we of course cannot guarantee what we will fly over and what we will see during a particular flight. However, we typically see a good diversity of animals, and it is likely you will spot elephants, giraffes, various antelope species, and ostriches from the balloon. Many of our guests also see hyenas, lions, and cheetahs, and ballooning is one of the best ways to search for the elusive black rhino, of which there are less than 40 in the Mara. Depending on the day's flight path, you may also drift along one of the rivers and see hippos and crocodiles.
We have had some truly amazing sightings over the years, including leopards in trees, lions on kills, and active hyena dens. If you visit the Mara between July and October, you will probably see the "Great Migration" of over a million wildebeest, along with large numbers of zebras and gazelles. Observing this phenomenon from the balloon is the best way to grasp just how huge the migrating herds really are, and is an experience not to be missed. Regardless of whether the "Big Five" are seen from the balloon, most people say that the balloon flight was a highlight of their safari.


Macs are generally believed to be protected from malware, but — setting aside the fact that they aren't — what about other risks? Try websites that provide value comparisons and then compare "apples to apples." Factor shipping and dealing with into the whole value of your purchase. After I truly get to go to a retailer, I usually spend most of my time researching manufacturers I'm all in favour of — instead of truly shopping to buy.
Bank cards tend to offer extra protection than debit playing cards as they don't directly take away funds from your own bank account. The net auction model signifies that shoppers can often rating great discounts on new and used gadgets. It is so much simpler to kind bomber jacket" or boyfriend cardigan" into the search bar than to find these objects in their shops.
Many several types of offers are available including discounted providers on massages, discounted merchandise and discounted lodge rooms. Create a PayPal account and securely link your bank, credit, and debit card details. If you choose to pay with a credit or debit card, please enter all your particulars within the packing containers offered.
These could also be store-extensive reductions or special offers on particular products. Verify the website is secure: before you enter your payment particulars, it's best to ensure the website is safe. I like ordering stuff online where (normally) the objects shall be coming from the positioning's distribution centers in new(er) condition.
If you happen to pay by credit score or charge card on-line, your transaction might be protected by the Fair Credit Billing Act Below this law, you can dispute expenses below sure circumstances and quickly withhold fee whereas the creditor investigates them.


This table is made of thick hand-engraved white brass. The intricate dots are meticulously hand-hammered by our experienced artisans in Morocco following a typical Moroccan rythme of drums. The base is made of cedar with elaborate lattice work, which makes this table even more special. This table will add that true Moroccan touch to your home.
Dimensions: Width = 39", Height = 22".


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Maria Bartiromo's Slow Start On Fox Business
Linette Lopez
Fox Business, screenshot
Maria Bartiromo premiered her new show on Fox Business Monday morning, and it's off to a pretty slow start.
We see two reasons for this. First, the former CNBC star known for her booking prowess failed to schedule any show-stoppers. Second the discussion-based format of the show isn't quite hot enough to keep viewers glued to the screen.
Bartiromo shocked Wall Street when she left her decades-long home of CNBC for the less-watched Fox Business Network at the end of 2013.
Being the scrappy kid nipping at Bloomberg and CNBC's heels, observers expected Fox Business and Bartiromo to pull out all the stops for her debut — ticker tape parade, 76 trombones, the works. The reason why a network hires a lifer like Bartiromo is for her fire (and star) power, after all.
And what makes a big part of a great hour of informative news? The guests. Booking is crucial and it means everything to financial news consumers, especially in a world where information on stocks and breaking news can be found online.
On day one Bartiromo booked Jon Hilsenrath, the Wall Street Journal reporter known for Federal Reserve scoops; Bank of America Head of U.S. Equity Savita Subramanian; Dallas Fed president Richard Fisher; and Mario Gabelli CEO of GAMCO investments. All of these folks are interesting people with large followings, but they aren't necessarily market movers (read: headline makers).
Plus, Gabelli was on Bloomberg TV on January 22nd. Wall Street has seen him since the 'hey, this ain't 2013's 30%-market anymore' discussion that's dominating headlines these days started.
Meanwhile, CNBC booked Verizon CEO Lowell McAdam (telecoms, so hot right now), former European Central Bank President Jean Claude Trichet (everyone's talking about eurozone inflation), and economist Larry Summers (he was a frontrunner for Fed chair) for Monday morning.
Booking day one isn't something you can do over again, but our second issue with the show — Bartiromo's comfort with its slightly more discussion heavy format — will likely to improve with time. For now, it's not quite lively enough to keep viewers from switching back to their regularly scheduled programming.
Here's an example — During her discussion with Hilsenrath and Subramanian, Bartiromo made a quick comment about the stock market, which people are getting into fist fights over on Wall Street these days.
"The corrective action of the market is almost over," she said, citing a technical trader.
It's a relatively bold statement to make in a year when analysts all over the street are predicting choppy waters. On Bartiromo's show though, it just rolled off the tongue and into the atmosphere without further debate. In fact, the S&P 500 actually went green for the year this morning — so what is there to discuss?
If you're trying to peel viewers away from channels that are muscle memorized into their fingertips, it's important to take every opportunity to jump on the questions that are on everyone's mind. Guests and hosts alike have to stay on their toes and be vigilant for moments when they can turn things up a notch.
All this said — hey, it's day one. Even a professional like Bartiromo needs time to hit a stride, no?
Wrinkles, like the one below can get ironed out ("Maria Gabelli).
clusterstock-us fox business network maria bartiromo money media

redpajama_set_name: RedPajamaCommonCrawl


The Hopup Dimension Kit 3 is a stylish and functional 10' straight wall setup. You can't beat the speed and effectiveness of the Hop up design's "expandable frame" where the display with attached graphic is able to set up in thirty seconds. Just expand the frame and you are ready for the show!
Please be sure to include a 2" bleed around perimeter more information.


