农村已婚人群避孕节育知情选择认知和需求调查

目的:了解农村已婚人群对避孕节育知情选择的认知与需求。方法:采用定性研究专题小组访谈的方法,选择甘肃省临泽县、永靖县的已婚育龄妇女,已婚男子,计划生育干部和技术服务人员等四类人群作为调查对象,每类人群组织2个小组,由项目专家主持,分组进行访谈。结果:甘肃省已婚男女对避孕节育知情选择的知识了解不多,避孕方法知道3～5种,但对各种避孕方法的原理、使用、优缺点及禁忌证知之甚少;在选择避孕方法方面仍显被动;男性对避孕方法知情选择的主动参与意识较差;多数人认为由计划生育服务人员和自管小组长提供避孕方法知情选择咨询最好,服务所的设备需加强,服务人员的技术水平需提高。结论:应加强对已婚男女避孕节育知情选择知识的宣传教育,提高计划生育服务机构的服务能力。     

上海市产后妇女避孕方法选择的定性研究

目的:了解上海市产后妇女避孕措施的选择及其影响因素,并了解妇幼保健和计划生育机构对产后避孕服务提供情况。方法:采用个人访谈和小组讨论的研究方法,对上海市分娩1年内的产妇以及参与产后家庭访视的妇幼保健和计划生育工作人员进行访谈。结果:妇女产后早期倾向选择对身体康复和哺乳没有影响的避孕套和安全期避孕,一段时期之后倾向选择避孕效率更高的方法。选择避孕方法的种类受妇产科医生的建议和亲戚朋友避孕经验的影响较大。产妇避孕知识整体水平不高,普遍不了解哺乳避孕法以及口服避孕药、皮下埋植剂等避孕方法。由于产后访视员避孕知识的不足使得产后访视几乎未开展有效的避孕指导。结论:采取多种措施,提高产妇避孕知识,扩大产后避孕方法的选择,改善产后访视的避孕指导。     

四川省农村育龄妇女避孕方法知情选择干预项目研究报告

目的:评价开展避孕节育知情选择活动对四川省农村育龄妇女的避孕节育知识和知情选择的知识、能力、态度和避孕行为等影响。方法:在四川省兴文县的2个乡开展持续1·5年的、以社区为基础、20~49岁的已婚育龄妇女为对象的干预性研究,干预活动包括组织社区宣传活动、发放宣传资料、播放录像带、组织讲座、面对面的宣传和开展同伴教育,分析干预效果。结果:干预组育龄妇女对避孕方法的使用、原理、优点、缺点得分明显高于对照组,且在干预后避孕方法使用率及使用避孕套的比例均高于干预前;避孕方法使用的最终决定者由干预前计划生育服务人员转变为干预后为本人。结论:集知识、信息、咨询与服务为一体的社区避孕节育知情选择干预项目的实施,可显著提高农村育龄妇女的避孕节育知识水平和她们选择避孕方法的能力。     

西安高校教工产后非意愿妊娠及相关因素调查

目的：调查西安高校教职工初产妇产后非意愿妊娠率和结局,以及避孕知识、需求及方法选择情况,为制定干预措施提供依据。方法采用自行设计的问卷,选择西安市4所非医学类本科高校教职工中2014年11月至2015年10月分娩的初产妇,于产后42天进行问卷调查其避孕知识与态度,于产后1年电话随访其避孕方法和非意愿妊娠情况,并进行分析。结果该时间段内分娩的初产妇共计277例,有效随访率为95．7％;调查对象对宫内节育器和安全套避孕法知晓率接近100％,但安全套正确用法知晓率仅为39．6％,其它避孕方法知晓率不足80％;对口服避孕药避孕法和口服药物紧急避孕混淆率高达77．7％;对自然分娩和剖宫产后放置宫内节育器的时间及哺乳期避孕法了解不足10％;绝大多数被调查者表示需要医务人员指导产后避孕知识;被调查者产后1年内意外妊娠率为9．4％。结论西安高校教职工初产妇产后避孕知识及方法认知水平较低且不全面,产后1年内意外妊娠发生率高达9．4％。多数初产妇对医务人员指导产后避孕知识需求迫切。医院、社区妇保及计划生育部门应加大健康教育指导水平和力度。     

