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PubMedDate not supplied

Vanguard family planning acceptors in Senegal.

This study examines contraceptive use among clients at the three clinics providing family planning services in Dakar, Senegal in early 1983. Most clients first became interested in family planning following the birth of a child, and most are interested in spacing future pregnancies, although one-third state that they want no more children. The clinic itself was found to be an important determinant of the type of contraceptive used, with only the government-operated clinic providing a balance between IUDs, oral contraceptives, and barrier methods. Nearly half of the clients interviewed said that a lack of knowledge about contraception is the reason for the low contraceptive prevalence rates among Senegalese women; another frequently cited reason was the opposition of the husband. Most clients reported the broadcast media to be the best means of providing family planning information to potential acceptors.

Contraceptive Devices, Male↗
PubMedDate not supplied

Barriers to modern contraceptive use in rural Peru.

This paper examines Quechua-speaking Indians' choice of contraceptive methods and discusses barriers to the use of modern contraceptives. A study conducted in a Peruvian highland community shows that contraceptive choice is strongly related to a couple's life experiences, their contact with urban centers, their economic status, and their emphasis on cultural values. Among contraceptive users, husbands are concerned with family size and encourage their wives to seek information about the use of modern contraceptives. A discrepancy in attitudes exists between spouses: the men's positive attitude toward modern contraception contrasts with the women's traditional desire for a large family. In this study population, modern contraception is a novelty that has reached only a few families. The majority of the couples practice natural and traditional family planning methods, which are not reliable. Villagers do not use modern contraceptives as a result of cultural barriers created by family planning services that do not take into account the lifestyle of these people, insufficient knowledge of human physiology, comments from dissatisfied users, and women's reliance on their reproductive role for self-esteem.

Abortion, Induced↗
PubMed1989

The effect of sexual behavior and a pregnancy on contraceptive method switching among black female teens.

Little is known about determinants of contraceptive method switching and few reports use data that can link events that occur close in time. Using retrospective information from the sexual calendars of black female teens who attended a reproductive health clinic, determinants of method switching in four areas were investigated. Method switchers, those who switched from an unprepared to a prepared method (n = 62) and those who switched from a prepared to an unprepared method (n = 18), were matched with nonswitchers who used the same initial method. Associations between switching and changes in the frequency of intercourse, sexual abstinence, and pregnancy were found. It is suggested that abstinence may have a different role in switching from each type of method. Counselors need to emphasize the importance of method continuation, even when sex has not occurred for a short period of time.

Adolescent↗
PubMed1996

[The perceived quality of service at a family planning clinic: a marketing focus].

OBJECTIVE: To measure the perceived quality of service at a Family Planning Clinic (FPC) in Burriana (Castellón), taking as reference the empirical studies developed in commercial marketing. DESIGN: A descriptive study based on a survey using a questionnaire adapted from the SERVQUAL and SERVPERF ones, then a multivariant analysis of the data. SETTING: Burriana Family Planning Clinic, Castellón. PARTICIPANTS: 183 women were interviewed after being attended, of whom 155 (85%) filled out the questionnaire correctly. MEASUREMENTS AND MAIN RESULTS: The overall quality of service is highly valued (6.1 out of 7 points). Six factors which explained 63.3% of the total variance were identified: high personal attention, little bureaucracy, modern installations and equipment, professionalism and competence of staff, accessibility, reputation and layout. It was also found that the Cronbach alpha coefficients were not acceptable in three factors. CONCLUSIONS: off Marketing proposes that the quality of health service provision must be measured from the user's point of view, i.e. the important question is the perceived quality. Research is still at an experimental stage and the two measuring tools (SERVQUAL and SERVPERF) are still under discussion. The conclusion is that marketing can be adapted perfectly to the needs of health provision, although a line of research to design the appropriate method for measuring the quality of any health service needs to be followed.

Analysis of Variance↗
PubMed1991

The modified mucus method in India.

The modified mucus method-Prajanan Jagriti (fertility awakening) is intended to serve the cultural needs of illiterate and semilliterate women. Over 10 months, 3003 women in northern India were taught the modified mucus method. There were a total of 42 pregnancies in 24,702 cycles for a Pearl index of 2.04. High effectiveness is attributed to the support that was provided to clients by the instructor.

Cervix Mucus↗
PubMed1991

Expanded services for intrauterine contraception in Sudan.