A superb striking turret clock movement by the world renown maker J. W. Benson of Ludgate Hill, London. It is of the firms usual horizontal, heavily constructed cast iron frame and beautifully machine brass wheels and is fully working (see the video clip below). It has hourly rack striking for a suitable bell and maintaining power.
The clock has been subject of a previous restoration and is in good running condition, will require timing up and adjustment. It has recently fitted wire rope and a test stand made from dexion. It is complete with original pendulum and two weights.
The clock comes with the accessories pictured below, winding crank, setting key, 5 pulleys for weights and bell strike, 2 additional weights, a short drive shaft, a three dial bevel drive and a 50v / 50 hz synchronous motor (not tested). We can supply a bronze bell if required.
Height 55", Width 31", Depth 33"
Height 15 1/2", Width 30.5", Depth 22"


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(-) 500 - Edu/Training/Empl/Soc Servs (2)
(-) House Committee on Financial Services (5)
Senate Committee on Commerce, Science, and Transportation (6)
Senate Committee on Health, Education, Labor, and Pensions (7)
Senate Committee on Small Business and Entrepreneurship (2)
(-) Senate Committee on the Judiciary (9)
H.R. 3180, An act to consent to certain amendments of the New Hampshire-Vermont Interstate School Compact
Cost estimate for the bill as reported by the Senate Committee on the Judiciary on November 14, 2002
S. 2395, Anticounterfeiting Amendments of 2002
Cost estimate for the bill as reported by the Senate Committee on the Judiciary on July 18, 2002
S. 1291, Development, Relief, and Education for Alien Minors Act
Cost estimate for the bill as reported by the Senate Committee on the Judiciary on June 20, 2002
H.R. 3951, Financial Services Regulatory Relief Act of 2002
Cost estimate for the bill as ordered reported by the House Committee on Financial Services on June 6, 2002
S. 1754, Patent and Trademark Office Authorization Act of 2002
Cost estimate for the bill as passed by the Senate on June 26, 2002
H.R. 1701, Consumer Rental Purchase Agreement Act
Cost estimate for the bill as ordered reported by the House Committee on Financial Services on June 27, 2002
H.R. 1886, An act to amend title 35, United States Code, to provide for appeals by third parties in certain patent reexamination proceedings
Cost Estimate July 3, 2002
H.R. 1866, An act to amend title 35, United States Code, to clarify the basis for granting requests for reexamination of patents
S. 1742, Identity Theft Victims Assistance Act of 2002
Cost Estimate June 4, 2002
Cost estimate for the bill as ordered reported by the Senate Committee on the Judiciary on May 16, 2002
H.R. 3717, Federal Deposit Insurance Reform Act of 2002
Cost estimate for the bill as ordered reported by the House Committee on Financial Services on April 17, 2002


Over the years, more and more economists have come to the conclusion that immigrant workers "complement" the native-born majority of the labor force by bringing different sets of skills and different demographic profiles with them, both of which enhance and expand the economy as a whole. Immigration restrictionists, in defiance of this growing body of evidence, continue to claim that immigrant workers undercut wages and job prospects for the native-born workforce. However, the restrictionists are increasingly outnumbered by more serious scholars who understand the differences between immigrant and native-born workers, and how these differences play out in the labor force and the economy.
Employment among the native-born population has decreased in recent years because more natives are leaving the workforce to retire, go back to school, or go on disability. They are not being pushed into unemployment by competition from immigrant workers. This is apparent from the fact that the unemployment rates for native-born and immigrant workers have stayed roughly the same at the same time total employment among the native-born has declined.
The wage differences between immigrant-heavy industries and native-heavy industries are explained by differences in the skill sets and education levels required by the industries; not ruinous suppression of native-born wages caused by competition from immigrants. Roughly half of the native-born and immigrant workforces are employed in different industries. Native-heavy industries pay more than immigrant-heavy industries because they require different levels of education and different skills. This difference in education and skill requirements explains most of the wage differential.
Demographer Dowell Myers, a professor at the University of Southern California, emphasized the fact that roughly 60 million Baby Boomers are now in the process of retiring, and that their exit from the labor force will not be fully compensated for by increases in the numbers of native-born workers. Clearly, immigration will be needed to pick up some of the slack.
David Dyssegaard Kallick of the Fiscal Policy Institute pointed out that much of the so-called "controversy" over the economic impact of immigration is propagated by the media. Among economists, there is relatively little disagreement. Rather than repeat the same debate over and over, Kallick recommended a focus on how to help the small number of less-educated natives who are most likely to find themselves in competition with immigrants.
Daniel Costa of the Economic Policy Institute warned against trying to use immigration policy to compensate for the failings of wage and labor laws. For instance, replacing the poverty-level minimum wage with a living wage would benefit both immigrant and native-born workers in a way that no change in immigration policy could accomplish.
Both the panel and the report underscore a relatively simple truth: immigration is an economic resource that enhances the U.S. work force—not to mention the tax base and consumer base. The key to maximizing the economic power of immigration is the creation of rational policies that admit needed workers under labor-market conditions which ensure that neither the immigrant workers nor native-born workers are disadvantaged in the process.