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。     

武汉市黄陂地区农村已婚育龄妇女人工流产原因分析

目的:了解黄陂地区已婚育龄妇女流产原因。方法:采用结构式问卷对2006年8月～2007年10月到黄陂区、乡两级计划生育服务站做终止妊娠手术的农村已婚育龄妇女进行问卷调查。结果:被调查者受教育水平以初中为主72.95%,有近50%的妇女认为流产引产对身体没有什么影响(23.41%)或者说不清(21.89%)。流产次数最高可达9次(2人),未采取避孕措施而流产的有1302人次,占46.60%。避孕失败的原因中有30.14%是因使用宫内节育器失败,有25.16%是使用避孕套失败。流产原因中因未计划妊娠有1997人次,占71.81%,政策不允许669人次,占24.06%。结论:应提高妇女的科学文化素质,加强避孕知识的普及和宣传,提高农村妇女的避孕使用率,提高正确选择和使用避孕工具的比率,通过这些措施来降低黄陂地区已婚育龄妇女的流产率。     

The nurse in family planning

Interviews were conducted in Salvador, BA, Brazil, to verify how nurses working with clients are prepared to answer questions about family planning. 56% of those interviewed had not received any training in family planning. 90% desired to increase their knowledge about contraceptive methods. The group that desires to learn more about contraceptive methods is younger and has less experience than the group that does not desire such information (pvalue .05). 74% of nurses reported inquiries about contraceptive methods by clients and 80% reported to give such information. 80% practiced any kind of contraception, with a significant difference between usage and marital status, but not with usage and religion. Some suggestions are presented to increase the nurse's ability to answer the necessary client inquiries about family planning.     

农村育龄妇女生殖与避孕状况调查分析

目的了解湖北省农村育龄妇女生殖与避孕知识以及生殖与避孕服务现状,为计划生育决策和服务提供依据。方法采用随机整群抽样方法,对湖北省安陆和荆州2市8个乡镇的338名育龄妇女进行问卷调查。结果农村育龄妇女生殖与避孕知识欠缺,仅42.2%的对象接受过避孕教育;避孕节育知情选择面低,避孕方法的选择上被动,63.6%的妇女有过人流史。结论农村育龄妇女生殖与避孕状况不容乐观,农村生殖健康工作仍面临巨大挑战。     

Revisiting community-based distribution programs: are they still needed?

Community-based distribution (CBD) programs are the optimum way of reaching people in rural areas of developing countries where conventional methods of delivery do not exist or fail. This paper reviews findings and experiences from over 30 years of efforts to implement CBD of family planning methods around the world. Although research suggests that community-based service delivery can contribute to contraceptive use, the magnitude of impact is often in doubt or its existence is questionable when compared to alternative family planning delivery services.

After the review of more than 30 years of CBD work, we found that these programs are still needed to meet the needs for contraception in rural communities and isolated city neighborhoods in developing countries. Integration with other health outreach programs, effective management, keeping training of agents brief and letting them distribute contraceptives and keeping all or part of the profits instead of paying them salaries are some of the strategies that can make CBD programs more efficient.     

Revisiting community-based distribution programs: are they still needed?

Community-based distribution (CBD) programs are the optimum way of reaching people in rural areas of developing countries where conventional methods of delivery do not exist or fail. This paper reviews findings and experiences from over 30 years of efforts to implement CBD of family planning methods around the world. Although research suggests that community-based service delivery can contribute to contraceptive use, the magnitude of impact is often in doubt or its existence is questionable when compared to alternative family planning delivery services.After the review of more than 30 years of CBD work, we found that these programs are still needed to meet the needs for contraception in rural communities and isolated city neighborhoods in developing countries. Integration with other health outreach programs, effective management, keeping training of agents brief and letting them distribute contraceptives and keeping all or part of the profits instead of paying them salaries are some of the strategies that can make CBD programs more efficient.     

浙江省台州市流动人口避孕知识、态度和行为调查

目的：了解台州市流动人口避孕知识、态度和行为,为提高流动人口生殖健康水平提供决策依据。方法：采取多阶随机抽样的方法,对台州市5个县、市、区共计1372名流动育龄人群的人口学特征、避孕方法知情选择及使用情况、避孕知识获取途径和避孕知识了解、态度及行为等进行调查。结果：调查对象平均年龄31.2岁,其中女性占54.7％,男性占45.3％;平均月收入1200元人民币;文化程度以小学、初中为主,占78.7％;职业以技术工、服务业为主;采取避孕节育措施的以女性为主,宫内节育器占所有避孕措施的40.76％,其次为避孕套（21.59％）;获得避孕节育知识的途径以广播电视媒体和报纸杂志为主（84.9％）;相关知识回答正确率〈80％;男性KAP值高于女性,文化程度是影响KAP得分的主要因素;对计划生育服务机构提供的服务内容的满意度为57.4％。结论：流动人121避孕方法知晓率较低,对避孕、节育知识及生殖健康服务需求强烈。应该加强普及计划生育／生殖健康知识,探索新的长效服务机制,以满足流动人口育龄人群避孕节育／生殖健康的需求。     

