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PubMedDate not supplied

Why do Chinese women practice contraception? The case of rural Jilin Province.

This study focuses on the relationship between contraceptive behavior, family size preferences, and perceptions of the one-child policy among young Chinese women in rural areas of Jilin Province. In 1985, about 85 percent of rural married women with one surviving child were practicing contraception, although most of them reported two as their ideal number of children. Most women with one surviving child, including those with one-child certificates, were practicing contraception in response to the government campaign, while more than half of women with two or more children were doing so voluntarily. Most of the women with one child were using the IUD, whereas more than half of women with two or more children were sterilized. Through multivariate analysis of contraceptive behavior and method choice, additional factors were found to be associated with the contraceptive behavior of rural Jilin women; achievement of their ideal family size was a significant factor in the voluntary practice of contraception as well as in contraceptive method choice. Implications of the results are discussed.

Adolescent↗
PubMed1991

Contraception in the perimenopause.

Pregnancy in women aged 40 and above is frequently unplanned and the legal abortion rate is high in this age group. Contraception and fertility are shrouded in popular mythology and many women do not appreciate either their risk of conception or the range of methods available to prevent conception. Either hormonal or non-hormonal methods of contraception may be appropriate.

Contraception↗
PubMedDate not supplied

Comparing the health risks and benefits of contraceptive choices.

Simulation models were used to compare the health consequences of birth control methods currently relied on by American women with those of using no method. The incidence of morbidity and mortality related to unintended pregnancies, live births, abortions, upper genital tract infections, tubal infertility, cardiovascular disease and reproductive cancers were estimated for hypothetical cohorts of 100,000 women aged 15-44. Women who never use any method and who never have an abortion would have an average of 18 births during their reproductive lifetime, compared with no more than five among women using any of the available birth control methods. Consequently, use of any method prevents more deaths from pregnancy and childbirth than are associated with method use. The proportion of women who would become infertile--estimated by taking into account the likelihood of developing upper genital tract infections and the probability that any pregnancies that occurred would be ectopic--is reduced substantially if women at low risk of sexually transmitted diseases use any method and if women at high risk use oral contraceptives or barrier and spermicide methods. Oral contraceptive use has a relatively small, independent effect on the risk of cardiovascular diseases, but it greatly augments that risk in combination with smoking and increased age. When ovarian, endometrial and breast cancers are considered together, there will be approximately 110 fewer diagnoses of these three cancers per 100,000 ever-users of the pill aged 15-54 than among 100,000 never-users; furthermore, prior to age 45, 100,000 ever-users will experience 10 fewer deaths from ovarian or endometrial cancers than never-users of the pill.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

The impact of service delivery frequency on family planning program output and efficiency.

Operations research is the study of factors that can be controlled by program administrators. Among such factors is the frequency of performing program activities. The present experiment, conducted in Lima, Peru during 1985-86, tested the impact of holding family planning post sessions once per month, twice per month, and weekly. Frequency was shown to have a major impact on program outputs, costs, and cost-effectiveness. Depending on the indicator, sessions held twice per month produced between 1.5 and 2.1 times the output of those conducted once per month. Weekly sessions produced between 1.3 and 1.6 times the output of those held twice per month. At an output level of nearly 11,200 visits per year, twice-per-month sessions were estimated to be 7-38 percent more cost-effective, depending on the indicator, than once-per-month sessions, and 6-28 percent more cost-effective than weekly sessions.

Community Health Services↗
PubMedDate not supplied

Fundamental elements of the quality of care: a simple framework.

This article argues for attention to a neglected dimension of family planning services--their quality. A framework for assessing quality from the client's perspective is offered, consisting of six parts (choice of methods, information given to clients, technical competence, interpersonal relations, follow-up and continuity mechanisms, and the appropriate constellation of services). The literature is reviewed regarding evidence that improvements in these various dimensions of care result in gains at the individual level; an even scarcer body of literature is reviewed for evidence of gains at the level of program efficiency and impact. A concluding section discusses how to make practical use of the framework and distinguishes three vantage points from which to view quality: the structure of the program, the service-giving process itself, and the outcome of care, particularly with respect to individual knowledge, behavior, and satisfaction with services.

Contraception↗
PubMedDate not supplied

Contraceptive use and fertility decline in Chogoria, Kenya.

This article describes the results pertaining to fertility and family planning from a 1985 survey conducted in the catchment area of Chogoria Hospital in central Kenya. Current contraceptive prevalence was found to be quite high, 43 percent as opposed to 17 percent for Kenya as a whole. The total fertility rate of 5.2 births per woman was 2.5 births lower than the national rate. Very few women reported wanting to have large numbers of children or thinking that fate or God should determine family size. Although these data cannot conclusively demonstrate that the family planning program operating in the area has been responsible for reduced fertility there, they do provide some support for this hypothesis.

Adolescent↗
PubMedDate not supplied

The correlation between family planning program inputs and contraceptive use in Indonesia.

Using 1980 Census and 1986 service statistics program inputs, this paper evaluates the net correlation of socioeconomic, region, and program variables with 1987 contraceptive prevalence and method-specific use rates for Indonesian regencies and municipalities. The region variables--primarily, though not exclusively, reflecting program design and maturity--correlate most strongly with the contraceptive prevalence rates. Field-worker activities, field-worker supervisor activities, and community-based distributors also have a correlation with these rates. Pill use is highest in the areas that are predominantly Islamic and least developed, whereas the pattern is reversed for use of the IUD, condom, and other modern methods (mainly female sterilization). The findings are assessed in terms of their implications for policymaking.

