Family Planning and Contraception Research Papers (original) (raw)

Le Vade-mecum pour la prise en charge des demandes de contraception d’urgence réalisé par la Fédération laïque de centres de planning familial contient : - Une synthèse de la littérature scientifique - Un arbre décisionnel pour la... more

Le Vade-mecum pour la prise en charge des demandes de contraception d’urgence réalisé par la Fédération laïque de centres de planning familial contient :
- Une synthèse de la littérature scientifique
- Un arbre décisionnel pour la prise en charge médicale
- Des recommandations de bonne pratique
- Un questionnaire

- by
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- Contraception, Emergency Contraception, Family Planning and Contraception

Introduction: Family planning is a means by which individuals or couples space pregnancy and childbirth at intervals, mutually determined by husband and wife in order to have the desired number of children. Unintended pregnancy is a worldwide problem and may result from contraceptive misuse and failure. Adherence to short-acting contraceptives has been shown to be poor, with many women repeatedly missing short-acting contraceptives. In an effort to improve compliance, long-acting contraceptives that minimize the frequency of dosing are becoming increasingly popular. In developing countries, 20% to 30% of women who use oral contraceptives or injectable stop within two years of starting because of side effects or other health concerns.

- by Leta Hinkosa
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- Family Planning and Contraception

This research explores the history of the birth control pill in America and its ties to feminism and women's reproductive rights. The Research highlights the 1970 Nelson Pill Hearings and the movements for women to have the autonomy to... more

- by Shannon Lobb
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- Women's History, Contraception, Women's Rights, Feminism

I consider myself a reasonably good catholic, yet I feel marginalized by the church I love. This is why. I am a retired obstetrician and gynecologist and throughout my career I have been dealing, almost on a daily basis, with issues of family planning. I am fully aware that the Catholic Church opposes any artificial methods of contraception and sterilization. Only the so called " fertility awareness methods " are condoned. That is just fine for motivated and somewhat educated couples, with some access to medical care and teaching; also this approach works best if the women has regular menstrual cycles. Medical advances have made these methods more sophisticated and precise than the original method, based on just counting the days of the menstrual cycle and abstaining from intercourse on the so called fertile days.(1) Under ideal circumstances these natural methods have a high success and low failure rate, equal or better than some artificial methods. Yet they still require a fair amount of effort. In my practice I have certainly made these methods available to couples who opted for them and I have helped these couples in their use. Many are very satisfied with them. Under less than ideal circumstances however, these natural methods have a high and unacceptable failure rate.(2) This is especially true in developing countries and areas (like refugee camps) where people live in squalor, lack food and most basic living needs, have no or inadequate medical care, and women often have very irregular or absent menstrual cycles, so that the natural methods of family planning become utterly impractical. Yet the Catholic Church insists that only these natural methods are acceptable. Proponents of the natural methods will argue that some methods of contraception might actually operate by preventing implantation of a fertilized ovum, and thus could be considered an abortifacient, which is certainly unacceptable to the Church. I acknowledge that some of the artificial methods may alter the lining of the uterus to the point that an ovum, if fertilized anyway, will not implant (abortifacient?). The majority of evidence however, points to the fact that these methods prevent either sperm transport, ovulation, or both, rather than preventing implantation, and therefor should not be considered abortifacients in the vast majority of instances.(3) One other argument that is often raised in this type of discussion is that artificial methods of family planning may have serious side effects. I also acknowledge that that may be so, even though the risks are small. As an example, the relative risk for a serious blood clot formation, a life threatening event, in a woman taking the combined oral contraceptive pill is certainly increased, but the absolute risk is very small.(4) However a consideration that is mostly overlooked, is the complication rate of failed contraception resulting in a pregnancy. As I argued earlier, that failure rate is considerably higher for natural methods when applied to the overall world population. An unwanted pregnancy, or any pregnancy for that matter, especially in developing countries, carries with it the risk of serious morbidity and even mortality associated

- by William LeMaire
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- Family Planning and Contraception

Contraceptive failure is a major contributor to unintended pregnancy worldwide. DHS retrospective calendars, which are the most widely used data source for estimating contraceptive failure in low-income countries, vary in quality across countries and surveys. We identified surveys with the most reliable calendar data and analyzed 105,322 episodes of contraceptive use from 15 DHSs conducted between 1992 and 2014. We estimate contraceptive method-specific 12-month failure rates. We also examined how failure rates vary by age, education , socioeconomic status, contraceptive intention, residence, and marital status using multilevel piecewise exponential hazard models. Our failure rate estimates are significantly lower than results from the United States and slightly higher than previous studies that included more DHS surveys, including some with lower-quality data. We estimate age-specific global contraceptive failure rates and find strong, consistent age patterns with the youngest users experiencing failure rates up to ten times higher than older women for certain methods. Failure also varies by socioeconomic status, with the poorest, and youngest, women at highest risk of experiencing unintended pregnancy due to failure.

