Quality of care among Jamaican private physicians offering family planning services

The National Family Planning Board is the agency of Government empowered to prepare, carry out and promote family planning programs in Jamaica. The Board has prioritized the expansion and sustainability of family planning services in large part through encouraging the participation of the private sector. To enhance the availability and effectiveness of private physician family planning services, information was collected on the service practices of 90 percent of physicians, through face to face interviews. Bruce's framework was used to evaluate the findings of the study. The study indicated that: (1) A wide variety of contraceptives are available. (2) Basic equipment and adequate supplies are in place for the provision of services. (3) Provider bias, inapproriate contraindicators and process and scheduling hurdles exist. The major recommendations relate to the: (1) Revision of norms and guidelines for all contraceptives. (2) Continuation of contraceptive technology updates for private physicians. (3) Revision of legal/regulatory barriers which restrict access to some contraceptives for certain target groups (AU)

Show, no show and sterilization

The study investigates the factors involved in the decision of a sample of women to break appointments for sterilizations at the Fertility Management Unit of the University of the West Indies. A case control study involved 50 women who did not show up (no-shows) and an equal number who did show up (shows) over the same period. The no-shows had spent a shorter time in their current union than the shows, and some had no children for their partners at the time the appointments were made. Marriage was the single most important event that would encourage the no-shows to consider sterilization in the future. As long as poor women see child bearing as a precondition for financial assistance from spouses, they will hesitate to give up this capability (AU)

Women in search of stability

This paper is based on a study of 97 recuits-50 sterilized and 47 non-sterilized--to a family planning programme in Kingston, Jamaica and tries to account for the reluctance of Jamaican women to accept contraceptive sterilization. The study demonstrates the association between mating patterns in the island and the acceptance of sterilization. This irreversible method was more likely to be chosen by women in more stable sexual unions.(AU)

High parity in the Negro parturient

The reproductive performance of 100 great-grand multiparous Negro mothers was compared with that of 100 Negro women of lesser parity but of similar social background. There was a higher incidence of maternal complications among the highly parous patients, these being hypertension, anemia and postpartum hemorrhage. The fetal risks were minimal and babies were heavier among the great grand multiparas. The improvement is attributed to the good quality of obstetric care care given to these high-risk mothers (AU)

Etiology of tubal ectopic pregnancy

Fallopian tubes, removed at operation from 100 tubal ectopic pregnancies, were injected with barium sulphate/gelatine suspension and radiographs taken. Histologic sections were then examined. One hundred control tubes were treated in the same fashion, and the findings in the two groups were then compared. The tubes from 50 autopsies of infants and children were also injected with contrast medium and studied microscopically in a search for congenital lesions. Tubal diverticula were found in 49 percent of gravid tubes as compared with 11 percent of those of the control group. Diverticula were confined to the isthmus and the proximal portion of the ampulla. They were not seen in the tubes of infants and children examined at autopsy, but an etiologic relationship with chronic inflammation was suggested. On the basis of this study, it appears also that the lesions referred to as salpingitis isthmica nodosa are in fact diverticula (AU)

Attitudes to post partum sterilization and results of this procedure - abstract

This study was designed to examine the problems of post partum sterilization at the University Hospital, Jamaica. From 1953 to July, 1968, there were 2,150 post mortem sterilizations of a total of 31,000 deliveries. The frequency rose from less than 1 percent in 1953 to 9.1 percent in 1957. All patients were multiparae and 77 percent of all cases were sterilized by the Pomeroy technique. Multiparity was the sole indication in 68 percent. The average age was 35 and parity 6.1. There was an overall failure rate of 0.14 percent. One hundred women were interviewed two years after sterilization in order to assess the after effects of the process. In 27 percent there was an increase in sexual frequency which was described in 12 percent. Another survey was carried out on 100 women offered sterilization in 1968. All were over 30 years old and had at least 7 children. Fifty two rejected the proposal immediately and fear was the major deterrent. Among antenatal patients knowledge of family planning was good and all patients were aware of at least 2 methods. These data indicate the attitude of patients to sterilization and the increase of this method of family limitation in the appropriate circumstaces (AU)

Control of some houseflies on some West Indian islands with metepa, alpholate, and trichlorfon baits

Two chemosterilants, metepa and alpholate and an insecticide, trichlorfon were applied in sweetened baits in the pits of all privies on 3 islands in the West Indies for control of houseflies, Musca domestica L. Semiweekly treatments were made, first with granular baits and then with sugar syrup. On Grand Turk, 1 percent metepa liquid bait usually induced sterility in excess of 80 percent and reduced fly abundance more than 90 percent over 18 months. On Mayaguana, 1 percent liquid apholate bait produced about 60-80 percent sterility over three months under less favourable conditions and reduced fly abundance 50-80 percent. On San Salvador, 1 percent liquid trichlorfon bait reduced fly abundance 50-90 percent. The flies did not develop resistance to the chemosterilants during two years of exposure; instead the fertility of the treated strain apparently declined slightly (AU)