Awareness and use of family planning methods among iTaukei women in Fiji and New Zealand

Objective : iTaukei women's awareness and practice of family planning methods was investigated in New Zealand and Fiji to ascertain differences in behaviour within the context of changing developmental settings. Methods : The study was cross‐sectional in nature and recruited women aged 18 years and over from three suburbs in Suva, Fiji, and five cities in New Zealand. Results : Overall, 352 women participated in the study, 212 in Fiji and 140 in New Zealand. The study found that living in New Zealand was significantly associated with lower odds of being aware of family planning (OR 0.4, 95%CI 0.2–0.9, p=0.029) and using family planning methods (OR 0.5, 95%CI 0.2–0.9, p=0.027). Tertiary education was found to increase the odds of being aware (OR 2.8, 95%CI 1.3–6.2, p=0.009) and of using (OR 3.9, 95%CI 1.9–7.8, p=0.000) family planning. Conclusions : Despite the greater availability of services and higher standards of living experienced in New Zealand compared with Fiji, there was no improvement in awareness and use of family planning among New Zealand participants. Implications for public health : Reduced awareness and use of family planning in New Zealand indicates a need for better targeting of services among minority Pacific ethnic groups.     

Providing family planning and reproductive healthcare to Canadian immigrants: perceptions of healthcare providers

Cultural impacts on health experiences and behaviours are profound in the area of reproductive health and family planning. Explored through interviews with family planning healthcare professionals, this paper evaluates their experiences in providing family planning and reproductive healthcare to immigrants in the Greater Toronto and Hamilton area of Ontario, Canada. Results reveal the complexity of delivering care to members of this group, particularly when dealing with language barriers, situations when professional and non‐professional interpreters are used, and instances where healthcare professionals realize that they themselves have misconceptions and misunderstandings about other cultures. The paper concludes by discussing future research options and implications for the delivery of reproductive health family planning services to this population.     

城乡哺乳期妇女避孕现状比较分析

目的分析比较城乡哺乳期妇女避孕方法的使用情况、获得渠道和选择决定者，以及未避孕原因等。方法利用国家人口和计划生育委员会2001年全国计划生育／生殖健康调查的原始数据，对城乡哺乳期妇女避孕方法的使用现状进行描述性统计分析。结果我国哺乳期妇女的避孕率为78％，城乡哺乳期妇女的避孕率、未避孕原因虽然没有较大差异，但在选择避孕方法、避孕工具获得渠道和选择决定者等方面差异有统计学意义。结论我国妇女对哺乳期避孕的必要性缺乏足够认识，需从多方面加强干预。     

Factors influencing the choice to use modern natural family planning

A discrepancy exists between the interest in modern methods of natural family planning (NFP) and their actual use in developed countries. To explore reasons for this discrepancy, we analyzed data from a questionnaire administered to postpartum women in Berlin (n = 223) and Cracow (n = 233). Knowledge of NFP, past use of NFP and expected effects of abstinence on the partnership were independently associated with interest in using NFP, but not the choice to do so among those interested. Desire for future pregnancies, importance of religious belief and location in Cracow were independently associated with the choice to use NFP among those interested. Perceived accuracy of observation to identify the fertile time and acceptance of own body were independently associated with both interest in and choice to use NFP. Frequency of intercourse had no effect on interest. These results suggest that increased access and cultural support would likely lead to a higher prevalence of NFP use in developed countries.     

Contraceptive use at the family planning clinic of the University of Nigeria Teaching Hospital, Enugu, Nigeria

During the five year review period (January 1993-December 1997), 19,470 clients visited the family planning clinic of the University of Nigeria Teaching Hospital, Enugu. Of these, 2402 clients (12%) were new patients and 17,068 (88%) were old patients. Among the new clients, 2262 (94%) eventually accepted a contraceptive method. The majority of the women (60%) chose the intrauterine contraceptive device (IUCD), 20% chose the injectables, while bilateral tubal ligation and norplant were chosen by 8% and 7%, respectively, of the clients. The oral contraceptive pill was the least popular (1%). Variations in the pattern of contraceptive use among clients at the family planning clinic were discussed. Measures to increase the contraceptive prevalence, and particularly strategies to meet the specific contraceptive needs of clients at the clinic, were also examined.     