In recent times, the showcasing of professional ethical standards at workplaces has become an imperative issue of interest in almost all professions including the health profession in general and nursing. This study investigated patient's knowledge and perception of patients on Nurses' adherence to their professional codes of ethics in Ghana, using Eastern Regional Hospital, Koforidua as a case study. A Cross-sectional survey was conducted among 400 patients at the Eastern Regional Hospital, Koforidua using a simple random sampling in selecting participants. A structured questionnaire was used to collect data from the participants. Females (64.8%) dominated the study and a Majority (68.5%) of respondents were between the ages of 21-40 years. Most of the respondents (83.2%) did not have any knowledge about nurses' professional code of ethics. The majority (59.8%) of patients agreed nurses do not introduce themselves with their name, title and professional role to patients. However, most of the respondents (60.3%) agreed that nurses carried out all nursing interventions and procedures with respect to preserving the patient's dignity. The respondents indicated that majority of nurses (78.5%) did not discriminate in attending to patients. Most nurses (66.0%) obtained the consent of the patient before any nursing intervention is performed. Majority of patients (83.3%) do not have knowledge of the nurses' professional code of ethics in Ghana. Ghanaians need to be sensitized on professional ethics of nurse to understand and know what is expected of nurses so they can be able to put nurses in check.

- by Augustine Kumah and +3
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- Sexual and Reproductive Health, Public Health Policy, Quality Improvement, Public Health

The contraceptive prevalence in Nigeria is generally very low in spite of the high rate of sexual activity and widespread awareness of the various contraceptive methods. This study sought to evaluate the Awareness, knowledge, attitude and use of contraceptives and to determine the sources of information on contraception and contraceptives among Niger Delta University staff and students. A 30‑item questionnaire was used to assess the objectives of the study. Data were analyzed using the Statistical Package of Social Sciences (SPSS) version‑16.0. Respectively, 50.5% and 49.5% of respondents were Students and Staff; 52% were unmarried; 65.5% were females; 46% were aged between 15-25 years; and Christianity was the dominant religion. High proportions of respondents (94.5%) were aware of contraceptives and had good knowledge of contraceptive use but only 59% have used contraceptive at a point in their sexual life. The most common method of contraceptive was condom (31%); major reason for non-use was side-effects. Awareness and knowledge of contraception is high but prevalence of use is low. There is need for educational interventions and enhanced access to family planning in this community.

- by Joshua Eniojukan and +1
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- Family Planning and Contraception

ABSTRACT
INTRODUCTION: Subsidisation of the levonorgestrel-releasing Jadelle® contraceptive implant in 2010 resulted in a rapid uptake. Clinicians had little prior experience of client satisfaction, side effect profile, and removal rate of this contraceptive method.
AIM: To obtain information on satisfaction, bleeding patterns, continuation rates and reasons for removal for New Zealand women during their first year of use of a subsidised contraceptive implant, Jadelle®.
METHODS: Women having a Jadelle® implant inserted in New Zealand Family Planning clinics were recruited to be followed up by phone, text or email at 1, 3, 6, 9 and 12 months. They were asked about their bleeding pattern, satisfaction and their views on benefits of, or problems with, implant use.
RESULTS: 252 women were recruited. The three common bleeding patterns in the cohort were regular periods, amenorrhoea and irregular bleeding. Eighteen percent had their implant removed within the first year with more than half of those being unhappy with their bleed- ing pattern. This was usually prolonged bleeding. Otherwise satisfaction rates were high throughout the year.
DISCUSSION: The majority of New Zealand women using Jadelle® were satisfied with this method of contraception during their first year of use. Implant removals were most likely to be related to prolonged bleeding. However the commonest bleeding pattern was regular periods.
KEYWORDS: Contraceptive implant; progestin; bleeding; satisfaction; continuation rate; reducing reproductive health inequalities

- by Anna Whitehead and +1
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- Contraception, Women's Health, Family Planning and Contraception

Despite the launching of a family planning programme in Ghana about 5 decades ago, the country's family planning prevalence rate remains relatively low and its total fertility rate is still considerably high compared with other African countries. One of the factors that may contribute to the low family planning prevalence rate and thus the slow fertility decline in Ghana is the perception of family planning use among married men and women in Ghana. This study sought to examine the perception of family planning use among married men and women at Anomabu community in the Mfantseman Municipality of the Central Region of Ghana. Data were collected among married men and women who were in their reproductive ages (15-49 years). Questionnaires were administered to 200 randomly selected respondents. The data collected were analyzed with Statistical Product and Service Solution (SPSS) software version 21 and presented using graphs and tables. The results revealed that 82.5% of the respondents had knowledge about family planning with media (radio, TV and internet) being the major source of information about family planning. Fifty-two percent of the respondents had ever used at least a type of family planning with 59.5% ever used modern type of family planning. However, 81% of the respondents were currently using at least a type of family planning of which 87.5% were also using modern family planning method. In conclusion, the findings indicate that respondents had high knowledge about family planning, especially the modern family planning method.