Community Health Services↗
PubMedDate not supplied

A decade of Nepal's family planning program: achievements and prospects.

Knowledge and practice of family planning in Nepal increased considerably from mid-1976 through mid-1986, with significant improvements in the availability of and accessibility to contraceptives. However, a proportionately larger share of the achievements were made during 1976-81 than in 1981-86. The impact on fertility of contraceptive use during the decade was minimal. Knowledge and use of reversible contraceptive methods remained very low, primarily because of the continued strong emphasis on sterilization in Nepal's family planning program. Consequently, the welfare of many couples who may be in need of contraception for spacing births, but not necessarily for terminating childbearing, does not appear to be adequately addressed by the program. A more balanced emphasis on reversible methods of contraception does not necessarily imply that a substantially higher level of contraceptive prevalence would be required to reach the fertility target. Several steps to improve program performance and contraceptive method mix are suggested.

Adolescent↗
PubMed1989

[Socio-hygienic aspects of performance of mini-abortion in women's consultation clinics].

The paper provides the results of sample socio-hygienic survey of 418 women after operation of mini-abortion. The women are classified according to age and family status. The contraceptive behaviour of women is analysed, methods and types of contraception are examined. With respect to this new type of activity, main causes of visits to the women's consultation clinic and certain medical and organisational aspects of its work are analysed.

Abortion, Induced↗
PubMed1988

Contraception.

The technology of fertility control has made dramatic strides in the past 25 years, offering a wider variety of safe, effective contraceptive choices than ever before. Lower dose oral contraceptives, new barrier techniques, and improved IUDs have been important recent advances, and new methods of hormonal delivery offer promise for the future. However, the search for safer, more effective, and more convenient contraceptive options must continue as a high research priority.

Contraception↗
PubMed1988

Case-control study of borderline ovarian tumors: reproductive history and exposure to exogenous female hormones.

Borderline ovarian tumors possess many of the same morphological features as their malignant counterparts, but they do not destructively invade the ovarian stroma, and the women in whom they develop generally have a favorable prognosis. Female residents of three urban counties of western Washington diagnosed with serous and mucinous borderline ovarian tumors between 1980 and 1985 (n = 116) were interviewed regarding past reproductive events. A random sample of women from the same counties (n = 158) was identified through random digit dialing and were interviewed. The risk of these ovarian tumors among women who had given birth to 1 or 2 children and to 3 or more children was, respectively, 0.7 and 0.4 that of nulliparous women. There was no consistent influence of increasing age at first live birth. Adjusting for parity, a history of lactation was associated with a 50% reduction in risk. Among nulliparous women, a further increase in risk was present in those who reported a history of infertility. Use of oral contraceptives was associated with a 60% reduction in risk. However, the size of the association was not dependent on duration, age at first use, or years since last usage. In conclusion, borderline tumors appear to have similar epidemiological patterns with regard to reproductive events as their more malignant counterparts.

Adult↗
PubMedDate not supplied

Medical termination of pregnancy and concurrent contraceptive adoption in rural India.

This study reports on 2,755 women seeking medical termination of pregnancy (MTP), and concurrent contraceptive acceptance, at a clinic in rural India from 1976 to 1987. The level of contraceptive acceptance among married women seeking MTP between 1976 and 1987 was 88.2 percent. Among married women seeking MTP in their first trimester of pregnancy, 43.4 percent accepted the IUD as a method of contraception and 41.8 percent accepted sterilization. By contrast, only 11.5 percent of women in their second trimester accepted the IUD, but 70.2 percent accepted sterilization. Seventy-two percent of the unmarried women and 43 percent of the married women seeking MTP were in their second trimester. Recommendations are made to: (1) combine contraceptive services and counseling with MTP whenever possible, (2) examine the consequences of policies that exclude unmarried women from contraceptive services, (3) investigate the reasons why so many women in this study sought MTP so late in pregnancy, and (4) obtain information on the determinants of contraceptive acceptance among women who seek MTP.

Abortion, Induced↗
PubMedDate not supplied

Medical and contraceptive reasons for sterilization in the United States.

Over the past two decades, the proportion of sterilizations--for both contraceptive and noncontraceptive reasons--among women of reproductive age (WRA) has risen in the United States. In 1982, more than one in ten WRA were sterilized for noncontraceptive, or medical, reasons. However, the rationales these women had for undergoing sterilization were not always clear-cut; often a mixture of medical and contraceptive reasons were given. In this study, Cycle III data from the National Survey of Family Growth, 1982, were used to investigate the determinants of different types of sterilization decisions--sterilizing for contraceptive, medical, or "mixed" reasons. It is important to recognize this "mixed" component of sterilization motivation. Parity and, to a lesser degree, education have consistent effects on differentiating these types of rationales, which appeared to have somewhat different patterns among black and white women.

Adolescent↗
PubMed1988

High school students' attitudes towards and use of contraceptives.

A questionnaire survey was conducted in an urban coeducational secondary school in the North Island region. Of the 162 adolescents sampled in this study, 39 percent reported coital experience. Of these coitally experienced students, contraception was always used by only 42%. The pill and the condom were reported as the most used contraceptives. Females were found to be significantly better contraceptive users than males. Although many students report preferring their parents as a source of contraceptive information, the majority of both males and females relied upon school sex education classes as their main source of their contraceptive education. Students ability to discuss contraceptive matters with parents was found to have no effect upon coital activity. These results indicate that society must come to terms with the fact that many adolescent New Zealanders are sexually active and run a high risk of having unplanned, unwanted pregnancies.

Adolescent↗