农村地区生殖健康/计划生育服务质量评估

目的 了解农村地区育龄男女对生殖健康／计划生育服务的利用情况和相关知识、态度、行为及保健需求。方法 采用定性研究的方法，于2001年对安徽、广东、青海、重庆4省(市)8个村的105名育龄男女分成16个小组进行专题小组讨论。结果 农村育龄妇女孕产期保健情况较好；村级孕产妇大多在乡镇卫生院分娩；妇女产后多采用宫内节育器避孕。育龄妇女中分别有72．5％，35．3％和70．6％的人了解有关生殖道感染／性传播疾病的传播途径、危害和预防措施。获取生殖健康知识的最佳形式是与医生和保健人员面对面地交流与咨询。结论 应加强孕产期保健工作，提高农村孕产妇的住院分娩率；为农村育龄男女提供完善的计划生育指导；并通过多种形式的健康教育，促进农村群众生殖健康水平的提高。     

Cultural eactors constraining the introduction of family planning among the Kassena-Nankana of Northern Ghana

This study presents a focus group investigation of reasons why women in a rural, Sahelian community are reluctant to adopt family planning even when convenient services are made freely available. First, women opting to practice contraception must do so at considerable risk of social ostracism or familial conflict. Implementing individual preference is something that must be done without the support of others. Second, few women view personal decisions about contraceptives as theirs to make. Women and children are the property of the corporate family-kin and community militate against reproductive control. Third, although children are highly valued for a variety of economic, social, and cultural reasons, mortality risks remain extremely high. Low fertility imposes the unacceptable risk that a woman will have no surviving children at the end of her reproductive life. Taken together, these findings attest to the inadequacy of service strategies focused on the contribution of distribution, individual agency, or personal choice. Outreach should also build a sense of community legitimacy for the program, collective health action, and traditional leadership support for family planning behavior.     

Perceptions of home and self-injection of Sayana® Press in Ethiopia: a qualitative study

Objective

Sayana® Press,¹ a new subcutaneous formulation and presentation of a popular injectable contraceptive, has the potential to expand non-clinic access to contraception, including home and self-injection (HSI). This study collected information from potential users and stakeholders on their perceptions and preferences, the feasibility of an HSI of Sayana Press program and key policy considerations.

Study design

PATH conducted 62 interviews and 7 focus groups with family planning users, non-users, physicians, other health care providers and key informants in the Oromia region of Ethiopia. Participants watched a demonstration and tested the device on a model mid-interview. The study did not involve product use in humans.

Results

Women found the product easy to use, liked the simple design and valued the time and expense that could be saved through HSI of Sayana Press (HSI-SP). Of those with inhibitions about their ability to self-inject, most shifted their opinion favorably after demonstration. The majority of other stakeholders also supported HSI-SP and thought it could increase contraceptive use in Ethiopia, and they suggested that any successful program must include proper training and supervision, particularly regarding product storage and waste management.

Conclusion

The data provide findings to stimulate further research and support future planning. They suggest that HSI-SP may meet the needs of many women if key requirements and challenges are met. It may also be necessary to revise policies and guidelines to integrate the approach with national family planning strategies.

Implications

This study provides the first available data on perceptions, feasibility and requirements for HSI of Sayana Press in a low-resource setting. Findings provide insights that may guide future implementation strategies, strengthen non-clinic family planning access programs and stimulate continued research.     