In the face of continuous efforts of the government and international organizations, population growth rate in Yemen still high. The present study was aimed to investigate the current prevalence and predictors of oral contraceptive pills (OCPs) use among Yemeni women in Dhamar area. A cross-sectional study was carried out among 400 women using a semi-structured questionnaire. The results showed that the prevalence rate of OCPs use is 33%. General characteristics showed that almost half of the study population had no formal education, ˃ 3 living children, and ˂ 20 years at marriage. The predictors found to be significantly associated with OCPs use were age, educational level, age at marriage, number of living children, attitude on safety of OCPs, and practice on contraceptives-seeking behavior. The present study reported a rise in OCPs use and seeking behavior, but that was not consistent with the obstetric characteristics of the study population. Community mobilization with efficient health education would improve the awareness of Yemenis about the advantages of contraception in family well-being.

- by A. Mehrass and +2
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- Obstetrics, Contraception, Yemen, Public Health

Η διπλωματική εργασία μεταπτυχιακής ειδίκευσης, η οποία εγκρίθηκε από τη Γενική Συνέλευση του Τμήματος Θεολογίας Α.Π.Θ με το βαθμό «΄Αριστα» το Δεκέμβριο του 1992. Τα δύο πρωτότυπα σημεία στη μελέτη αυτή είναι ο ηθικός σχολιασμός των αντισυλληπτικών μεθόδων και τεχνικών μέσων (β΄κεφάλαιο) και η τυποποίηση των απαντήσεων των ποιμένων για την αντιμετώπιση των θεμάτων της τεκνογονίας και της αντισύλληψης στον ορθόδοξο γάμο (γ΄κεφάλαιο).

Background: In developing countries such as Zambia, couples seldom make decisions with regard to fertility solely in consultation with each other. At all stages of family formation couples are strongly persuaded by cultural and social norms. In additions couples are influenced by opinions and information provided by close friends and relatives in couple's social net works. Social net works play an important role in enabling husbands seeks information with respect to planning births. One drawback of studies on expected fertility in developing countries is that they have not adequately addressed the impact of reproductive decision making on expected fertility. Consequently, though husbands strongly influence fertility decision making, fertility studies do not pay adequate attention to the role played by husbands in fertility decisions making. The objective of this study is to examine the development of a planning process with respect to timing and spacing of children. Methods: The sample for this study consists of husbands from one hundred sixty three households randomly selected from low income communities located in Kitwe, Zambia. Two questionnaires, one for the husband and the other for the wife, were designed to gather data. Husbands and wives were interviewed simultaneously in order to limit opportunities for spouses to influence each other. We examine men's fertility decision making by analyzing data on six questions: Can a couple ever have too many children?; Have you ever talked or received advice from any one about the best length of time to have between pregnancies?; Have you ever talked to or received advice from anyone on methods how to space your children or prevent pregnancy?; Have you and your husband/wife ever talked about the number of sons and daughters you would like to have before stopping?; Have you and your wife ever discussed the best length of time to have between pregnancies and finally, is it costly to have children today? Results: Husbands who engaged in birth planning were more likely than the rest to believe that too many children are undesirable. In Zambia, a rational approach to the control of fertility among birth planers is realized in social settings rather than in isolation. The transition from natural fertility to controlled fertility is associated with modernization and accepting modern values. Knowledge of birth control is also essential and is often associated with increases in education. However, social networks also play an important role in reducing expected family size by facilitating a rational and planned approach to family building in Zambia. Conclusion: Husbands were not averse to sharing information with group members in close social networks to arrive at decisions with respect to planning births. Recognition of the social milieu in which contraceptive use takes place is necessary for the promotion of modern contraception. Husband's social networks significantly influence his fertility decisionmaking. Subsequently, from a policy point of view it appears crucial to facilitate the maintenance of the social networks involved in making contraceptive use decisions to promote prolonged use of modern contraception. The implications for family planning programs are discussed.

- by Vijayan Pillai
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- Family Planning and Contraception

Contraceptive counselling is seen as a major part of public health care, maternal and child health care. Therefore, antenatal and postnatal periods are regarded as the appropriate opportunities for women to receive education on contraceptives. However, not much attention has been given to the contents, materials used and frequency of the contraceptive education women receive as this is critical in understanding the contraceptive behaviour of these women. Against this backdrop, this study explores the components of contraceptive counselling postpartum women receive when they attend antenatal and postnatal health care services in order to provide insights into the various contraceptive counselling given to postpartum women who attend antenatal and postnatal clinics. The study uses exploratory methodological approaches, where qualitative data were collected through individual in-depth interviews. Thirty women of the age 20-35 years attending antenatal and postnatal clinics were interviewed at the University of Ghana Hospital and Achimota Hospital. The analysis shows that women were counselled on the direct and indirect benefits of contraceptive uses, the various types of contraceptives and duration of use. The study further found the use of teaching materials such as audio visuals and leaflets during counselling sessions. However, less education was provided on the possible side effects of using contraceptives. The study therefore recommends continuous education on the benefits of contraceptives as well as possible side effects of these contraceptives to achieve higher contraceptive use.

