武汉市建立“避孕药具进产科”服务模式探讨

产后避孕是计划生育工作的难题之一.武汉市“避孕药具进产科”服务模式,提高了产后避孕药具发放的可及性和时效性,实现了药具服务的均等化,并提高了避孕相关知识的知晓率.但此种模式仍存在新型外用避孕药具使用率不高的问题.建议加大避孕药具知识宣传和药具管理人员的培训力度,提高避孕药具使用率.     

武汉市户籍人口与流动人口避孕知识、行为调查对比分析

目的分析比较参加武汉市"避孕药具进产科"活动的户籍人口与流动人口中育龄妇女产后避孕知识的知晓程度和避孕措施的实施情况。方法采用整群随机抽样的方法,对508名调查对象进行电话问卷调查。结果户籍人口与流动人口在年龄、文化程度、工作情况、产后性生活开始的时间、避孕知识知晓程度方面的差异均具有统计学意义。结论武汉市流动人口产后性生活开始的时间较早,避孕知识知晓程度偏低,避孕措施的采取情况相对滞后。建议应加强避孕相关知识的宣传教育,提高流动人口免费药具可获得性。     

让药具服务随人口“流动”起来

正流动人口主体是育龄人群,处于生育高峰期。笔者了解到,流动人口中避孕药具停用率高、意外妊娠率高,并非都是因为不想避孕,而多是由药具供应不稳定、避孕出现副作用等原因所致。如何加强流动人口避孕药具服务,让药具服务随人口"流动"起来,提高生殖健康水平,不妨从以下几方面着手。——多渠道宣传。首先要充分利用卫生计生基层服务阵地,广泛开展避孕药具宣传服务活动,突出宣传避孕药具发放的重要性、     

流动人口避孕药具发放模式改革效果评价

目的通过避孕药具发放模式改革，提高流动人口避孕药具的可及性和使用满意率。方法对深圳市南山区8个社区工作站年龄在20～40岁之间的已婚育龄流动人口进行基线调查，然后利用半年的时间进行避孕药具发放模式的改革，避孕药具发放采用统一药具发放专柜、统一药具发放品种、统一避孕药具免费发放点的标识、统一布点、统一工作流程（简称“五统一”）的模式进行，1年后进行终点调查。结果对避孕节育有关知识的了解，终点组的比率明显高于基线组，在避孕药具发放可及性及满意度方面，2组避孕失败率、目前措施满意率、绝育率比较，差异无统计学意义（P〉0．05），但计划生育率、男性参与率、IUD使用率、药具使用方便率、对计生工作的满意率终点组明显高于基线组，差异有统计学意义（P〈0．05）。结论避孕药具发放“五统一”模式改革，可以提高流动人口避孕药具的可及性，使用率和满意率。     

以人为本提高育龄群众领取避孕药具的积极性和易得性

我国避孕药具实行计划免费发放政策,凡自愿要求使用药具避孕的本市常住人口和属地管理的外来人口的育龄夫妇,都可到居住地所属的居委会领取所需的免费避孕药具。目前避孕药具的发放渠道有两个:一是药具发放员定期将药具送上门;二是群众根据个人需要,可到就近的避孕药具免费发放     

避孕药具失败原因调查分析

随着计划生育工作水平的不断提高,知情选择的深入开展,越来越多的育龄群众选择了避孕药具避孕。药具使用人数增多,避孕失败人数也相应增加。为了提高避孕药具的使用有效率,本站对2004年本地区257例使用药具(不含IUD,以下同)避孕失败原因进行了调查分析,现报告如下。一、对象与方法1.对象为2004年本地区使用避孕药具失败人员,年龄23～45岁。2.方法对乡镇药管员统一培训后深入到使用药具避孕失败者家中与其进行面对面交谈,流动在外人员通过电话咨询。调查内容有:一般个人情况,使用避孕措施,避孕失败的具体原因,避孕药具发放及随访情况,失败…     

北京市育龄人群免费避孕药具使用现状及需求的定性调查

目的:了解北京市育龄群众对免费避孕药具发放和使用的评价及需求。方法:对北京市8个区县65名育龄群众进行小组访谈,对14名计划生育人员进行个人深入访谈。结果:访谈对象主要是户籍地常住育龄妇女,初、高中文化者居多,现多在使用避孕套;药具质量可靠和方便获取是访谈对象利用免费避孕药具发放网络的主要原因;对避孕套、口服避孕药、杀精剂有不同看法;虽然获取信息的途径多样,但访谈对象不能全面准确地掌握药具知识;对自助设备、避孕药具及生殖健康知识等有需求。结论:北京市免费避孕药具发放工作具有成效,但存在药具品种单一,知识宣传不够等问题。为推进工作,建议增加免费避孕药具品种,加强使用指导和宣教咨询,促进计划生育人员培养和队伍建设。     