广州市人工流产后计划生育服务的现状分析

目的调查广州市开展流产后计划生育服务(post abortion family planning service,PAFPS)的现状,为进一步改进广州市PAFPS提供依据。方法采用定性访谈和定量调查的方法,对在广州市3个区的4家二级公立医院进行人工流产的妇女820例进行PAFPS调查。结果在820例妇女中,46.71%≤25岁,52.60%未婚,60.61%未产,68%文化程度高中或以下,31.71%为重复流产,78.60%经济收入≤2000元/月,50.49%未避孕导致人工流产,40.12%因避孕失败导致人工流产,44.61%未正确掌握生殖保健及避孕方法知识,89.51%接受了计生宣传教育,其中77.07%能确定人工流产后将使用哪种避孕方法。100%接受了咨询服务,97.23%对咨询表示满意或基本满意。调查的4家医院都能提供良好的PAFPS。结论广州市人工流产患者年龄相对偏小,以未婚、未产为主,文化程度较低,收入较低,避孕知识欠缺,避孕方法使用率低。现有流产后计划生育服务提供的数量和内容有限,应针对其特点加强PAFPS,特别是提供社区PAFPS。     

Knowledge and beliefs about reproductive anatomy and physiology among Mexican-Origin women in the USA: implications for effective oral contraceptive use

Inherent in many reproductive health and family planning programmes is the problematic assumption that the body, its processes and modifications to it are universally experienced in the same way. This paper addresses contraceptive knowledge and beliefs among Mexican-origin women, based upon data gathered by the qualitative component of the Border Contraceptive Access Study. Open-ended interviews explored the perceived mechanism of action of the pill, side-effects, non-contraceptive benefits, and general knowledge of contraception. Findings revealed complex connections between traditional and scientific information. The use of medical terms (e.g. ‘hormone’) illustrated attempts to integrate new information with existing knowledge and belief systems. Conclusions address concerns that existing information and services may not be sufficient if population-specific knowledge and beliefs are not assessed and addressed. Findings can contribute to the development of effective education, screening and reproductive health services.     

Adolescent demand for contraception and family planning services in low- and middle-income countries: A systematic review

ABSTRACT

An estimated 23 million adolescent girls age 15–19 in low- and middle-income countries (LMICs) have an unmet need for contraception. Despite the recognised importance of expanding access to appropriate methods of contraceptives for adolescents in LMICs, the evidence base on their total demand for contraception is limited, and there is no consensus on how to measure this important phenomenon. The aim of this study was to review the published literature in order to better understand the level of adolescent demand for contraception in LMICs and to explore what demand-related indicators are being measured. A total of 1375 articles were identified and 18 met the inclusion criteria. Included studies reported findings from 29 LMICs, revealing high adolescent demand for contraception. The demand for contraception among adolescents and young women ranged from 22% among married adolescents in Azerbaijan to 98% in Peru. However, measures of this phenomenon were limited, with most studies only reporting current contraceptive use or unmet need. Most studies relied on cross-sectional data, and young, unmarried, and male adolescents were largely excluded. We make several recommendations for alternative approaches for a more comprehensive understanding of adolescent demand for contraception in LMICs.     

北京市计划生育机构生殖道感染防治能力调查

目的 调查北京市县区级计划生育机构开展生殖道感染(Reproductive Tract Infection，RTI)防治能力现状，为进一步推进RTI防治工作提出建议。方法 采用调查问卷对北京市县级计划生育机构及其工作人员进行调查。调查内容包括：(1)机构设备配置情况；(2)开展的服务项目；(3)计划生育工作人员RTI相关知识、提供RTI服务的意愿等情况。结果 有86％的县区计划生育机构拥有宣教设备。86％的机构有显微镜，能够开展滴虫性阴道炎、霉菌性阴道炎的诊断和治疗，71％的县区计划生育机构能开展细菌性阴道病的诊断和治疗，对其它常见性病的诊治目前还不能开展。计划生育工作人员已具备一些生殖健康知识和技能，而且愿意参与RTI防治工作。结论 现有设备和技术力量为开展RTI防治工作提供了基础，为使此项工作持续深入，需拓宽服务内容和提高工作人员有关RTI的知识和技能。     