- by DESMOND KLU
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- Family Planning and Contraception

Background: The global population growth rate is wreaking havoc on a wide array of health, economic, social and personal decisions. However, what may remain lost with other effects and dangers is the detailed impact on sexual reproductive health and rights, for both people in the world and around Uganda. Moreover, the unmet need for family planning has remained high among married women in the country that contributes to unplanned pregnancies. The WISH2ACTION project uses Public-Private-Partnership working with facilities as a strategy to improved provision of services. We designed this study to evaluate the effectiveness of public-private partnership in the provision of long-acting reversible and permanent family planning methods in WISH2ACTION operation region of Uganda.
Methods: retrospective analysis of data on core Women's Integrated Sexual Health 2 Action Project (WISH2ACTION) indicators; Implants, Intrauterine devices and Permanent Methods and methods provided to youth under 20 years. Data were extracted from RHU DHIS2 and assess for compliance with MANOVA assumptions. The data was further powered to provide an appropriate sample estimation before running the MANOVA model to evaluate the effectiveness of the public-private partnership.
Results: analysed data from 228 associated facilities adequate to accept hypothesis testing based on 177 samples after power estimation. The multivariate analysis of variance (MANOVA) showed significant differences hence we infer that PPP strategy was more effective on long-acting reversible and permanent contraceptives outcome under the WISH2ACTION project and significantly different than that of the NPPP strategy. Post hoc analysis indicates that public-private partnerships strategy positively affects the provision of Implant and provision of FP to under 20 by 76% & 68% respectively. The findings also indicate that as the modern contraceptives prevalence rate increase, the sample size for such research keeps on reducing to determine whether the unmet need for family planning reached. However, the strategy did not show any impact on the provision of IUCD and permanent methods.
Conclusions: The study concludes that Public-Private Partnerships associated facilities (PPPF) enabled effective delivery of services to the clients. The existence of a partnership is an opportunity to achieve the goals of reducing limited access to family planning services. Young people have been engaged through dialogue meetings, radio spots, YAM under RHU rallying other young people to demand for SRHR services remains as most vigorous measures. We recommend services Integration in most facilities to improve uptake of IUCD and permanent methods of family palling, which is greatly affected.

The aim of this study is to look at the problem of contraception in the ecumenical context. A special occasion for such reflection is the fiftieth anniversary of the publication by Pope Saint Paul VI the Humanae vitae encyclical on the regulation of birth (1968). It is known that the Catholic Church in its official statements completely differently evaluates the use of contraceptives than the Evangelical Churches. Evangelicals, like other Protestant communities, already in the 1930s accepted contraception as a form of responsible spouses' approach to parenthood. In the Catholic Church, contraceptive methods are treated as wicked, opposed to the morality of a marriage act. The subject of contraception is therefore still a controversial area of ecumenical dialogue. Nevertheless, the statements of some theologians or Catholic bishops referring to the teaching of Pope Francis may perhaps change something in this matter.

This document presents a summary of family planning. It reviews existing literature, examining carefully what the current knowledge is, where the important issues or problems lie and “what works”.

Introduction Reduced funding to contraceptive
services in the UK is resulting in restricted access
for women. Pharmacists are already embedded
in sexual and reproductive health (SRH) care in
the UK and could provide an alternative way
for women to access contraception. The aim
of this study was to determine the views of
UK contraception providers about community
pharmacist-led contraception provision.
Methods An anonymous questionnaire was
distributed to healthcare professionals at two
UK SRH events, asking respondents about: (1)
the use of patient group directions (PGDs) for
pharmacist provision of oral contraception (OC);
(2) the sale of OC as a pharmacy medicine or
general sales list medicine; (3) the perceived
impact of pharmacy provision of OC on broader
SRH outcomes; and (4) if other contraceptive
methods should be provided in pharmacies.
Results Of 240 questionnaires distributed,
174 (72.5%) were returned. Respondents
largely supported pharmacy-led provision of
all non-uterine methods of contraception,
excluding the contraceptive implant. Provision
of the progestogen-only pill by PGD was most
strongly supported (78% supported initiation).
Respondents felt that the use of bridging
(temporary) contraception would improve
(103/144, 71.5%), use of effective contraception
would increase (81/141, 57.4%), and
unintended pregnancies would decline (71/130,
54.6%); but that use of long-acting reversible
contraception would decrease (86/143, 60.1%).
Perceived barriers included pharmacists’ capacity
and competency to provide a full contraception
consultation, safeguarding concerns, and
women having to pay for contraception.
Conclusions UK SRH providers were largely
supportive of community pharmacy-led
provision of contraception, with training and
referral pathways being required to support
contraception delivery by pharmacists.

