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Biomedical subjects

E Ollila

Publications and source records attributed to E Ollila.

9 recordsLinked to original sources
PubMed2000

International actors and population policies in India, with special reference to contraceptive policies.

The international population policy agenda has traditionally been dominated by demographically driven population control policies. However, in the population policy development that preceded the International Conference on Population and Development in 1994, people's reproductive needs and rights received more emphasis. The aim of this study was to analyze how the new emphasis in population policies has been interpreted at the country level. In analyzing population policy rhetoric and its practical interpretations in India in 1994, the authors found that the rhetoric was broadening to encompass women's empowerment and reproductive health and that the use of direct method-specific monetary incentives and disincentives for accepting family planning methods was disapproved. However, population policy options were still considered mainly in terms of their ability to reduce fertility. Furthermore, the increased emphasis on the general market agenda was more important than that on reproductive needs and rights in molding population policies, as was evident in the greater stress on cost-recovery systems and nongovernmental actors. The findings suggest that the broader agenda for population policies and reproductive rights has been interpreted so that it can serve the aims of population-growth control and be implemented in the context of more market-oriented social policies and trade liberalization.

Contraception↗
PubMed1997

Experience of Finnish women with Norplant insertions and removals.

OBJECTIVE: Norplant and Norplant-2 have been available for use by Finnish women since 1984 and 1986, respectively. The objective of this study was to explore Norplant users' experiences of insertions, removals and medical treatments. DESIGN: A questionnaire was sent to women who had received Norplant or Norplant-2 implants one to two years earlier (n = 262) in normal clinical settings; the response rate was 79%. RESULTS: At insertion, problems were experienced by 9% and at least some pain by 23% of women. During the first year 20% of all users (14% of Norplant and 33% of Norplant-2 users) had their implants removed. Problems were experienced at removal by 33% of women and pain was experienced by 40%; nevertheless most users were satisfied with the device. Findings were similar for the two types of Norplant. Forty-two percent of the women had received minipills containing levonorgestrel before Norplant insertions in an attempt to assess Norplant's suitability, and 8% had received drugs for adverse effects caused by Norplant. CONCLUSIONS: Studies including perspectives of Norplant users and the whole lifespan of Norplant (including removal) should be conducted in all clinical settings where Norplant is provided.

Contraceptive Agents, Female↗
PubMed1997

Does licensing of drugs in industrialized countries guarantee drug quality and safety for Third World countries? The case of norplant licensing in Finland.

Norplant implantable contraceptives were developed mainly for use in Third World countries, but first were approved for marketing in Finland in 1983 and in Sweden in 1985. Since then Norplant has been approved in more than 40 countries, most of them in the Third World. The authors analyzed the clinical documentation submitted to the Finnish and Swedish drug control authorities, and the assessments made of the data. The Finnish review process lasted for three years, and the number of data increased substantially during that time. The authors have not been allowed to publish the clinical data submitted in Finland, but a reconstruction from the Swedish data showed that the clinical data were of poor quality and were mainly focused on assessing efficacy. Side effects, acceptability, and requirements of the health care system for proper use of Norplant were poorly studied. This example of Norplant licensing in Finland shows that licensing of drugs in industrialized countries is insufficient for guaranteeing their safety in Third World countries.

Contraceptive Agents, Female↗
PubMed1995

Physicians' experience with Norplant implantable contraceptives in Finland.

Norplant contraceptives are manufactured in Finland, but the majority of Norplant users live in the Third World. The objective of this study was to study Finnish family planning physicians experience with and attitudes towards Norplant contraceptives. Three data sources were used: (1) review of articles published in non-commercial Finnish medical journals between 1980 and 1990, (2) a sample of eleven physicians known to have experience with Norplant and chosen by a snow-ball method, and (3) a random sample of 22 physicians in charge of public family planning services stratified by municipality and degree of urbanization. The articles reflected a positive attitude towards Norplant, but the authors did not believe that Norplant should replace any previous method of contraception. In the random sample the amount of experience with Norplant was low. In both groups the general attitude towards Norplant was reserved. It was not used as a method of first choice, but was considered a good method for carefully selected women. Norplant was considered troublesome for the physician, requiring surgical procedures, producing side-effects and demanding time for counselling. Adequate use of Norplant calls for a good health care infrastructure, hygienic facilities and trained personnel. These are often lacking in Third World settings.

Attitude of Health Personnel↗
PubMed1995

Perceptions and satisfaction among Norplant users in Finland.

OBJECTIVE: This study was designed to assess users' perceptions of and satisfaction with the Norplant contraceptive implant. METHODS: A questionnaire was mailed to all women having had Norplant inserted one or two years before the study initiation in seven public out-patient family-planning clinics in the capital area of Finland, of whom 82% responded (n = 207). RESULTS: Practically all women (97%) had experienced some side-effects and 72% considered at least one of them to be disruptive. Of these side-effects, bleeding irregularities proved most often bothersome during the first 6 months of use, but depression and nervousness were relatively more important reasons for early removal. Regardless of the ubiquity of side-effects, 78% were satisfied with Norplant. High satisfaction was common especially among older users with their second set of capsules. Dissatisfaction with the method was best explained by the experience of unexpected and disruptive side-effects. CONCLUSIONS: Our results suggest that mental problems related to Norplant use have received too little attention and that satisfaction is highest in carefully selected users among older women.

Adult↗
PubMed1994

Impact of induced abortions and statistical definitions on perinatal mortality figures.

Two problems originating from the advanced use of medical technology in screening for malformations and in the care of preterm and low birthweight infants are presented: the impact of the increasing number of induced medical abortions and the differences in statistical definitions on perinatal mortality (PNM) figures. Data on 186,562 births registered in the Finnish Medical Birth Registry between 1987 and 1989 were studied, and 65,554 medical abortions (of which 1647 were performed after the sixteenth week of gestation) registered in the Abortion Registry between 1985 and 1990. A 115% increase in abortions for medical reasons in the period 1985-1990 was found. It was estimated that the trend accounted for up to one-third of the decline in PNM rate during that time. The perinatal mortality rate was strongly influenced by very small infants. The application of the Finnish version of the International Classification of Diseases, Ninth Revision (ICD-9) (including all livebirths and using both birthweight of 500 g and gestational age of 22 weeks as the criteria) resulted in PNM rates which were about 5% higher than according to ICD-9. We suggest that the impact of medical abortions on perinatal statistics has reduced the value of the perinatal mortality rate as an indicator of the standard of care.

Abortion, Induced↗
PubMed1994

Who uses Norplant. A study from Finland.

OBJECTIVE: Although Norplant implantable contraceptives were introduced first in Finland, their use has been infrequent. The objective of this study was to investigate what kind of women use Norplant in Finland, who suggested its use, and from what source women get their information on Norplant. METHODS: A questionnaire was mailed to all women having had Norplant inserted one to two years before the study initiation (June 1992) in seven family-planning clinics in the Helsinki city area (n = 262). After one reminder, the response rate was 82%. RESULTS: Most of the users were 25-34 years old, and many of them had had a previous abortion. Half of the women were still considering a (subsequent) child. All the women had used some birth control method before Norplant and reported several problems with it. Women reported that they themselves had chosen Norplant, but physicians and nursing staff in the family-planning clinic were their most important information sources. Most women considered that they had received sufficient information before insertion regarding both the good and bad aspects of the method. CONCLUSIONS: Women with previous abortions are a special users' group for Norplant, even though most users are in no way exceptional women.

Abortion, Induced↗