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1.
J Coll Physicians Surg Pak ; 16(4): 261-4, 2006 Apr.
Article in English | MEDLINE | ID: mdl-16624188

ABSTRACT

OBJECTIVE: To determine the factors affecting the health-seeking behavior of couples with secondary infertility in Karachi. DESIGN: A descriptive case series. PLACE AND DURATION OF STUDY: The data was collected from women attending infertility clinics in five tertiary care hospitals in Karachi from March to June 2003. PATIENTS AND METHODS: All currently married women, between the age of 15-35 years, with at least one previous conception, irrespective of outcome, attending an infertility clinic and consenting to participate in the study, were included. Women with corrective surgery on vagina and uterus, and cases of primary infertility, were excluded. Multiple logistic regression models were used to determine the association of various factors, affecting the health-seeking behavior, with statistical significance set at p < 0.05 for the covariates and the interaction terms between various factors. RESULTS: The women consulted multiple health care providers for treatment of secondary infertility. The main reasons for seeking treatment were couple s wish (54.2%), family pressure (22.6%) and want of a son by husbands or in-laws (20.4%). The most commonly sought providers were physicians (74.7%), Traditional Birth Attendants (TBA, 39.5%), Spiritual healers (26%), Hakeems (23%) and Homeopaths (17.2%). Most of the women who consulted non-physicians were illiterate (69.4%) as compared to those who consulted a physician (37.8%, p-value = 0.00). The non-physicians were more commonly consulted by women belonging to low socioeconomic group. The posttreatment complications were more common among women who consulted non-physicians. CONCLUSION: Pressure from husbands and in-laws compels women for consulting multiple providers. Health seeking behavior for infertility is affected by the literacy and socioeconomic status of the women.


Subject(s)
Health Behavior , Infertility, Female/diagnosis , Infertility, Female/therapy , Reproductive Techniques , Adolescent , Adult , Developing Countries , Educational Status , Family Characteristics , Family Planning Services , Female , Humans , Logistic Models , Male , Multivariate Analysis , Pakistan , Pregnancy , Pregnancy Rate , Probability , Risk Assessment , Social Class , Socioeconomic Factors
2.
Patient Educ Couns ; 55(1): 105-13, 2004 Oct.
Article in English | MEDLINE | ID: mdl-15476997

ABSTRACT

In the context of a qualitative study exploring patients' participation in decision-making, we investigated how people interpret and respond to structured questions about decision-making about their health care. Seventy-four participants who attended consultations in five clinical areas completed structured measures of decision-making and discussed their responses during interviews. They identified a range of decisions as having being made in their consultations. People who picked particular responses on measures of participation in and satisfaction with decision-making gave varied explanations for these, not all of which were consistent with the way their responses are usually interpreted. The interview data suggest that people's evaluations of decisions to follow a particular course of action were influenced by various factors including what they focused on as the alternative, their perceptions of constraints on choices, and their assessment of how good the best possible solution was. Responses to simple structured measures of participation in and satisfaction with decision-making should be interpreted with caution. They are not reliably attributable to health care providers' actions and are thus unsuitable for performance assessment purposes.


Subject(s)
Decision Making , Patient Participation/psychology , Physician-Patient Relations , Attitude of Health Personnel , Communication , Cooperative Behavior , England , Family Planning Services , Family Practice , Female , Genetics, Medical , Health Care Surveys , Health Knowledge, Attitudes, Practice , Homeopathy , Humans , Male , Medical Oncology , Middle Aged , Qualitative Research , Referral and Consultation , Role , Scotland , Self Concept , Surveys and Questionnaires
3.
Int J Gynaecol Obstet ; 123 Suppl 1: e29-32, 2013 Nov.
Article in English | MEDLINE | ID: mdl-24035007