江苏省流动人口药具知识掌握及使用代际差异研究

目的:了解江苏省新老两代流动人口避孕知识掌握及避孕药具使用差异。方法:2011年江苏省计划生育药具管理站开展抽样调查,抽取有效样本7758份,其中新生代流动人口3584人。结果:新老两代流动人口对避孕药具知识的掌握不存在显著差异。新生代和老一代流动人口中分别有12.93%和11.43%不知道紧急避孕药的使用方法,从计划生育部门获得避孕知识的比例分别为87.94%和86.12%,意外妊娠的比例分别为10.66%和12.58%。结论:两代流动人口在避孕药具获取途径和使用偏好上存在差异,在免费避孕药具发放时需考虑到不同流动人口群体的需求和偏好,有针对性地宣传避孕药具知识及提供多样化产品服务,改善服务效果。     

北京市西城区新街口社区妇女健康促进项目——计划生育服务现状及生殖保健服务需求调查

1999年北京市西城区妇幼保健所以新街口社区为试点 ,开展社区妇女健康促进项目 ,对 1998年分娩的妇女进行计划生育现状及服务需求的调查 ,以了解社区生育高峰期妇女婚后及产后避孕节育措施、知情选择知识、计划生育综合服务需求情况 ,探索社区计划生育优质服务的基本规律。结果 ,婚后有生育规划的占 88.6 % ,主要避孕措施是外用工具占 6 7.7% ,避孕知识来源主要是书本占 6 1.7% ,药具主要来源是商店占 42 .4% ,婚后育前人工流产率 5 1.2 % ,保健服务需求主要为能提供方便得到避孕药具的服务 ,发放避孕节育宣传手册 ,介绍方便长效的避孕方法 ,避孕失败的补救措施 ,避孕与健康和优生优育等知识     

浙江省杭州市计划生育药具服务需求的现状研究

目的:了解杭州市育龄群众计划生育药具服务需求现状,为完善相关政策提供科学依据。方法:由经统一培训的调查人员,使用自制的计划生育药具服务需求调查问卷,对杭州市的1610名育龄群众开展问卷调查。结果:74.6%受访者知晓国家计划生育药具领取政策;76.0%受访者知道可以到社区领取免费避孕药具;避孕套、口服避孕药、宫内节育器、皮下埋植知晓率分别为93.2%、93.2%、53.2%、17.2%。67.7%受访者遇到避孕节育困惑选择去医院;53.9%是在专业人员推荐下选择目前避孕方法;60.6%受访者目前使用免费避孕药具;免费避孕药具咨询服务满意度为59.4%。34.5%受访者希望得到个性化咨询服务;≤25岁对象对性知识教育、避孕方法和避孕药具知识介绍需求最多;文化程度在初中及以下者对各项需求最大;65.6%的受访者希望开通"避孕药具公共服务"微信公众号。结论:新时期应加强避孕知识的宣传,提高计划生育公共服务知晓率;提升药具服务人员的服务能力,保障避孕节育措施落实;推进互联网药具服务,满足群众对计划生育公共服务需求。     

Results of testing the basic questionnaire "SINDI" in the evaluation of prophylaxis program development

The results are considered of testing questionnaires designed to evaluate the progress in the implementation of the complex prevention programme "CINDI". The questionnaire survey was carried out in two ways--by post and by telephone. The sample size amounted to 248 people each. The response in the questionnaire survey by post accounted for a little more than 50 percent, by telephone--about 56 percent. The survey methods were acceptable for population: there were almost no omissions, no refusals to give answers by telephone (low response rate is attributable to the absence of the interviewed). The questionnaire survey indicates that the amount of information acquired on health is not great. The main source of information is TV and other mass communication media. The most effective means of influencing the behaviour are individual recommendations of physicians but they are given very rarely (in 10-20 percent of cases). Persons aware of their risk factors are the ones who most actively perceive the information on the problem of health. The major part of the interviewed (20-50%) attempted to change their habits. The most popular attempts were made to change physical activity, the most successful--to change diet. Interviews by post and by telephone give similar results and might be recommended for assessing the development of prevention programmes.     

