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PubMed1994

Reproductive health in central and eastern Europe: priorities and needs.

The countries in Central and Eastern Europe combine induced abortion as the method of choice for family planning with low contraceptive use (Hungary and Slovenia excepted). This widespread use of induced abortion has a negative influence on reproductive and general public health, and an effort should be made to introduce modern, effective family planning. Both information, education and communication (IEC) programmes (for the users) and training in contraceptive technology and counselling (for the providers) is badly needed, as well as a continuing supply of contraceptives. In order to design optimal programmes, more research into knowledge, attitude and practice with regard to sexuality, sexual behaviour and contraception is urgently needed. So far, little research into contraceptive behaviour and its determinants has been done in Central and Eastern Europe, but the few data that are available point towards a lack of contraceptive knowledge in both the population and amongst contraception providers. The cultural differences between Western and Eastern industrialized countries are often underestimated or ignored, but because of the special situation in the countries in Central and Eastern Europe, education programmes which were successful elsewhere in the world may not work in these countries and may require extensive adaption to local needs and customs. Alternatively, special education programmes need to be developed. Programmes, especially those addressing contraception, should be combined with a long-term commitment for support and the provision of contraceptives.

Abortion, Induced↗
PubMed2003

Facility-level reproductive health interventions and contraceptive use in Uganda.

CONTEXT: In Uganda, modern contraceptive use has recently increased in areas served by the Delivery of Improved Services for Health (DISH) project. Whether these increases are associated with facility-level factors is unknown, however. METHODS: Data from the 1999 DISH Evaluation Surveys were used in multivariate logistic regressions to assess the independent relationships of five indicators of the family planning service environment with individual-level use of a modern contraceptive in rural and urban areas. The surveys consisted of a household questionnaire of 1,766 women of reproductive age and a facility module implemented in all health facilities that serve the sampled population. RESULTS: After women's social and demographic characteristics were controlled for, none of the service environment factors was independently associated with current use of a modern method in rural areas. By contrast, in urban areas, the proximity of a private health facility (which likely reflects an increased availability of methods) was positively associated with current use (odds ratio, 2.1), as was the presence of a higher number (three or more) of DISH-trained service providers (1.7). CONCLUSIONS: The presence of private health facilities was the factor most strongly associated with contraceptive use in urban areas, perhaps because they improved the availability of methods. Few other facility-level program inputs had significant effects.

Adolescent↗