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MosaicArticlesThe WeekEventsNews
Time running out for betrayed Afghans and their families
282996 09: Veiled women stand in the street October 11, 1996 in Kabul, Afghanistan. The Taliban army faces opposition by the guerrillas of Ahmas Shah Masoud, allies of the ousted Afghanistan President Burhanuddin Rabbani. (Photo by Roger Lemoyne/Liaison)
Cannes, August 19, 2021
by Mark Porter
Taliban death squads are intensifying their search for anyone they believe worked with UK, US, and NATO forces and are now at Kabul airport. According to a confidential United Nations document, leaked to the New York Times, they are going from door to door threatening to kill or take hostage family members – unless their targets give themselves up.
Women wearing self-imposed burkhas
This flatly contradicts Taliban assurances that they would not seek vengeance on members or supporters of the fallen government, according to the account prepared by a UN threat assessment analyst.
A document issued by the Norwegian Centre for Global Analyses and datelined yesterday reports that the Taliban are working from a list of people and locations. Most at risk are interpreters, members of the Afghan military, of the police, and of course Western journalists. Many are in hiding or on the run.
The document contains a letter dated August 16 to an unnamed Afghan counterterrorism official who worked with British and US intelligence who was told to report to the new Islamic Emirate of Afghanistan offices in Kabul. It warned that his family members "will be treated on the basis of Shariah law" if he failed to give himself up.
The Taliban is issuing repeated assurances that they will not use their victory to take revenge. These ring increasingly hollow as more and more force is applied, for example shots being fired into crowds of protesters in Jalalabad, with at least three killed.
The extreme urgency for hundreds of Afghan families is brought into sharp focus by the plight of an Afghan interpreter named Ahmadzai whose permission to come the UK was revoked overnight despite his being sentenced to death. An utterly shocking London Times podcast told of the Taliban raid on his home last weekend, and of his life in hiding with wife and children.
Working for the British forces "was my mistake", he said. "Not only have I risked my life and made the Taliban want to kill me, but I've also risked the life of my kids."
ex-soldier UK minister Ben Wallace
UK Defence Secretary Ben Wallace almost broke down in tears after admitting earlier this week that some Afghans who had helped British forces would not make it out of the country. As a former soldier he found it "sad", he said, but added that "the West has done what it's done" and must get as many people out of Afghanistan as possible.
Ahmadzai worked in the office of exiled former President Ghani, and watched as four helicopters airlifted Ghani and his entourage out of the palace. Meanwhile Ahmadzai's home was being searched by the Taliban. His high-profile role working alongside some of the most senior British officers in Helmand had brought a legion of threats and he was sentenced to death by a Taliban court, reported The Times.
"In June he was told that he had been granted permission to come to the UK. However, last week the Home Office decided to revoke his visa."
NOT CONDUCIVE TO THE PUBLIC GOOD?
Home Secretary Priti Patel – overnight rejection of veteran UK army interpreter
The UK rejection signed by Home Secretary Priti Patel said that Ahmadzai's "character, conduct, and associations" were not "conducive to the public good". He has no right of appeal. "Take me to the UK and put me in prison. Take me to court. If you believe I'm bad, you can sentence me to death," he said. "But to leave me behind in Kabul, you are inviting the Taliban to come and kill me. The Taliban won't give me a chance to speak. They will just shoot," he says in the Stories of Our Times series of podcasts.
Maj-Gen Charles Herbert with interpreter
Charlie Herbert, a former major-general who worked closely with Ahmadzai in Kandahar, says: "You're telling me this man is a threat to the United Kingdom? Absolute rubbish." Wallace told LBC radio yesterday that about 1,400 people would be processed to come to the UK in the coming days but that it would be a challenge to help people further away from Kabul.
One interpreter, Sharif Karimi, 31, was told on Saturday that he was eligible to come to the UK in a government U-turn. He said that after hearing the news he fled to Kabul with his wife and children. "All the way from Lashkar Gar, the Taliban was standing on the road," he said. They were not searching for people but we were so scared in case they searched the vehicle or any of us."
However no such luck for Bashir, who was wounded by a sniper during a daytime operation to capture Taliban targets while serving for 14 months in Helmand with the British army. "I am desperate to escape. Kabul is full of fear. If I am captured, I will be killed because of my work, and I know the Taliban is searching for us," he told a UK newspaper. "All my paperwork is ready and with the UK authorities. I served them bravely and loyally, and it is now in their gift to save me and my family. "The window for our escape from the Taliban is closing and I do not understand the delay. Why have some been approved and others not?"
Campaigners estimate 200 translators who worked for UK may not be rescued. And yesterday it also emerged that a 125-strong team of guards at the British embassy in Kabul will not be eligible for UK government protection because they were hired through an outsourced contractor, GardaWorld. The guards, many of whom had worked at the embassy for more than a decade, were summarily fired as embassy staff scuttled to the airport, with no chance of being rescued.
"This now looks like a deliberate policy to sacrifice Afghan lives rather than accept refugees," said the British commentator Nick Cohen.
John Bolton, former national security adviser to Donald Trump, said that the West looked like "suckers". He said: "I think in Beijing and Moscow they're laughing at this. It makes us look like we're suckers. It was a very big mistake."
Times of London – harrowing podcast
August 19, 2021 NYT How much did Biden really know?
August 19 World Politics Review – Allies withdrawal a gift to Russia and China
August 18 CNN Correspondent on what the Taliban are really like
August 17 MSNBC. US vet – "I will never forgive my country"
Previous articleKabul – dark "new normal" for journalists and freedom
Next articleThe EU is nothing but a feckless spectator in the unfolding Afghan crisis


