Contraceptive technologies and consumer choices

Whilst a greatly increased range of contraceptive methods is now available, in practice it requires a very strong national delivery system to provide reliable access to contraceptives if users are to have an effective choice of methods. Contraceptive use in the Caribbean varies amongst countries but, with an average for the region of over 40 percent of women of reproductive age using modern contraceptive methods, it is comparatively high. Generally there is wide public awareness and knowledge about contraception and how it may be used safely and effectively. Despite the relatively high contraceptive use in the Caribbean, in practice the full range of contraceptive choice for consumers is not always available. The paper details 4 critical steps that must be taken for the Caribbean consumer to benefit from the full range of contraceptive choices (AU)

Knowledge, attitudes and practices of parents in a rural community with regard to the distribution of contraceptives to sexually active children under 16 years

Parents play a vital role in the lives of their children because they transmit and interpret acceptable cultural behaviour and help to mold the personality of their children. The study was designed to assess knowledge, attitude and practices of parents with regard to early sexual debut and distribution of contraceptives to sexually active children under 16 years. It was carried out on 75 parents in a rural district in Westmoreland. Two streets in the district were randomly selected and all parents with children aged 10-15 years were interviewed. Personal interviews were conducted by the researcher using pre-coded questionnaires. The result showed that while the majority of parents were knowledgeable about sexual activities in children, less than half knew about sexual activities in their children. They strongly disliked the practice of early sexual activities in children. Parental consent for contraceptive was not the preferred practice as the majority of parents expressed that they would not give consent for their children to access contraceptives but it must be made available so that children can access it when all else fail. Parents prefer to talk to and to counsel their sexually active children instead of offering contraceptives. The majority indicated that they are fulfilling their role as sexuality educators for their children.(Au)

Contraceptive use during lactational amenorrhea

OBJECTIVE: The study uses data from nationally representative sample surveys in developing countries to estimate the overlap between lactational amenorrhea and contraceptive use during the first 6 months postpartum. METHOD: Secondary analyses of survey data were used to tabulate the proportion of the population in lactational amenorrhea among contraceptive users of all women, for postpartum women and for the country as a whole. RESULTS: Among postpartum women, the proportion in lactational amenorrhea was particularly high in Africa and the Near East and lower in Latin America and the Caribbean where breast-feeding practices have declined. The median duration of use for oral contraceptives is also presented as an aid to interpreting the significance of the findings. CONCLUSIONS: The significance of the findings is considered in the context of planning reproductive health services in the postpartum period. Decisions about timing of contraceptive use for postpartum women, while arrived at on an individual basis, also result from program strategies that focus counseling immediately postpartum or at a later interval, such as when menses resume. On a national level the impact of postpartum contraception policies on use of commodities may be substantial.(AU)

The effect of economic factors on contraceptive choice in Jamaica and Thailand: a comparison of mixed multinomial logit results

In this study the sensitivity of specific potential users and user groups to the prices charged for contraceptives was investigated. The results of the author's estimations explaining the choice to use priced contraceptive sources when free sources are available, for those who choose to purchase methods, are much hypothesized. In both Jamaica and Thailand, factors other than prices tend to dominate in determining whether a woman or her partner will purchase contraceptives, given free availability. In separate analyses for Jamaica and Thailand, the results explaining the choice of a specific method for those who choose to purchase contraceptives are consistent with expectations based on economic theory. Money prices and time costs are found to be negatively related to the choice of contraceptive method, but for several of the priced contraceptives, the effects of money prices are seen to be small in magnitude. The policy implications for these results are large and obvious. They suggest that decreases in subsidization of the money price of low elasticity contraceptives (the pill, IUD, sterilization) will not significantly alter the pattern of choice of contraceptive methods. Other methods, including condoms in both Jamaica and Thailand and injections in Jamaica, are found to be relatively sensitive to money price, and the results suggest that price increases would substantially decrease their use. (AU)

Depo-provera: a preliminary report on its use on a Family Island in the Commonwealth of the Bahamas

A preliminary report on the use of depo-provera amongst a group of women within childbearing age on an island of the Bahamas shows promise. The duration of administration of the drug in this particular study should be borne in mind when anticipating defaulters (AU)

Plants of Haiti used as antifertility agents

Haitian empirical medicine sprang from both European (16th to 19th century) and African (especially voodoo) traditional therapies. The use of medicinal herbs is highly developed. Our purpose was to list the plants held to be antifertility agents n the island. We identified about twenty species more or less currently used by the women as abortifacients or emmenagogues. The chemistry and active components of a few species are well-known. However, for most of them, some were partially studied, and no relation could be established between their chemical composition and their potential activities, and the rest are chemically unknown. We chemically screened extracts of casearia ilicifolia, Eleutherine bulbosa, Rhoeo spathacea and the leaves of C.ilieifolia, and naphthoquinones, and a new anthraquinine, anthracene -9, 10-dione-1, 5-diol-4-methoxy-3-methyl-2-carboxylec acid methyl ester, in the bulbs of E. bulbosa, R.spathacea showed a stimulative activity on mouse uterus. Antifertility screening tests of C.ilieifolia and E. bulbosa showed activity in rats, but also probably toxicity

Clinical effects on long term users depo provera, oral contraceptives and intra uterine devices

An evaluation of the Jamaican Family Planning programme was undertaken specifically to assess the clinical effects of the oral contaceptive, depo-provera injection and the intra uterine contraceptive device on long term users. Two hundred and forty six patients participated in the study, and this number was made up of: 86 users of the oral contraceptive, 82 users of the I.U.C.D. and 78 users of the depo-provera. Clinical examination elicited no complication outside those known to occur on the individual methods. A few interesting observations were high-lighted which may need further evaluation before any reasonable conclusions could be drawn from them (Summary)