The willingness of spouses to seek marriage and family counseling services

Drawing upon a probability sample of 928 military couples (1,856 spouses), three clusters of variables were identified from a review of the help-seeking literature and examined for their contribution to explaining variation in the likelihood of husbands and wives seeking marriage and family counseling services given a marital or family problem: (a) demographic, (b) program-related, and (c) informal help-seeking orientation. Three of the six independent variables that were included in the analysis emerged as significant predictors of the potential use of counseling services by both husbands and wives: knowledge and prior use of services, years of formal education, and willingness to consult parents and other relatives given a major personal or family problem. Interpretations of the findings are offered for consideration, and recommendations are presented both for expanding clinical outreach efforts and for guiding further research.The data for this study were collected under USAF Contracts F33600-70-C-0423 and F33600-70-81-R-0290. Any opinions, findings, or conclusions expressed in this publication are those of the authors and do not necessarily reflect the views of the Department of the Air Force.     

The family planning “know–do” gap among married women of reproductive age in urban Pakistan

OBJECTIVE:To examine the prevalence and predictors of family planning (FP) know-do gaps among married women of reproductive age (MWRA) in low socio-economic urban areas of Karachi, Pakistan.DESIGN:This was a cross-sectional survey of randomly selected 7288 MWRA (16–49 years) to identify predictors of the know-do gap in FP using a logistic regression model.RESULTS:More than one third (35.5%) of MWRA had FP know-do gap, i.e., despite having a knowledge of contraceptives and desire to limit or delay childbearing, they were not using contraceptives. Women were less likely to use FP if they were getting older (25–35 years: OR 1.45, 95% CI 1.09–1.94; >35 years: OR 3.02, 95% CI 1.90–4.80), from certain ethnicities (Sindhi: OR 1.64, 95% CI 1.11–2.42; Saraiki: OR 1.66, 95% CI 1.01–2.71; other minorities: OR 2.37, 95% CI 1.63–3.44); did not receive FP counselling: OR 1.43, 95% CI 1.13–1.80; and had not made a joint decision on FP: OR 1.44, 95% CI 1.06–1.98). Conversely, women were more likely to use contraceptives if they had >10 years of schooling (OR 0.66, 95% CI 0.46–0.94), with each increasing number of a living child (OR 0.68, 95% CI 0.62–0.75) and each increasing number of contraceptive method known (OR 0.93, 95% CI 0.88–0.98).CONCLUSION:The predictors associated with the FP know-do gap among MWRA should be considered when planning future strategies to improve the contraceptive prevalence rate in Pakistan.     

市县级妇幼保健与计划生育服务机构资源整合研究

为推动妇幼保健机构和计划生育服务机构的资源整合,采用现场问卷调查、专题小组访谈、个人深入访谈等方法调查了7个省的5个地市级和9个区县级14所完成了妇幼保健和计划生育整合的实施机构。了解其资源整合模式、资产归属、人员安置和人员薪酬分配等内容,梳理归纳了整合中存在的技术人员未得到有效补充、人员培养和配备不能满足新形势需求、免费计划生育技术服务政策落实受到影响、妇幼保健与计划生育信息整合有待加强、科室设置还需规范等问题,提出建立健全补偿与激励机制、加强人才队伍建设、加强绩效考核和薪酬管理、加强医疗服务机构价格管理和信息化建设、做好生育全程优质服务等建议,为我国妇幼保健和计划生育服务的资源整合提供借鉴。     

北京市东城区流动人口接受计划生育/生殖健康咨询服务的情况分析

目的了解北京市东城区流动人口接受计划生育/生殖健康咨询服务的情况,以及流动人口对咨询服务的需求,为完善流动人口计划生育/生殖健康管理和服务提供参考。方法在北京市东城区流动人口集中的工厂、企业、建筑工地和服务/娱乐场所选择18~49岁的育龄流动人口进行结构式问卷调查,内容包括一般人口学特征,婚育史及婚育观念,接受计划生育/生殖健康咨询服务的情况等。采用SAS 9.1软件对收集到的资料进行统计分析。结果本研究共调查2 099名流动人口,21.39%的流动人口在调查的近1年内接受过计划生育/生殖健康咨询,学历越高的流动人口接受计划生育/生殖健康咨询服务的比例越低。有41.31%的对象表示愿意接受咨询服务,咨询途径以"报刊专栏、信箱"、"专业网站咨询"、"电话热线咨询"的比例较高,"面对面"咨询的比例为33.21%,计划生育服务站、妇幼保健院是流动人口面对面咨询的主要地点。结论流动人口在现居住地接受计划生育/生殖健康咨询服务的情况不理想。现居住地应加强对流动人口的计划生育/生殖健康咨询服务。     