Twenty nurse-midwives in government service in the Sudan (health visitors) were trained to provide intrauterine contraceptives in a research project designed to evaluate the safety of insertion of IUDs by medical personnel who are not physicians. After training, they inserted 763 IUDs. Independent evaluation of 520 clients was conducted by obstetrician-gynecologists who found that only six (1.2%) had been incorrectly inserted. Outcomes for clients of the health visitors with respect to perforations, infections, expulsions, and pregnancies compared well with those of eight physicians who participated in the study. The research strongly supports the concept of nurse-midwife training for IUD insertions which would greatly expand the availability of family planning services and would conserve physician time and skills for problem cases.

Community Health Nursing↗
PubMedDate not supplied

The influence of health care on contraceptive acceptance in rural Mexico.

This paper offers two types of evidence in support of the idea that family planning services are most expediently provided as an integral part of the health and medical organization for maternity care. First, prenatal care and medical attention at delivery are found to be closely associated with postpartum contraceptive acceptance in a 1981 survey of family planning in rural Mexico. Second, interviews of a sample of doctors, nurses, and auxiliaries who provide maternal health services to the rural population reveal that these practitioners favor long birth intervals and small completed families, that they recommend the use of modern contraceptive methods including female sterilization, and that those in the employ of public institutions are motivated to recruit acceptors of these methods. The main impediment to contraceptive acceptance in this context is believed to be fear of side effects and permanent health consequences rather than the desire for additional children.

Attitude of Health Personnel↗
PubMed1989

Evaluation of training program for volunteer family planning communicators.

The objectives of the VFPCs training program are to develop the strategy for promotion of sterilization by contraceptive comsumers in the provinces. The program promoted coordination among government and the private sector. The project was planned to cover 12 provinces in Northeastern Thailand. The results indicated that the project had achieved readiness to some degree. Consequently, the significant differences between pre and post tests (p less than 0.01) indicated that the VFPCs had benefited by the training program. For the most part, the objectives of training were achieved.

Communication↗
PubMed1995

Oral contraceptive use among African American adolescents: individual and community influences.

Side effects of oral contraceptives are a noteworthy problem, particularly among low-income young women who reside in inner-city communities. The problem may be compounded by inadequate family planning services, particularly when such services are provided by general medical practices with high volumes of clients. This study examined the prevalence and correlates of pill-related side effects, with particular attention to the role of clinic characteristics. Participants were 177 pregnant and parenting African American adolescents and young women (average age = 18.34). The experience of a pill-related side effect was the most frequently cited barrier to birth control use, and it was significantly related to contraceptive behavior. Finally, although participants attending comprehensive clinics experienced more barriers to medical service use than those attending neighborhood clinics, they reported fewer problems with pill-related side effects and better psychological functioning. Implications for future research and policy are discussed.

Adolescent↗
PubMed1991

Natural family planning use-effectiveness and continuation.

Numerous studies have been conducted to assess the use-effectiveness of natural family planning. However, because of imprecise definitions of terms, these studies show noncomparable results. Special effort is required to study natural family planning use-effectiveness by the same criteria as other family planning methods.

Family Planning Services↗
PubMed1991

Efficacy studies in natural family planning: issues and management implications illustrated with data from five studies.

Studies of method effectiveness must be carefully assessed for comparability of findings. Several parameters are identified that are important in the assurance of comparable results. This article discusses these issues with the use of data from previously published studies and emphasizes the management implications of use-effectiveness data.

Data Interpretation, Statistical↗
PubMed1991

Measuring natural family planning in terms of couple-years of protection.

Couple-years protection is a summary index of contraceptive protection. Couple-years protection allows comparisons of natural family planning with other methods. One couple-year protection for condoms is equal to 1 couple-year protection for pills and 1 couple-year protection for natural family planning. Critical in the calculation of couple-year protection for natural family planning is average duration of use. A working group on natural family planning recommended that 2 years of use be used as average duration until more data are available.

Contraception↗
PubMed1998

From efficacy to effectiveness: selecting indicators for a community-based lactational amenorrhoea method promotion programme.

This paper reviews the results of clinical trials and community studies of lactational amenorrhoea and its role as a contraceptive method (LAM). Indicators which are used in efficacy trials and effectiveness interventions are compared and sets of indicators of effectiveness appropriate to community-based LAM programmes are recommended. A five-tiered ecological framework is used to facilitate selection of indicators which range from individual to policy level outcomes. The indicator framework is intended as a tool for health practitioners in family planning and maternal and child health service delivery settings who are interested in designing programmatic interventions for the promotion of LAM, particularly among less well-educated women of lower socioeconomic communities.

Amenorrhea↗