Engelli bireyler, toplumda karşılaştıkları çeşitli durumlar nedeniyle özel bakıma ve desteğe ihtiyacı olan gruplardır. Bundan dolayı sağlık profesyonellerinin toplum sağlığını koruma ve geliştirme kapsamında engelli birey ve ailesinin bakım ve sağlık hizmetlerine yönelik sorunlarının çözümünde kilit rolleri bulunmaktadır. Sağlık profesyonelleri, engelli bireylere bütüncül bakım felsefesi doğrultusunda topluma liderlik ve eğitimci/danışman rollerini ön plana çıkararak farkındalık yaratmalıdır. Bu nedenle özellikle; hemşireler ve ebeler engelli bireylerin üreme sağlığı ve aile planlamasına yönelik problemlerini iyi tanımalı ve bireylere doğrudan iletişime geçmelidirler. Disabled individuals are groups that need special care and support due to various situations they encounter in society. Therefore, health professionals have a key role in solving the problems of the disabled individual and their families regarding care and health services within the scope of protecting and improving public health. Health professionals should raise awareness by emphasizing leadership and educator/counselor roles in the society in line with the philosophy of holistic care for people with disabilities. Therefore, especially; Nurses and midwives should know the reproductive health and family planning problems of individuals with disabilities and should communicate directly with individuals.

- by Akgün Yeşiltepe
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- Contraception, Disability, Disabled People, Family Planning

Background: Oral Contraceptive Pills (OCPs) are the most widely prescribed form of hormonal contraception both in developed and developing countries. They are also the most popular nonsurgical method of contraception. Objective: To determine the prevalence rate and socio-demographic characteristics of oral contraceptive pills acceptors at the Rivers State University Teaching Hospital (RSUTH), Port Harcourt. Methods: A 10 year review of all clients who accepted oral contraceptive pills in the family planning clinic of the hospital from 1 st January, 2008 to 31 st December, 2017. Data was extracted, coded and analyzed using the Statistical Package for Social Sciences (SPSS) IBM version 25.0 (Armonk, NY). Results: There were 1893 contraceptive acceptors during the study period, out of which 86 (4.5%) accepted the oral pills. Majority of the clients 66 (76.8%) were between the age range of 20 to 34,

- by Felix C . C . Wekere
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- Family Planning and Contraception

Abstract
Objective: To describe subdermal implant use in Mexico over time, by state and by
age.
Methods: We conducted a repeated cross-sectional study using the 2009, 2014, and
2018 waves of the National Survey of Demographic Dynamics (Encuesta Nacional de
la Dinámica Demográfica [ENADID]). Our outcome was current use of contraception,
by type, with a focus on the implant. We used visualizations, descriptive and bivariate
statistics, and multinomial models to assess change over time, geographic patterns,
method mix, and factors associated with implant use (vs intrauterine device [IUD] or
other hormonal methods).
Results: Implant use is increasing over time in Mexico, from 1.1% of women who have
ever used a method in 2009 to 4.5% in 2018 (P < 0.001); the change is greatest among
adolescents (2.5% in 2009 to 12.2% in 2018; P < 0.001). Change in implant use as a
fraction of modern method use was heterogeneous across Mexican states. The adjusted relative likelihood of using an implant compared with IUD was 34% higher for
adolescents compared with women aged 20–29 years (relative risk ratio 1.34, 95%
confidence interval 1.16–1.55, P < 0.001), controlling for other variables in the model.
Conclusion: Use of subdermal implants is increasing over time in Mexico and is concentrated among adolescents. Implants have the potential to expand access to highly
effective contraception in Mexico.
KEYWORDS
adolescents, contraception, Mexico, subdermal implant

The contraceptive prevalence in Nigeria is generally very low in spite of the high rate of sexual activity and widespread awareness of the various contraceptive methods. This study sought to evaluate the Awareness, knowledge, attitude and use of contraceptives and to determine the sources of information on contraception and contraceptives among Niger Delta University staff and students. A 30-item questionnaire was used to assess the objectives of the study. Data were analyzed using the Statistical Package of Social Sciences (SPSS) version-16.0. Respectively, 50.5% and 49.5% of respondents were Students and Staff; 52% were unmarried; 65.5% were females; 46% were aged between 15-25 years; and Christianity was the dominant religion. High proportions of respondents (94.5%) were aware of contraceptives and had good knowledge of contraceptive use but only 59% have used contraceptive at a point in their sexual life. The most common method of contraceptive was condom (31%); major reason for...