Social Work Student Attitudes Toward Contraception and the HPV Vaccine

The purpose of the current study was to examine social work student attitudes toward the social work profession's perspective on certain aspects of reproductive health in the United States: contraception, emergency contraception, and the Human Papillomavirus (HPV) vaccine. Students at a large, public, land grant university were surveyed to determine whether their personal attitudes were in line with the National Association of Social Workers (NASW) stance on reproductive health outlined in the NASW policy statement on family planning and reproductive health. The relationship between levels of religious activity and attitudes toward these aspects of reproductive health was also examined. Results suggest that almost all of the respondents support public funding for family planning. Furthermore, almost all students indicate willingness to refer clients for general contraception. However, results related to emergency contraception indicate that 72% of students disagree that it should be available for adolescents over the counter, even with parental consent, which is inconsistent with the NASW perspective. Sixty-four percent of students report believing that the HPV vaccine is unsafe. Further, as levels of religious activity increased, acceptance of some of these aspects of reproductive health decreased. Implications for social work practice, education, and directions for future research are discussed.     

上海市社区计划生育综合服务站工作人员紧急避孕知晓程度调查

目的:了解上海市社区计划生育综合服务站工作人员紧急避孕意识和服务水平,探讨社区紧急避孕规范化服务。方法:2010年1月～2010年12月对上海市闵行区和徐汇区25个街道计划生育服务站的275名服务人员进行问卷调查(紧急避孕相关知识及可接受性情况),同时进行紧急避孕专业培训。结果:社区计划生育服务人员均知道有紧急避孕,但在工作中应用比例为38.5%,73.8%调查对象知道紧急避孕的具体方法,能够正确回答紧急避孕使用常见问题的比例有33.87%。社区计划生育服务人员能够区别紧急避孕与常规的避孕方法,而对紧急避孕的局限性、副作用和失败后的处理方法认识还不足。通过紧急避孕专业培训,78.65%服务人员能够正确回答紧急避孕常见问题,同时纠正了原有的一些认识误区,提高了紧急避孕的知晓度和服务意识。结论:社区人口与计划生育服务人员应定期接受紧急避孕知识及技术培训,及时更新知识,提高服务水平。     

Availability of long-acting and permanent family-planning methods leads to increase in use in conflict-affected northern Uganda: Evidence from cross-sectional baseline and endline cluster surveys

Abstract

Humanitarian assistance standards require specific attention to address the reproductive health (RH) needs of conflict-affected populations. Despite these internationally recognised standards, access to RH services is still often compromised in war. We assessed the effectiveness of our programme in northern Uganda to provide family planning (FP) services through mobile outreach and public health centre strengthening. Baseline (n=905) and endline (n=873) cross-sectional surveys using a multistage cluster sampling design were conducted in the catchment areas of four public health centres in 2007 and 2010. Current use of any modern FP method increased from 7.1% to 22.6% (adjusted odds ratio [OR] 3.34 [95% confidence interval (CI) 2.27–4.92]); current use of long-acting and permanent methods increased from 1.2% to 9.8% (adjusted OR 9.45 [95%CI 3.99–22.39]). The proportion of women with unmet need for FP decreased from 52.1% to 35.7%. This study demonstrates that when comprehensive FP services are provided among conflict-affected populations, women will choose to use them. The combination of mobile teams and health systems strengthening can make a full range of methods quickly available while supporting the health system to continue to provide those services in challenging and resource-constrained settings.