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Phillip Howard Smith
January 20, 1949 ~ May 4, 2019 (age 70)
Phillip Howard Smith, age 70, went to be with the Lord on May 4, 2019. He was born January 20, 1949 in Kalamazoo, Michigan to Margaret and the late Lincoln Smith.
He was the second oldest of 5 brothers; Steven Smith, Mikel Smith, Mark Smith, and Kenneth Kirsch. He attended Comstock Schools and graduated in the class of 1967. Phillip attended Kellogg Community College and worked at Durametallic Corporation starting in 1967 until drafted into the United States Army, serving in infantry combat in Vietnam. He was later stationed in Okinawa for the remainder of his duty. Phil was honorably discharged in the fall of 1971. Following discharge, he returned to work at Durametallic Corporation, now Flowserve, where he was employed until he retired in 2004.
In his spare time, Phillip enjoyed hunting, fishing, up north trips, working outside, camping, fixing things, and spending time with family and friends.
He was preceded in death by his three brothers, Steven, Mikel, and Mark Smith, and his step-father, Carl Kirsch.
Phillip is survived by his son, Jared and Lindsay (Stapert) Smith and their children, Jordan Smith and Jada Clomon and daughter, Jill (Smith) and Russ Mitchell and their children, Hannah, Mary, Emily, and Rusty Mitchell. Also surviving are his mother, Margaret (Koscher) Smith-Kirsch; brother, Kenneth Kirsch; and many nieces and nephews, whom he loved very much.
A funeral service will be held Friday, May 10, 2019 at 4:00 PM at Langeland Family Funeral Homes, Memorial Chapel, 622 S. Burdick St., Kalamazoo, MI 49007, where friends and family may visit two hours prior from 2-4:00 PM. A private interment at Ft. Custer National Cemetery will take place at a later date.
In lieu of flowers, memorial donations may be made to St. Jude Children's Research Hospital at www.stjude.org.
Memorial Processing - Source Code: IIQ180788777, 501 Street Jude Place, Memphis TN 38105-9959
Web: https://www.stjude.org/