商务楼工作的未婚职员性行为及避孕措施使用情况调查

目的:了解在商务楼工作的未婚职员性行为及避孕措施使用情况。方法:对上海市黄浦区1775名商务楼职员进行了匿名自填问卷调查,本文以其中1192例未婚男女作为研究对象。结果:未婚男女性行为发生率分别为24%和12%,54%近1年性行为时每次都使用了避孕措施,其中避孕套的使用率为80%。多因素分析显示年龄较大、外地户籍、有饮酒习惯、生存质量自评分数较低和有正在交往的恋人的未婚者容易发生性行为。结论:商务楼未婚人群发生性行为者较多,避孕措施使用情况不如人意。人口计生工作者应针对商务楼未婚职员的特点及需要进行避孕节育的宣传,提高咨询服务的有效性。     

北京市人工流产青少年避孕知识、态度及行为现况研究

目的:了解北京市流产青少年的避孕知识、态度、行为及避孕知识、态度与行为间的关系。方法;于2005年7～9月,在北京市10家医院以封闭式问卷对寻求流产的25岁以下青少年进行横断面调查。结果:1008名调查对象中,85.3%和61.4%不知道口服避孕药和紧急避孕药正确服用方法;27.7%不知道避孕套的正确使用时间。29.8%的调查对象本次妊娠前3个月内未使用过任何避孕方法,60.2%是由于未采用任何避孕方法而造成本次妊娠。既往使用过避孕措施的708名调查对象中,576人次使用过避孕套,占81.4%;有306人次使用过紧急避孕方法,占43.2%。安全期和体外排精分别占40.3%和41.0%,口服避孕药占13.4%,0.7%使用过宫内节育器。以避孕套为唯一避孕方法的154人中,能坚持每次都用的占22.9%;分析发现,知识态度水平高,避孕措施的使用率高。结论;调查对象的避孕知识不全面,对避孕方法存有不正确态度,避孕方法使用率及坚持使用率不高,其避孕知识水平影响避孕措施的使用。     

Phone respondents reported less mental health problems whereas mail interviewee gave higher physical health ratings

OBJECTIVE: This study examines the effects of telephone and mail interview methods on the measurement of health-related quality of life. STUDY DESIGN AND SETTING: One thousand six hundred ninety individuals aged 25-66 were interviewed randomly either by telephone or by mail. Health-related quality of life was assessed with the German SF-8. RESULTS: Although respondents in the telephone survey were more willing to participate (77.4% vs. 47.5%) the difference in the accessibility of publicly available address and telephone records meant that overall more people were interviewed by mail than by telephone (53.2% vs. 46.8%). No differences occurred in terms of the sociodemographic makeup. Telephone respondents gave a more positive account of the mental dimension of their health-related quality of life; whereas mail interviews led to a better rating of the respondents' physical well-being. Gender-specific analyses indicate a slight discrepancy in the influence of the method of interviewing on men and women. Further differences were identified concerning the variance in the existence of ceiling and floor effects and the correlation between items. CONCLUSION: Found differences are small but at least to be valued as relevant in certain settings. Therefore, we approve the use and development of factors of amendment.     

Emergency contraception and prevention of induced abortion in India

OBJECTIVE: Induced abortion is associated with high morbidity and mortality in India. Use of regular contraception with emergency contraception (EC) as backup can reduce the incidence of induced abortion. The study aimed to assess women's knowledge, practice, preference and acceptance of different contraceptive methods with special reference to the causes of induced abortion, and their willingness to use hormonal EC. METHODS: The study comprised a structured questionnaire survey conducted in the family planning clinic of a tertiary teaching hospital in New Delhi, India. A total of 623 women and three men seeking contraceptive advice and/or termination of pregnancy were interviewed. The main outcome measures were knowledge of different contraceptive methods including EC and the reasons for unintended pregnancy. RESULTS: More than 99% of the respondents knew about most of the modern methods of contraception whereas only 37 (5.9%; 95% CI 4.0-7.8) of the respondents knew about EC and none of them had ever used it. Contraceptive method failure led to unintended pregnancy in 39.1% (95% CI 33.7-44.5) of abortion seekers. Correct use of EC could have prevented nearly 65.5% (95% CI 57.0-74.0) of induced abortions due to contraceptive method failure and 25.6% (95% CI 20.7-30.5) of all induced abortions. CONCLUSIONS: More efforts are required to generate awareness about the safety, efficacy and availability of EC, regular use of effective contraception and the health hazards of induced abortion.     