Factors associated with family planing acceptance in Bangkok metropolis health clinic areas (MHCs)

To study contraceptive use in Bangkok, 6,809 eligible women were interviewed in a community survey of 5 Metropolis areas. 34.7% were current users of interval contraception and the pill was the most common method. 29.9% were not currently in need of family planning. 18.3% of women were not using contraception, but only 6.2% were in need of family planning (FP) and not currently practising contraception. Non-acceptors who were in need of FP, had a lower educational level; 13.4% did not know about contraception but 52.4% previously used contraception. The most common reason for not currently practising FP was fears about contraceptive safety (37.5%). The prevalence of pregnancy in the community was 10.4%.The fact that only 6.2% of women were not practising FP and were in need of contraception suggests that the services in Bangkok are adequate to meet the needs of most women. However, the subgroup of non-acceptors in need of FP who were from a low socio-economic group require special motivation and services. 1,835 women attending Metropolis Health Centres in the same areas were interviewed to determine their choice of contraception; 57.4% chose the pill.     

从计划生育工作者角度看四川省男性绝育应用下降

目的：探索影响四川省男性绝育应用下降的因素。方法：小组访谈会。结果：共66人参加了访谈会（计划生育干部30人、避孕药具发放者36人）。计划生育工作者对男性绝育的认识、对避孕方法宣传的偏好和引导对育龄人群的避孕选择具有较大影响。结论：持续的宣传和倡导可提高公众包括计划生育工作者对男性绝育的认识,克服误区,鼓励更积极的态度。全面、客观、不带个人偏见地向育龄群众介绍避孕节育措施,对于促进绝育方法的安全、正确和持续使用具有重要意义。     

武汉未婚重复人流女性避孕节育知识、态度、行为现状调查

目的 了解武汉未婚重复人流女性对避孕节育的知识、态度、行为(KAP)及生殖健康状况,为降低重复人工流产率提供科学依据及思路。方法 设计KAP问卷调查表进行队列研究,然后在队列数据库中,随机抽取来自武汉13个辖区的共1127名未婚重复人流女性的调查问卷进行分析。结果 未婚女性重复人流的高发年龄段在20-30岁之间,占77.37%;重复人流者对避孕知识的掌握情况较差,答题正确率仅35.89%;在避孕态度方面,表示愿意采取避孕措施的占83.85%;但有53.24%的人对人流的危害认知不足;采用低效避孕措施如体外排精、安全期避孕、紧急避孕药的占50.67%;通过学校、医院、社会宣教等相对正规渠道获取避孕知识的比例不高。结论 社会应关注未婚人群的生殖健康需求,扩大避孕知识的普及率,提高未婚重复人流女性避孕措施使用率。     

Induced abortion: a method for birth control?

Despite the recent improvements in services and an increase in available funds, the expected increase in usage of effective contraceptive methods and decrease in number of induced abortions has not been seen in Turkey. This study investigates the causes of this situation and argues whether induced abortion is being used as a birth control method. Eight-five subjects were involved in the study, all of whom came to a family planning clinic for an induced abortion. Forty-seven (55.29%) of the participants had had at least one induced abortion prior to this. Eight-four (98.8%) had knowledge of at least one contraceptive method, and 80 (94.1%) had knowledge of at least one effective contraceptive method. Eighty (94.1%) participants had used some form of contraception at some time in their lives; 52 (61.17%) had used an effective contraceptive method at some time in their lives. When they became pregnant, 60 (70.6%) were using ineffective methods or were not using any contraceptive method. Both the participant and the spouse wanted the abortion in 68 (80%) cases.     

乡级计划生育服务人员计划生育政策及相关知识调查研究

目的了解乡级计划生育服务人员对计划生育政策的认知、态度及避孕知识知晓情况。方法采用封闭式问卷调查形式对119名乡级计划生育服务人员(简称乡级服务人员)进行研究。结果绝大多数乡级服务人员对现行计划生育"一孩政策"的可接受性较高,对国家实行避孕节育知情选择政策持赞同态度;并认为推行知情选择政策可提高群众参与计划生育的积极性,有利于促进妇女健康。调查显示,乡级服务机构中,初级职称人员和无职称人员所占比例较高,分别占63.87%和22.69%;乡级服务人员对计划生育避孕节育相关知识的掌握率普遍偏低,不同地区服务人员知识水平不同(P0.01)。结论甘肃省乡级服务人员素质偏低,对开展日常工作所需的避孕相关知识掌握不足。     