- by Joshua Eniojukan
- •
- Medicine, Clinical Pharmacy, Family Planning and Contraception

Background: Empowering women to choose timing and number of children is the key to improve her reproductive and overall health. This requires availability of basket of contraceptives to choose from, improving access to contraceptive methods to women for acceptance of long term and short-term family planning methods. To date, efforts to assess progress on this front have been largely limited to the estimation and projection of family planning indicators at the national and state level but they are much needed at the district level, particularly for the most populous state in India with large demographic diversity like Uttar Pradesh. Methods: We have used a statistical model that can generate estimates and projections of rates and trends in indicators related to access to reproductive health at the national and subnational levels. For this, Avenir Health has packaged this model in the form of a user-friendly web application, the Family Planning Estimation Tool (FPET), which can be operated by local stakeholders with little external support. We present annual estimates and projections of rates and trends in the modern contraceptive prevalence rate, unmet need, and met demand for modern family planning methods for Uttar Pradesh state and all its 75 districts from 1991 to 2025 produced with FPET. Findings: There is a large amount of heterogeneity between the districts; only six districts have high modern contraceptive prevalence rate *Key Message: It is hoped that the analysis presented here will be helpful to planners and implementers of family planning program in Uttar Pradesh, India.

- by Naveen Roy and +1
- •
- Family Planning and Contraception

Background: The global population growth rate is wreaking havoc on a wide array of health, economic, social and personal decisions. However, what may remain lost with other effects and dangers is the detailed impact on sexual reproductive health and rights, for both people in the world and around Uganda. Moreover, the unmet need for family planning has remained high among married women in the country that contributes to unplanned pregnancies. The WISH2ACTION project uses Public-Private-Partnership working with facilities as a strategy to improved provision of services. We designed this study to evaluate the effectiveness of public-private partnership in the provision of long-acting reversible and permanent family planning methods in WISH2ACTION operation region of Uganda.
Methods: retrospective analysis of data on core Women's Integrated Sexual Health 2 Action Project (WISH2ACTION) indicators; Implants, Intrauterine devices and Permanent Methods and methods provided to youth under 20 years. Data were extracted from RHU DHIS2 and assess for compliance with MANOVA assumptions. The data was further powered to provide an appropriate sample estimation before running the MANOVA model to evaluate the effectiveness of the public-private partnership.
Results: analysed data from 228 associated facilities adequate to accept hypothesis testing based on 177 samples after power estimation. The multivariate analysis of variance (MANOVA) showed significant differences hence we infer that PPP strategy was more effective on long-acting reversible and permanent contraceptives outcome under the WISH2ACTION project and significantly different than that of the NPPP strategy. Post hoc analysis indicates that public-private partnerships strategy positively affects the provision of Implant and provision of FP to under 20 by 76% & 68% respectively. The findings also indicate that as the modern contraceptives prevalence rate increase, the sample size for such research keeps on reducing to determine whether the unmet need for family planning reached. However, the strategy did not show any impact on the provision of IUCD and permanent methods.
Conclusions: The study concludes that Public-Private Partnerships associated facilities (PPPF) enabled effective delivery of services to the clients. The existence of a partnership is an opportunity to achieve the goals of reducing limited access to family planning services. Young people have been engaged through dialogue meetings, radio spots, YAM under RHU rallying other young people to demand SRHR services remains as a most vigorous measure. We recommend services Integration in most facilities to improve uptake of IUCD and permanent methods of family palling, which is greatly affected.

- by mithun mog
- •
- Tribal studies, Family Planning and Contraception

Introduction: Harmful use of alcohol result in 3 million people die each year, which means 5.3% of all deaths worldwide. Alcohol has a contribution on the global burden of disease and injury which accounts approximately 5.1 per cent of the disability-adjusted life years (DALYs), and approximately 13.5 per cent of the total deaths in the age group 20-39 years were caused by alcohol consumption. Objectives: To understand the changes and differentials in alcohol consumption in India and its states, and to examine the determinants of alcohol consumption in India. Data Source and Methodology: The present study has used the national representative Indian Human Development Surveys (IHDS) I (2004-05) and II (2011-12). Bivariate analysis was used to show the prevalence of alcohol consumption concerning some selected socioeconomic and demographic background variables. The Chi-square and multivariate logistic regressions were also employed to estimate the odds ratio (95% CI) for alcohol consumption. STATA and Arc GIS 10.1 software were employed to carry out the analyses. Findings: The alcohol consumption was two per cent higher in 2004-05 (37%) than the recent survey of IHDS (2011-12) (35%) in India. In addition to that, there were some states where the consumption of alcohol had increased from 2004 to 2012 like Mizoram (44%), Kerala (19%), and Jammu and Kashmir (16%). In contrary to that, there were also a few states where alcohol consumption had decreased from 2004 to 2012 like Rajasthan (8%) and Tamil Nadu (5%).

- by mithun mog and +1
- •
- Tribal studies, Family Planning and Contraception, Health and Women's Issues

This paper was presented at the Conference on Communication, Mass Media and Development, Northwestern University, October 13-15, 1983. A model of the interrelationship between socioeconomic status, knowledge, communication, and... more

- by Farag Elkamel
- •
- Social Marketing, Mass Communication, Egypt, Reproduction and human fertility

Levonorgestrel (LNG), a progestin widely used for regular hormonal contraception, is also used for emergency contraception (EC) to prevent pregnancy after unprotected intercourse. However, its mode of action in EC is only partially understood. One unresolved question is whether or not EC prevents pregnancy by interfering with postfertilization events. Here, we report the effects of acute treatment with LNG upon ovulation, fertilization and implantation in the rat. LNG inhibited ovulation totally or partially, depending on the timing of treatment and/or total dose administered, whereas it had no effect on fertilization or implantation when it was administered shortly before or after mating, or before implantation. It is concluded that acute postcoital administration of LNG at doses several-fold higher than those used for EC in women, which are able to inhibit Ovulation, had no postfertilization effect that impairs fertility in the rat.