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Celeb Experts > Celebrity Campaigns
Campaign Crusade: The Super Bowl
Super Bowl Matchup, who wins: Football or Ads? As yet another Super Bowl approaches, we take a look at some of the biggest game of the year's most memorable campaigns, and what's in store for this year In order to develop a successful and effective marketing campaign and partnership focused on a celebrity, the timing, identity, relevance and appeal must all coalesce. The Super Bowl is the most prevalent time of year in which we can see this dynamic in play, both successfully and forgettably. There are countless examples of past campaigns that have successfully utilized the talents, charisma, andREAD MORE
Tips and Tricks for Game day with Celebrity Chefs
Game day can be daunting when you have invited guests over, but have no idea what to make. Anne Burrell has shared her top game day tips and tricks to make this game day the best one yet! As a top chef on the market, Anne Burrell is the perfect celebrity to share her insight. 1. Plan Ahead Planning ahead is the first step in a successful game day celebration. Burrell says, "Think, 'What can I do the day ahead? The day of?' Once you have that, you won't have to stress and everything will come out great and willREAD MORE
The top health, wellness, and nutrition influencers to watch
With "New Year, New You" upon us, the spotlight is on social media health influencers. From macros, to body image, to moms, these influencers are the ones to watch for any social media marketing or healthcare marketing campaign. 1) Amanda (Meixner) Rocchio aka @meowmeix With over 1.3 million followers on Instagram and an 85% female audience, this health influencer inspires others to makes changes to help them live a fuller and healthier life. This wellness expert and funky dancer understands living a healthy lifestyle can be difficult, especially without the right tools and knowledge. Amanda creates easy, approachable recipes andREAD MORE
Snoop Dogg remixes with Dunkin' Donuts
Dunkin's new Beyond Sausage Sandwich has hit the TV screens and media harder than ever. The collaboration is named Launch of the Beyond Collection by Dunkin' x Snoop, where Dunkin' is inviting all guests to try samples of the Beyond Sausage Sandwich at their restaurants nationwide on January 24 and 25. Inspired by Snoop Dogg's diet of plant based protein, Dunkin' and Snoop have come together to create a limited time only spin on the Beyond Sausage Sandwich. The brand new, exclusive Beyond D-O-Double G Sandwich will be available for one week only, January 13 through 19. This Snoop inspiredREAD MORE
Ashley Graham takes body positive leadership to a new level with Vogue
Ashley Graham's Body Positive Mission Takes Off with Cover of Vogue With the initiative of making the fashion industry more inclusive of all body types, Ashley Graham has become one of the hottest models in the industry Ashley Graham describes herself as a model, designer, entrepreneur, and body activist. Within her recent work, she has proven herself to be successful in each and every one of these roles. In the past year, Ashley Graham has been featured on Elle, Harper's Bazaar Australia and UK, MOJEH Magazine, Allure, and topped the year off with the cover of Vogue. Graham began herREAD MORE
Cardi B reigns as Queen of advertising with new Pepsi Campaign
As the Holidays approach, Pepsi releases new ad campaign around their most popular new star, Cardi B After releasing popular Super Bowl ads capitalizing on the rap star's widespread influence, Pepsi looks to cash in again with new Holiday ads Cardi B has had an ascendance unlike any celebrity star in years. Starting her career as a dancer much like her role as depicted in the new comedy hit Hustlers, Cardi came from nothing and entered the entertainment scene with a charismatic dazzle that fans adored. As her hits rolled in, it was only natural that brands of all shapesREAD MORE
CelebExperts CEO Evan Morgenstein helps mentor a young entrepreneur while working to save the oceans.
Earthly Bikinis founder Katie Goodwin partners with Big Blue Ocean Cleanup and CelebExperts' Evan Morgenstein to bring her line to market.
Are you dug in on influencer marketing campaigns? CelebExperts has FIVE surefire tips to ensure your campaign is a success.
CelebExperts Offers Brands Expertise Finding Fitness and Lifestyle Influencers For 2019 Campaigns
The alphabet soup of influencer marketing has reached fever pitch with the newest classification of "nano-influencers". Added to the lexicon of micro and macro influencers. This ever evolving re-categorization of groups of social media celebrities utilizing their influence over followers from thousands to millions has erupted into a full on "Hatfield vs. McCoy" debate amongst marketers regarding the efficacy and effectiveness of using influencers at all. There are several camps that have different entrenched beliefs about the success and ROI when utilizing untrained social media celebrities to force a result usually tied to metrix such as sales, engagement, click thruREAD MORE
Today's Top Sports Stars Are Changing the Way Brands Command Influence and Corner the Marketplace to Win Business
CelebExperts explains why this Fall's top ad campaigns using sports stars will change the future of sports endorsements forever. With the NBA, NFL, and college football in full swing, the Fall is the perfect time for industry-leading brands and up-and-coming companies to utilize today's top athletes to grab the attention of their target consumers. This month, CelebExperts has evaluated the fall advertising landscape to uncover the top ad campaigns featuring celebrity spokespeople. Hiring sports stars as celebrity spokespeople is nothing new, but Fall 2018's latest top ad campaigns will change the game forever! There was an overwhelming amount of sports stars beingREAD MORE
Peak Hydrate is a healthy performance drink with fast-absorbing, body-friendly ionic minerals. Ionic minerals are highly efficient nutrients designed to easily deliver healthy goodness to your cells. These ionic minerals are almost impossible to get from a basic diet. Peak Hydrate has formulated a win-win for your body. The product has nothing fake in it, like so many other products in the market currently. There are no fake sweeteners or unnatural ingredients. Peak Hydrate is sugar free, carb free as well as gluten free. Each bottle of Peak Hydrate helps the body maximize performance, naturally increase the consumer's energy without caffeine,READ MORE
CelebExperts Announces It's 90-Day CMO Program for Startups and Emerging Companies/Brands!
CelebExperts' new 90-day CMO Program provides the knowledge gained from 20+ years working with Fortune 500 companies, emerging brands and startups in a new and innovative way which they can both afford and achieve exponential growth for their company. CEO Evan Morgenstein comments, "I have spent almost five years trying to perfect a model that works for me and works for most of the startups and emerging companies we service. Originally, companies hired us to help sell through product. While that is an aspect of what we do, we do it very organically vs. a distributor or broker whose jobREAD MORE
Fall Brings Sports Endorsements To The Forefront!
Not only are the leaves changing colors slowly, but sports are at a pinnacle. NBA and NHL are starting their long journey for a new season. College football is starting to shape up. Women and men's college basketball is in the air. In addition, the MLB is hurtling to the finish line, NASCAR is in playoff mode, golf season is done, tennis is essentially over and the MLS well, I am not sure but I assume they are getting to where ever they are going. What does this all mean? It means Rob Gronkowski is selling Tide, Steph Curry isREAD MORE
CelebExperts Celebrity Booking Agency Marks 10-Year Anniversary
One of the 1st truly integrated celebrity marketing, speakers bureau and consulting agencies in the U.S., CelebExperts, has far exceeded my wildest dreams when I envisioned it in 2008 at the Beijing Olympic in China. Here is the little known story about the creation of this incredible brand and celebrity booking agency. In 2008, I had 7 athletes competing in Beijing for U.S. in swimming and gymnastics. All would win medals, with most of them gold. Names like Dara Torres, Nastia Liukin, Cullen Jones and others. After one of the events during an evening session, I walked out to whereREAD MORE
CelebExperts Books Randi Zuckerberg, One Of The Most Desired Speakers In The World!
What's in a name? When it comes to booking the best keynote speakers for events, name-recognition is almost always one of the first things our clients mention. They want someone with cache who will generate a buzz around their event. But when it comes to leaving a lasting impact on your audience on site, you need a speaker with more than just name recognition. You need someone who will resonate with your audience, align their messaging with your overarching event theme, and give the audience tangible takeaways they can employ in their work and life immediately. Unfortunately, this is notREAD MORE