流动人口紧急避孕知识状况分析

对1998年1～12月在上海市闵行区开展的“以现居住地为主”计划生育综合干预项目中4679名外来育龄妇女的紧急避孕知识状况进行分析,以了解她们的紧急避孕知识状况及影响因素,评价计划生育宣传教育干预对提高本市外来育龄妇女紧急避孕知识水平的效果。结果显示:外来育龄妇女紧急避孕知识贫乏,干预前仅3.9％的妇女听说过紧急避孕,其中仅有28.8％能正确回答在何种情况下及如何使用紧急避孕措施。干预后实验组紧急避孕知晓率由干预前的4.4％。增至干预后的39.4％,而对照组紧急避孕知晓率从3.4％仅提高到7.0％。干预后有68.5％的对象认为应该推广紧急避孕。此外,采用过紧急避孕措施的29人中16人均为干预后的实验组研究对象。多因素分析显示,户籍地、受教育年限、避孕知识来源及常用避孕方法知识得分,计划生育宣传教育为紧急避孕知晓率的影响因素。因此,必须大力开展计划生育宣传教育,提供与计划生育、生殖健康相关的信息与服务。通过电视、广播、宣传材料、专题讲座等各种途径向流动人口宣传紧急避孕的相关知识,以使她们在发生无保护性行为或避孕失败时采取补救措施,降低人工流产率,提高其生殖健康水平。     

基层计生干部对计划生育优质服务和避孕方法知情选择认知水平调查及影响因素分析

目的:了解基层计生干部对计划生育优质服务和避孕方法知情选择的认知水平,同时分析其影响因素。方法:调查76名基层计生干部对计划生育优质服务、避孕方法知情选择的认知情况及对实行避孕方法知情选择的态度和建议。结果:基层计生干部对计划生育优质服务“六要素”的认知及格率为75·4%,但无1人能全部正确回答,其中年龄、职业级别和文化程度影响及格率;对于避孕方法知情选择57·89%的基层计生干部是通过上级领导会议传达了解,影响因素为职业级别、有无专业技术职称。结论:当前政府相关部门应重视对基层计生干部的培训,提高其业务素质,保证计划生育工作的顺利健康开展。     

The effect of consolidation of abortion services on patient outcomes

BACKGROUND: In 2001, a service dedicated to family planning was created within a large public hospital to improve patient care services. This retrospective chart review demonstrates the benefit of focusing these services in a specialty clinic. STUDY DESIGN: A power analysis was performed and determined that a minimum of 136 charts were needed in each arm of the study to determine if, following an elective abortion, there was a significant increase in attendance at the scheduled postoperative visit. Secondary variables included analysis of contraceptive choice, incidence of continuation of injectable contraception and incidence of repeat pregnancy. RESULTS: After counseling services were initiated, there was a 27% increase in the number of patients returning for the postoperative clinic appointment within 8 weeks [32% (61/191) in 1998 vs. 59% (80/136) in 2001; p<.0001]. There was also a significant decrease in patients without a plan for contraception, 29% in 1998 vs. 11% in 2001, and a decrease in repeat pregnancies from 9% in 1998 to 1.5% in 2001. There was no difference in patient adherence with injectable contraception. CONCLUSION: Consolidation of abortion services improves subsequent use of contraception and reduces incidence of repeat pregnancy.     

医院流产后计划生育服务干预效果分析

目的:分析和评价对年轻人工流产妇女开展两种不同流产后计划生育服务干预的效果。方法:采用流行病学社区干预试验研究方法,随访调查在基线调查6个月后进行。结果:干预前组、基本干预组、全面干预组流产妇女调查人数分别为992、672、705,随访人数分别为590、476、519;干预前组、基本干预组、全面干预组流产妇女年龄分别为21.8±1.77、21.75±1.86、21.9±1.77岁;避孕知识得分分别为7.11±2.73、6.77±3.04、8.27±2.40分(F=58.96,P<0.001);流产后第一次性生活避孕措施使用率分别为76.3%、94.6%、90.1%(x2=76.08,P<0.01);流产后半年内有效避孕措施使用率分别为94.0%、83.2%、99.1%(x2=79.32,P<0.05);流产后性生活每次都使用避孕套的分别为22.7%、28.7%、36.1%(x2=73.37,P<0.01);流产后性生活正确使用避孕套的分别为20.3%、26.6%、53.2%(x2=331.35,P<0.01);流产后再次妊娠率分别为9.96%、10.3%、6.4%(x2=5.18,P<0.01);流产后非意愿妊娠率分别为18.8%、15.91%、0(x2=8.67,P<0.05)。结论:干预对改变流产后妇女避孕知识、态度和行为等方面都有一定的效果,全面干预效果更优。应在医院全面开展流产后计划生育服务。