- by Andrés L Müller González
- •
- LNG, Contraception, Contraceptives, Emergency Contraception

Despite the launching of a family planning programme in Ghana about 5 decades ago, the country’s family planning prevalence rate remains relatively low and its total fertility rate is still considerably high compared with other African countries. One of the factors that may contribute to the low family planning prevalence rate and thus the slow fertility decline in Ghana is the perception of family planning use among married men and women in Ghana. This study sought to examine the perception of family planning use among married men and women at Anomabu community in the Mfantseman Municipality of the Central Region of Ghana. Data were collected among married men and women who were in their reproductive ages (15-49 years). Questionnaires were administered to 200 randomly selected respondents. The data collected were analyzed with Statistical Product and Service Solution (SPSS) software version 21 and presented using graphs and tables. The results revealed that 82.5% of the respondents...

- by Ebenezer Armah-Ansah
- •
- Geography, Perception, Family Planning and Contraception

- by Srinivas Goli
- •
- Article, Contraceptive Use, Family Planning and Contraception, Sustainability

- by Priya nanda
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- Article, Contraceptive Use, Family Planning and Contraception, Sustainability

Making universal access to sexual and reproductive health care a reality, and thus building momentum for comprehensive family planning by 2030, is key for achieving sustainable development goals. However, in the last decade, India has been retreating from progress achieved in access to family planning. Family planning progress for a large country such as India is critical for achieving sustainable developmental goals. Against this backdrop, the paper investigated the question of how far family welfare expenditure affects contraceptive use, sources of contraceptive methods, and method-mix using triangulation of micro and macro data analyses. Our findings suggest that, except for female sterilizations, modern methods of contraception do not show a positive relationship with family welfare expenditure. Notwithstanding a rise in overall family welfare expenditure, spending on core family planning programs stagnates. State-wise and socio-economic heterogeneity in source-mix and method-mix continued to influence contraceptive access in India. Method-mix continued to skew towards female sterilization. Public sector access is helpful only for promoting female sterilization. Thus, the source-mix for modern contraceptives presents a clear public-private divide. Over time, access to all contraceptive methods by public sources declined while the private sector has failed to fill the gap. In conclusion, this study identified a need for revitalizing family planning programs to promote spacing methods in relatively lower-performing states and socio-economic groups to increase overall contraceptive access and use in India through the rise in core family planning expenditure.
Keywords: contraceptive use; family welfare expenditure; sources of contraception; method-mix; India

- by Sheuli Misra
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- Contraceptive Use, Family Planning and Contraception
- by mithun mog
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- Finance, Psychology, Tribal studies, Financial Ratio Analysis
- by Hilda Agortimevor
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- Psychology, Nursing, Sexual and Reproductive Health, Public Health Policy
- by nasim ahamed
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- Finance, Psychology, Tribal studies, Financial Ratio Analysis

OBJECTIVE The purpose of this study is to describe subdermal implant use in Mexico over time, by state, and by age. METHODS We conducted a repeated cross-sectional study using the 2009, 2014, and 2018 waves of the National Survey of Demographic Dynamics (ENADID). Our outcome was current use of contraception, by type, with a focus on the implant. We used visualizations, descriptive and bivariate statistics, and multinomial models to assess change over time, geographic patterns, method mix, and factors associated with implant use (vs. IUD or other hormonal methods). RESULTS Implant use is increasing over time in Mexico, from 1.1% of women who have ever used a method in 2009 to 4.5% in 2018 (p<0.001); the change is greatest among adolescents (2.5% in 2009 to 12.2% in 2018; p<0.001). Change in implant use as a fraction of modern method use was heterogeneous across Mexican states. The adjusted relative likelihood of using an implant compared to IUD was 34% higher for adolescents compared to women 20 to 29 years old (RRR 1.34, 95%CI 1.16-1.55 p<0.001), controlling for other variables in the model. CONCLUSION Use of subdermal implants is increasing over time in Mexico and is concentrated among adolescents. Implants have the potential to expand access to highly effective contraception in Mexico.