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Home » Trinity Industries Accused of Hiding Failed Crash Tests in Whistleblower Trial over Guardrails
Trinity Industries Accused of Hiding Failed Crash Tests in Whistleblower Trial over Guardrails
In a trial over its guardrails, Trinity Industries was questioned about why they did not tell authorities about five failed crash tests. The New York Times reports that the case was filed under the False Claims Act by a competitor who alleged that the company violated federal rules when it failed to notify the Federal Highway Administration that it modified the design of its ET-Plus rail head in 2005.
These guardrails are the subject of the safety concerns outside of this federal lawsuits, according to The New York Times. Last month, the states of Missouri and Massachusetts banned the design and began their own investigations. Virginia also took issued with Trinity, and said in a letter that it believes the company failed to adequately test the ET-Plus. The state wants further testing.
Trinity claims that it unintentionally failed to disclose the changes, and denies that the guardrails are dangerous. The federal agency has accepted this claim thus far. However, plaintiffs in Texas federal court this week showed that Trinity and its research partner Texas Transportation Institute also failed to tell the agency about additional tests of a modified ET-Plus in 2005 and 2006, NYT reports. Issues with the ET-Plus surfaced two years ago, but even then the five failed tests were not disclosed, according to the testimony of Trinity executive Brian Smith. Trinity says that the tests were only for research purposes.
According to the whistleblower, however, the rail head in those tests are the same as the ones being questioned now. The company hid the tests on purpose, the suit alleges. A testimony was also obtained from Roger Bligh, a research engineer at the Texas Transportation Institute. He testified that he did not talk about the tests even after meeting Nicholas Artimovich, government's lead engineer on the ET-Plus investigation.
In the event of a car accident, guardrails are meant to absorb the impact by collapsing when struck head-on; this mechanism is intended to prevent injuries. The rail head, a flat piece of steel in front of the rail, should slide along the rail to push metal out of the way. Trinity altered the design of the rail head in 2005 by narrowing the channel behind the head. Some say that this modification can cause the head to jam; as a result, the rail can be pushed into a vehicle and possibly cause serious injuries.


"No chlorine smell or corrosion, and it produces perfect crystal clear water. It is also easy to install, fully automated and makes maintenance simple."
Installed by Fountains Direct, a leading UK based company who specialise in the design, installation and maintenance of both commercial and domestic fountains and water features, this sizeable project uses the newest alternative to chlorine with superb results.
Nick Roberts, Managing Director of Fountains Direct, was responsible for the design and Paul Everdell, Sales and Design Engineer at Fountains Direct, for the over view of the installation. Paul says Waterco's chlorine-free Hydroxypure System was the obvious choice for the Muslim Burial Ground project.
"We are always looking for an alternative to chlorine and Hydroxypure presents many benefits," he explains. "No chlorine smell or corrosion, and it produces perfect crystal clear water. It is also easy to install, fully automated and makes maintenance simple.
Completed in June 2015, the concrete water feature at the Muslim Burial Ground holds approximately 8,000 litres of water, is fully tiled and incorporates a small waterfall at one end.
Installing the water feature at this site was not without its challenges.
"There were no foul drains in the filter chamber area so to bring one to it would cost a large sum of money," says Paul. "This made Hydroxypure the best choice, as the water can be backwashed to the surface waste water system (in this case a soakaway) as there are no harsh chemicals in the water to damage the environment.
Also installed at the site is a Waterco Micron 30" side mount sand filter which incorporates the unique fish tail lateral under drain arrangement – this works to increase filtration quality and reduces water loss through backwashing, which were two important features on this installation.
resulting in 30% savings of backwash water.
These two products have been successfully keeping this famous architectural feature looking its best since it was first installed.
"The architect wanted a shallow reflective surface with little water movement so the feature had a calming effect," explains Paul.
"The pool is very shallow, black tiled and open to full sun, so it is even more impressive that the Hydroxpure is working so well. The water is soft and does not leave lime scale marks–which is so often the case with other features that use a different sanitation system.


The actress threatened to tell the wife of the host.
This late night talk show host thought this B+ list mostly television actress who is on a hit network show that requires zero acting was hitting on him before and during the show.
So, the married host hit on her hard and was rejected in a second.


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Home > News > Traitor or Hero? US Military Refuses To Release Report On Bowe Bergdahl
Traitor or Hero? US Military Refuses To Release Report On Bowe Bergdahl
The Pentagon finished its formal investigation, known as an Army Regulation 15-6, more than a year ago. That report, led by a two-star general, includes interviews with more than 50 people, including Bergdahl. In 371 pages of sworn testimony, he told General Kenneth Dahl what he did, why and what he endured during his five years as a hostage. The 15-6 is not classified, and at a preliminary hearing, General Dahl testified that he does not oppose its release. But the Army won't budge.
The Independent >


