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At least 73 records · Page 4Linked to original sources

Contraceptive prevalence in the slums of Rio de Janeiro.

A community-based family planning operations research project was undertaken in selected low income communities of Rio de Janeiro; project field work began in February 1982. Prevalence data were collected and service delivery strategies were tested, including home visits promoting family planning, home distribution of condoms, and the introduction of community family planning depots. A high baseline contraceptive prevalence rate (CPR) of 70.1 percent was found for nonpregnant women currently in union, as well as substantial use of the private sector for contraceptive supply, despite the presence of free or subsidized sources within the communities. However, the most economically disadvantaged subgroups made the greatest use of the subsidized sources. The provision of additional service delivery sites may have contributed to a small increase in contraceptive prevalence noted over the life of the project; however, the high baseline CPR precluded a large increase in contraceptive use as a result of the program.

Adolescent↗

Integrating health services into an MCH-FP program in Matlab, Bangladesh: an analytical update.

This is a follow-up to a 1984 study that analyzed the relationship between areal variation in the contraceptive prevalence time series and in the intensity of maternal and child health (MCH) services of the Matlab Family Planning Health Services Project. Results based on 69 months of observation suggested that the addition of MCH components to a program with basic MCH and comprehensive family planning services had no incremental impact on family planning efficacy. However, basic MCH services, involving clinical back-up to family planning and child care since the beginning of the program in Matlab, may have contributed to clients' faith in the clinic staff and the overall efficacy of the Matlab program. In the 18 months that followed the cut-off date for this analysis, contraceptive prevalence increased markedly in the study areas. The present analysis repeats the earlier one for the extended time series to determine if the intensification of health services in Matlab contributed to this secondary increase in prevalence, and to ascertain whether the MCH service regimes have long-run differential impacts. Results for the 87-month time series are similar to those of the previous analysis, suggesting that the introduction of additional MCH inputs in the Matlab service area over the 1982-83 period had no incremental impact on the contraceptive prevalence rate time trend.

Bangladesh↗

Delivery of fertility control services by male and female obstetrician-gynecologists.

Sex differences in the delivery of fertility control services were explored in a national survey of 1420 recently trained obstetrician-gynecologists in active practice. Women were found to be more likely than men to provide abortion services but less likely than men to provide amniocentesis and certain infertility services. Women were found to contribute less than their proportionate share of two services for which volume was measured: artificial inseminations and sterilizations. Physician gender, however, was a less important predictor of volume of sterilizations delivered than were a set of practice-related variables. Overall our findings suggest that the increased representation of women among obstetrician-gynecologists could influence the delivery of a few specific services.

Family Planning Services↗

A consumer intercept study of oral contraceptive users in the Dominican Republic.

Purchasers of a low-cost oral contraceptive were intercepted and interviewed in a sample of Santo Domingo pharmacies that represented the highest sales of the product, yet also reflected the socioeconomic profile of the city's entire population. Users of the contraceptive were later interviewed in greater depth in their homes. The survey of users showed that the Dominican Republic's social marketing program, implemented by PROFAMILIA, was reaching an appropriate target market--that is, younger, lower-middle-class women of low parity. The program was, in addition, successful in attracting first-time adopters, and it was also expanding the overall commercial market for all contraceptives. The marketing campaign was successful in part because a mass audience was reached, through brief television spots. Program impact on contraceptive prevalence can be assessed from sales data.

Adolescent↗

Estimate of births averted in the Profamilia program.

Kelly's parity approach is used to estimate the number of live births averted at 6, 12 and 18 months after acceptance by 3,518 acceptors at nine Profamilia clinics in 1969. The calculated rates per thousand acceptors at 6, 12, and 18 months, respectively, are 137, 267, and 363. In order to obtain a general idea of the number of abortions averted by contraceptive use through the Profamilia program, Kelly's formula is also used, with modifications, to estimate the number of fetal losses (stillbirths and spontaneous and induced abortions) averted by the sample of users. It is estimated that 86 fetal losses per thousand acceptors are averted at 18 months postacceptance.

Adolescent↗

Comparative analysis of the effectiveness of the diaphragm and birth control pill during the first year of use among suburban adolescents.

Little attention has been paid to the diaphragm as a contraceptive option for adolescents. To compare diaphragm and birth control pill use by adolescents, 124 females (aged 13-20 years) in a suburban-based adolescent health service were interviewed at least one year after receiving a contraceptive prescription. The 73 diaphragm choosers did not differ from the 51 pill choosers in age, race, or reason for their original visit to the health service. Diaphragm choosers, however, were better students, of higher socioeconomic status, and had had fewer prior pregnancies. In the year following prescription, continuous use for 12 months was reported by 43% of diaphragm choosers and 45% of pill choosers, with significantly more pill (26%) than diaphragm (8%) choosers reporting discontinued use for at least one month while remaining sexually active. Regular use (diaphragm every intercourse, missing less than or equal to 1 pill/month) was reported by 36% of diaphragm choosers compared to 88% of pill choosers; and at least one pregnancy during the year was reported by 15% of diaphragm choosers and 18% of pill choosers. At follow-up interviews, diaphragm subjects disliked the immediate annoyances of the diaphragm, and pill users expressed concern about the potential side effects of the pill. No single factor or set of factors correlated with continuous and regular use of either method. Because both methods present specific problems for certain patients, we suggest that in addition to the pill, the diaphragm should receive serious consideration as a contraceptive option for adolescents.

Adolescent↗