Prevalence and determinants of the use of modern contraceptive methods in Kinshasa, Democratic Republic of Congo

INTRODUCTION: In 2003, a cross-sectional study was carried out in Kinshasa to determine the prevalence and to identify the correlates of the use of modern contraceptive methods among sexually active females. METHODS: Five hundred females of childbearing age (15-49 years) who were selected through a stratified sampling procedure were interviewed with a standardized questionnaire. The interview collected sociodemographic data, knowledge, perception and current use of modern contraceptive methods. RESULTS: Condoms appear to be the most widely known modern contraceptive method since it was cited by 43% of women; the pill was cited by only 28%, injectables were cited by 16.2%, IUD was cited by 8%, spermicidal foam was cited by 2% and the diaphragm was cited by <2%. Teenagers and young adults (15-24 years) were less knowledgeable of modern methods, while a noticeable proportion reported unwanted pregnancies. The prevalence of the utilization of modern contraceptive methods (barrier and hormonal methods) was estimated at 7%, with the male condom being the most commonly used method (reported by 74.3% of those using a modern method). Hormonal methods were used less often (the pill, 0.2%; others, <1% each). The current use of a modern contraceptive method correlated with having discussed contraception with someone [odds ratio (OR)=3.18; 95% confidence interval (95% CI)=1.52-6.64] and having ever used a modern contraceptive method (OR=11.57; 95% CI=2.71-49.48). CONCLUSION: An increase in the level of knowledge on modern contraceptive methods through mass and interpersonal communications could be one of the key strategies to increase the utilization rate of modern contraceptive methods in the Democratic Republic of Congo. Teenagers should be considered a priority group since there is evidence of unmet needs among them.     

闵行区新婚女性对避孕方法的知晓和使用情况调查

目的:了解闵行区新婚女性对避孕方法的知晓及使用情况,为进一步实施干预和提高育龄妇女的生殖健康水平提供依据。方法:采用面对面的方式对450名登记结婚的新婚女性进行避孕知识问卷调查。结果:调查对象对避孕套、口服避孕药的知晓率较高,达到95%以上,避孕率为83.33%;使用率最高的避孕方法是避孕套,满意率最高的是口服避孕药;避孕知识主要来源于报刊、杂志、书籍。结论:生殖健康服务要真正实现避孕知情选择,必须开展各种形式的健康教育,让人们全面、正确地掌握避孕知识和信息,提高其避孕知识水平和避孕意识。     

云南省贫困农村妇女对基本生育健康服务的利用

本文对云南省2个县3个乡的1766名已婚育龄妇女的基本生育健康服务利用状况进行了调查分析。结果表明,农村妇女对基本生育健康服务的利用普遍不足,贫困妇女对服务的利用更低。妇女对各项基本生育健康服务的利用也不平衡,表现为对孕产期保健服务、妇科病防治服务和计划生育术后追踪服务的利用不足,对计划生育手术服务的利用相对较多。     

Comparison of telephone vs face-to-face interviews in the assessment of dietary intake by the 24 h recall EPIC SOFT program--the Norwegian calibration study

OBJECTIVE: To compare food group intakes in grams, total energy and energy contribution from macronutrients between two random samples of women, using a standardized computer program (EPIC SOFT) with either a face-to-face or a telephone 24 h recall interview design. METHODS: Two groups of Norwegian women living in Troms? were drawn at random from the Norwegian Women and Cancer Study (NOWAC) cohort. The EPIC SOFT computer program was used to conduct single 24 h dietary recalls either by telephone or face to face. For the latter, 160 women were invited, of whom 111 responded positively (crude response rate=69.4%) and 102 were interviewed. For the telephone option, 180 were invited to participate, 109 responded positively (crude response rate=60.6%) and 103 were interviewed. RESULTS: The two groups of women were similar with respect to age, body mass index, basal metabolic rate, smoking, education, physical activity and special diet status. No statistically significant difference in dietary intake was found between interviews conducted by telephone and face-to-face, except for 'egg and egg products' (P<0.01), for which intake was higher in the telephone group. Total energy intake differed, but the difference was attributable to one interviewer. The distribution of energy-contributing nutrients was not significantly different between groups, except for reported energy percentage from protein (P=0.02), which was significantly higher in the face-to-face group. CONCLUSION: The telephone vs face-to-face interview design did not influence recalled diet when using the EPIC SOFT program.