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5x National Enduro Champion Russell Bobbitt Wins Sumter
Feb 4, 2019 | National Enduro, US Racing
Bobbitt At Sumter National Enduro
Wedgefield, SC (February 3, 2019) – Russell Bobbitt claimed a stunning victory at the Sumter National Enduro in Wedgefield, South Carolina, marking the start of the 2019 Kenda AMA National Enduro Series AMA National Enduro Series presented by Moose Racing.
Bobbitt's win was somewhat of a surprise since the 33-year-old Georgia rider retired from full-time racing nearly two years. The Gnarly Routes KTM rider last won a national event in 2016, however at the Sumter event he managed to find a bit of that old Bobbitt magic while outrunning defending national champ Tely Energy Racing's Steward Baylor by 16 seconds after six tests and 64 miles of racing.
This year's Sumter Enduro was highly anticipated since it marked the 50th anniversary of the event, and the SERMA Club did not disappoint, putting on a near-perfect event. The turnout was massive, as well, with over 800 riders filling the start grids. In fact, the event sold out within 10 minutes after signup opened on the Internet, which is another sign that National Enduro is alive and well in the U.S.A.
Bobbitt started fast, winning the first three tests, as dark clouds threatened to dump rain on the area. Heading into the fourth test, Bobbitt enjoyed a 54-second advantage over Husqvarna/ Max Motorsports/FXR Racing's Evan Smith, with Baylor another four seconds back.
Baylor, who has been dealing with a nagging knee injury, made things worse when he took a practice crash a week before, but he was still able to get settled in during the second half of the race and started reeling off test wins in an effort to catch Bobbitt.
Baylor would catch and pass Smith in the final test of the day, but he would come up 16 seconds short of catching Bobbitt.
The final tally showed Bobbitt with the win, followed by Baylor in second, and Smith in third.
"It was super fun to be back on the two-stroke, it felt like old times," said Bobbitt. "The first three tests went well and I kept it clean. The wet sand conditions make up some of my favorite style terrain to ride. I caught a flow early on and rode well all day. The last three tests went well, too, with good times and I was stoked to be in the top five."
Baylor was happy with second after finishing 2-4-5 in the first three tests.
"I started the day off riding very tight and almost with a mental block and I really found myself struggling in the first half," said Baylor. "But for the final half of the race, I was able to turn the day around and win the final three tests but it just wasn't enough to close the gap that I had lost in the first three."
Smith matched a career-best with his third place finish.
"I rode tight most of the day and I just didn't have that comfort level I was looking for, but I think I was capable of going faster," said Smith. "I had a couple of crashes that cost me some time, but I picked up some good lines and for the most part it was a clean day. I was ahead of Steward going into the last test, but I jammed my wrist and struggled to hold on."
Mike Witkowski turned in a career-best ride with fourth overall. The Beta USA rider also finished second in test four, which is another first for him.
"I rode well in the first four tests," said Witkowski. "I struggled a bit in the last two tests, I think I just got tight. Those tests were definitely rougher and a bit tighter. We had a good day, for sure, and I think we improved over last year's finishes."
GasGas North America's Thorn Devlin looked impressive all day and rounded out the top five, finishing 36 seconds ahead of Ohio Husqvarna rider Cory Buttrick.
"The day started off a little rough, I was trying some things out," said Devlin. "I lost my brakes in the first test so I was like a pinball going through those tight trees. We got things sorted out and the rest of the day went great. I'm super happy to finish fifth and I feel like I'm a step ahead of last year."
Zach Hayes (KTM) overcame a crash in the second test to finish seventh overall and first in the NEPro2 class. "Seventh overall is a personal best so I'm really happy with that," said Hayes. "After I crashed I just put my head down and started charging."
XC Gear/Enduro Engineering Husqvarna's Jake Froman, who is starting his first full year in the Pro division, came away with eighth overall, just 23 second behind Hayes.
New Zealand's Liam Draper put his Tely Energy KTM into ninth overall, which was good enough for second in the NEPro2 division. Meanwhile, Tegan Temple (KTM) was 10th overall and third in NEPro2.
Mackenzie Tricker (KTM) got the season off to a good start with a big win in the Women's Elite class, topping defending champion Tayla Jones (Hsq) by over a minute. These two battled back and forth all last year and it looks like 2019 will be more of the same. Brooke Cosner rounded out the podium on a KTM after posting some impressive rides.
Eight-time National Enduro Champ Mike Lafferty came out of retirement to compete, riding a KTM 500 EXC to the win in the AA division. Mike thrilled the fans with his go-for-it style and his trademark smile.
The Kenda AMA National Enduro Series returns to action on March 24th at the Alligator Enduro in Ormond Beach, Florida. For more information on the series go to www.nationalenduro.com.
1. Russell Bobbitt (KTM)
2. Steward Baylor (KTM)
3. Evan Smith (Hsq)
4. Mike Witkowski (Bet)
5. Thorn Devlin (GG)
6. Cory Buttrick (Hsq)
7. Zach Hayes (KTM)
8. Jake Froman (Hsq)
9. Liam Draper (KTM)
10. Tegan Temple (KTM)
Courtesy NEPG
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OIA publishes new guidance on Fitness to practise
Published on 7 Oct 2019
The OIA has published a new section of the Good Practice Framework: Fitness to practise.
View the Good Practice Framework: Fitness to practise
Higher education providers that run courses leading to professional qualifications should have in place procedures that ensure any concerns about a student's fitness to practise are dealt with fairly, promptly and proportionately. The Fitness to practise section gives good practice guidance for providers in designing these procedures and in handling individual cases. The section includes guidance on:
What fitness to practise is, including behaviour-, health-, and disability-related fitness to practise concerns;
How to help students understand the professional standards they need to meet and to support them to meet those standards where possible;
What a fair process looks like.
The guidance is drawn from the OIA's broad experience of handling complaints, and was put together in consultation with the Good Practice Framework Steering Group. A draft was published for consultation in June 2019 and feedback was received from providers, student representative bodies, other higher education bodies, professional, statutory and regulatory bodies, stakeholders and interest groups. The final version incorporates many of the very helpful suggestions we received.
To coincide with the publication of the fitness to practise section, we are also publishing some case summaries of complaints involving fitness to practise issues.
Felicity Mitchell, Independent Adjudicator, said:
"Fitness to practise processes are about ensuring the safety of the student and those around them, including members of the public, and preserving public confidence in the profession. This must be balanced with fairness to the individual student whose career is at risk. The process should be supportive even when the outcome is that the student cannot continue with their studies.
We are very grateful to all of those who contributed to the development of this section. The purpose of the guidance is to help providers treat their students fairly, not to provide answers to what are often complex questions that involve professional judgment. We hope the section will be another useful addition to the Good Practice Framework."
The guidance will inform the way that the OIA considers complaints relating to fitness to practise concerns from the 2020/21 academic year.
For further information please contact Sarah Liddell, Head of Leadership Office, mediarelations@oiahe.org.uk, 0118 959 9813.
The Office of the Independent Adjudicator for Higher Education (OIA) is the independent student complaints ombuds for higher education in England and Wales. It is the designated operator of the student complaints' scheme under the Higher Education Act 2004.
The Fitness to practise section is the fifth section of the Good Practice Framework, which provides operational guidance to support higher education providers in England and Wales. The Framework sets out overriding principles including accessibility, fairness and timeliness. The other sections are: Handling student complaints and academic appeals, Supporting disabled students, Delivering learning opportunities with others, and Disciplinary procedures. Learn more about the sections of the Good Practice Framework.
The Good Practice Framework is one element of the OIA's good practice work. We also provide guidance through a range of webinars, podcasts, workshops and visits. Find out more about our upcoming outreach programme.