- by Raffaela Schiavon
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- Medicine, Mexico, Gynecology and Obstetrics, Contraceptives

Background: Mass media plays an important role in information dissemination in Nigeria and studies have shown that the interrelationship that exists between reproductive health behaviour and mass media campaigns on the use of modern contraceptives have resulted in the improvement of reproductive health outcomes. There is a need to examine the differentials in mass

- by David Turok
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- Demography, Sexual and Reproductive Health, Qualitative methodology, Contraception

Background: Contraceptive use initiation and continuation is one of the major interventions for reducing maternal deaths worldwide. Nigeria aimed to achieve a 27% prevalence rate of modern contraceptive uptake by 2020, however, this seems to have remained unachieved. The objective of this study was to investigate when Nigerian women initiate contraceptive use and its associated factors, using nationally representative data. Methods: Data on 11,382 Nigerian women (aged 15-49 years) from the 2017 Performance Monitoring and Accountability 2020 (PMA2020) survey were used to determine the prevalence of lifetime contraceptive use. The Kaplan-Meier test was used to determine median time (years) to contraceptive uptake. In addition, the factors associated with contraceptive use were determined using multivariable logistic regression model. Statistical significance was determined at 5%. Results: The prevalence of modern contraceptive use was 14.2%. There were disparities in the timing (years) of contraceptive use initiation across several women's characteristics. Women from urban residence, highest household wealth index, nulliparous, unmarried, and highly educated women had the minimum median time (years) to contraceptive use initiation. The multivariable logistic model showed that rural women were 26% less likely to initiate contraceptive use, when compared with the urban dwellers (OR= 0.74; 95% CI: 0.65, 0.84). Furthermore, married women were 24% less likely to initiate contraceptive use, when compared with the unmarried (OR= 0.76; 95% CI: 0.63, 0.93). In addition, geographical region, wealth, television source, ever given birth, education, age, and religion were significantly associated with contraceptive use. Conclusion: The prevalence of contraceptive use is low in Nigeria. There were differences in contraceptive use initiation among women of reproductive age in Nigeria. There is a need to adopt sustainable strategies to improve contraceptive uptake and to reiterate the benefits of contraception, including providing enlightenment programs among key populations such as the rural dwellers and low income earners.

- by Kayode R . Fowobaje, PhD and +1
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- Nigeria, Inequality, Contraceptive Use, Family Planning and Contraception

"Il "laboratorio portoricano" si riconferma un luogo denso di significato per le relazioni interamericane, e sullo scenario globale, anche per il ruolo giocato nella creazione della pillola che milioni di donne oggi utilizzano per evitare gravidanze indesiderate. Nei primi anni Cinquanta costituisce infatti uno dei principali teatri di sperimentazione di Enovid" (p. 125). 1 El magnífico trabajo de investigación de Benedetta Calandra, historiadora italiana y profesora de Historia de América Latina en la Universidad de Bérgamo, resulta un so-bresaliente material que contribuye en profundizar líneas de investigación recientemente exploradas en los procesos de intercambio cultural, cientifico, eidético y político en la historia de las relaciones entre Estados Unidos y América Latina durante el siglo XX. ¿Es Puerto Rico una colonia estadounidense, dentro de un mundo postcolonial? La obra de la profesora Calandra problematiza una cuestión histórica elemental en la vinculación interamericana, que a propósito del caso puertorriqueño deja en evidencia múltiples contradicciones en los lineamientos de la política exterior de Washington no únicamente hacia la isla del Caribe, sino que también frente a la región latinoamericana. La investigación de Calandra ahonda en esta interrogante con eminente agudeza analítica, ofreciendo una mirada novedosa y concreta, circunscrita directamente a los cuerpos fe-meninos: las políticas de reproducción en Puerto Rico entre 1898 y 1993, y la influencia norteamericana en el proceso histórico de contexo. Desde su primer capítulo, la investigación da cuenta cómo el status semicolonial en la isla, heredado de la matriz de identidad latina, mestiza y católica, experimenta un foco de tensión con su vecino gigante, liberal y anglosajón, que proveerá las pautas para un esquema de modernización, confeccionado bajo medidas hegemónicas pro capitalista. 1 El "laboratorio puertorriqueño" se confirma como un lugar lleno de significado para las relaciones interamericanas, y para el escenario global, también por el papel desempeñado en la creación de la píldora que millones de mujeres usan hoy para evitar embarazos no deseados. A principios de la década de 1950, fue uno de los principales teatros experimentales de Enovid (...).

User-Blog. DerStandard. 2018.

On May 22, 2006, the State of Wisconsin submitted a Citizen Petition with the Food and Drug Administration (FDA) and, on July 24, 2006, submitted a Supplement to that Petition. The State of Wisconsin sought a switch of Plan B®, an emergency contraceptive drug approved in 1999 for sale and use on a prescription basis, to over-the-counter status and a similar switch regarding any drugs equivalent to Plan B® from prescription. The State of Wisconsin, based on relevant scientific research cited in those submissions, sought that switch to OTC status for all menarchal women regardless of age. Eight years later, in the Tummino case filed in the US District Court for the Eastern District of New York, FDA was ordered to make a successor to Plan B® (Plan B® One-Step) available over-the-counter without any age restrictions.

- by Richard B Moriarty
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- Contraception, Abortion, Teenage Pregnancy, Impartiality