Richard Harris worked as a mechanical engineer/scientist at IBM for 43 years prior to his retirement in February, 2009. Today he continues to work with IBM as a part time consultant. He serves as an elder at Providence Baptist Church in Raleigh, NC. Mr. Harris received his B.S. and M.M.E. degrees in Mechanical Engineering from North Carolina State University.


I was on a train, somewhere near midnight, traveling south trough Italy. I was 20-years-old, traveling with another girl my age who was hardly bigger than a middle schooler. We found a sleeping car, closed the door and latched it shut. These are the things you do when you're a small girl, traveling by train in the recesses of a foreign country, you lock all doors with all available locks.
While boarding we'd seen the guys who loudly claimed the car next to ours and seemed to be throwing an Italian frat party inches from the beds we'd claimed for the night. We hear them quiet down, chatter in hushed Italian, laugh, whisper again. Then they start to bang on the adjoining wall. Their shouts get louder. We hear the door open, two of them start to bang on our flimsy door secured with an equally flimsy lock. We tell them to go away, we don't want to party, but this somehow is perceived as encouragement. They don't understand English, and their reply is just as unintelligible to us. They retreat.
Throughout the night, and the various stops along the route between Venice and Bari, we hear them attempt to make contact again. We hardly sleep, scared that the lock will give out and we will finally find out what a pack of mid-20's Italian men want with the two American girls. Somewhere near dawn, we pull into a small train station in a remote part of Southern Italy and we hear them file out of the door and into the small train hallway, clearly they've reached their destination. Just before the car next to us is finally quiet we hear a loud, aggressive knock on the pocket door that's served as our bouncer and safeguard for the night. We both sit bolt upright.
Maybe someone else would have felt guilty for shunning what ended up being decent people, maybe I should have. I was touched by the gesture, even though the safeguard of an appropriate red flag in that situation kept me from enjoying what may have been some pleasant company. The chocolate was great, as chocolate at dawn always is. Perfect with espresso and laughing about what happened, what could have happened, and how glad we were that the trip ended the way it did.
Great story. I have also had some very nerve racking train journeys in Italy. Love these brownies.
LOVE these!!!! What could possibly pair better with strawberries than loads of chocolate!
We are who we are, our 'station' in life dictated at conception. Lucky you to have had the experience you wrote about at such a young, fearless and impressionable age. Can you tell that I am old and jealous?
Chocolate and strawberries taste so delicious together!
Your work on this blog is absolutely out of this World.
Recipes which work, photos are just looking so delish! It is a big motivation in trying to get better myself with my recipes.
Could regular beer be used in place of Stout?
I'm not sure what you mean by "regular beer," can you be more specific? If you are worried about finding a stout, Guinness would work fine, but you'll get more of a beer flavor with a Russian Imperial stout or a Barrel Aged stout.
what could I substitute beer with?
can I also leave out espresso powder?
Espresso enhances the flavor of the chocolate, you won't be able to taste it, it will just make it taste more chocolatey. The alcohol almost completely bakes off, if that's what you are worried about. You can substitute seltzer water, but I've never done it so I can't speak to what the results will be.
This recipe is awesome! Just made it with Meantime Chocolate Stout and pecans, and when I told my husband to thank the Beeroness, he said, "That sounds like a superhero." I assured him that you most certainly are.
Awwwwww! Thank you so much!
What can I put instead of the beer?
Can I substitute espresso instant coffee for espresso powder?
Thank you for answering so swiftly.
I recently made them and they were the hit at a party we went to. I liked that the brownies weren't too sweet. I'm making them again this week.


Discussion in 'Buy Sell Auction - Archives' started by ae50mag, Apr 3, 2008.
IT MAY BE 12 IT MAY BE 24 EGGS, BUT IT WILL BE MORE THAN 12 FOR SURE--- I AM INCUBATING TURKEY,DUCK AND LARGE BREED BIRDS AND HAVE NO ROOM TO HATCH MY SERAMA EGGS SO I WILL INCLUDE ALL SERAMA EGGS THAT ARE LAYED WED-FRI AND SHIP SATURDAY.. I JUST ADDED ANOTHER LINE IN MY BREEDING PROGRAM FOR WHITE SERAMA AND A EXPANDED EXTENDED BLACK LINE FROM ANOTHER WELL KNOWN TOP NOTCH BREEDER. YOU WILL NOT BE DISAPPOINTED..
I love serama's but i can't get any eggs right now for i have eggs already filling my incubator.
SOLD. wish me luck in getting a mottled boy!
I have heard great things about you and your birds...do you by any chance have any pics of your seramas ? and would you put me on your list for some eggs?
i have some posted on here and on the ussc.us forum, i will take some more pics of this years breeders and upcoming breeders and new bloodlines. once we have nicer days and the chickens can warm up and strut around the yard and hoop houses. bear with me and i will add you to the list ..
I am interested in some Serama eggs also, but loaned out my incubator to one of my 4-H kids. Their eggs haven't arrived yet, and they are duck eggs, so it will be a month or so before I can incubate again.
Would you add me to your list? Thanks!!