ABSTRACT

OBJECTIVE: To describe women who accept single-rod progestogen contraceptive implants (Implanon; N.V. Organon, Oss, Netherlands) from community health workers in Ethiopia and to assess whether community-based provision addresses unmet need for contraception. METHODS: Women who accepted Implanon during training events in 4 regions were asked about their characteristics and use of family planning. They were compared with implant users nationally and women with unmet need in the Ethiopia Demographic and Health Survey (DHS). Differences between groups were tested using 2-sample comparisons of proportions and means. RESULTS: On average, Implanon acceptors were younger and had more years of education and fewer children than implant users nationally. Almost one-quarter (22.9%) of all participants had never used contraception before; this was slightly higher among women who chose Implanon (23.1% vs 16.4%; P=0.04). Acceptors were also less likely than non-acceptors to be using contraception (70.8% vs 77.3%; P<0.05) but all women interviewed were more likely to be using contraception than the rural population. Women who accepted Implanon were younger but more educated than women with unmet need for contraception in the 2005 DHS. CONCLUSION: Provision of Implanon at the community level through community health workers is effective in reaching women with the greatest need for contraception.


Subject(s)
Contraceptive Agents, Female/administration & dosage , Desogestrel/administration & dosage , Health Services Needs and Demand , Patient Acceptance of Health Care/statistics & numerical data , Adolescent , Adult , Age Factors , Community Health Services/organization & administration , Contraception/statistics & numerical data , Cross-Sectional Studies , Drug Implants , Educational Status , Ethiopia , Family Planning Services/organization & administration , Female , Health Surveys , Humans , Middle Aged , Rural Population/statistics & numerical data , Young Adult
4.
Contracept Technol Update ; 19(7): 85-7, 1998 Jul.
Article in English | MEDLINE | ID: mdl-12294126

ABSTRACT

PIP: The new low-dose oral contraceptive (OC), Mircette, is the first pill to shorten the hormone-free interval. The dosing regimen begins with 21 days of 20 mcg of ethinyl estradiol and 150 mcg of desogestrel; the last 7 days start with 2 days of placebo, followed by 5 days of 10 mcg of ethinyl estradiol. These 5 days of ethinyl estradiol are expected to oppose the effect of any follicle-stimulating hormone in promoting growth of a follicle in the estimated 20% of pill takers who are close to ovulation at the end of each pill-free interval. The efficacy trial, which included more than 1000 women followed for 18 menstrual cycles, reported a Pearl index of 1.02. Breakthrough bleeding occurred in 3.5% of the 18 cycles. Less than 3% of women discontinued Mircette use because of menstruation-related side effects. The small amount of estrogen provided by Mircette during the last 5 days of the cycle helps prevent the withdrawal headaches many users of OCs with a longer hormone-free interval experience. Mircette will become available in the US in July 1998.^ieng


Subject(s)
Contraceptives, Oral , Americas , Contraception , Developed Countries , Family Planning Services , North America , United States
5.
Contracept Technol Update ; 19(5): 57-9, 1998 May.
Article in English | MEDLINE | ID: mdl-12293563

ABSTRACT

PIP: Vaginal contraceptive rings, currently in advanced clinical trials, offer a simple, long-acting, woman-controlled method of fertility control. A ring developed by the Population Council's Center for Biomedical Research, with continual release of 20 mcg of ethinyl estradiol and 1 mg of norethindrone acetate, has been accepted by a commercial partner for further studies leading to market introduction. Another Population Council-developed ring combines an even lower dose of estrogen (15 mcg) with its own patented progestin, NESTORONE. Organon is in phase III trials of a ring combining 15 mcg of ethinyl estradiol and the progestin etonogestrel and expects to complete its research by mid-1999. Of particular interest is the potential for vaginal irritation. The one-size ring is smaller than most diaphragms and does not require fitting. Once a woman has received instructions, she can insert and remove the ring herself. The ring's regimen of 3 weeks of use and 1 week of rest is similar to the schedule for oral contraceptives (OCs), but provides better cycle control than a combined OC that delivers one-third more of the same progestin and estrogen. Finally, a progestin-only vaginal ring for lactating women has been licensed for manufacture and distribution in Latin America.^ieng


Subject(s)
Contraception , Contraceptive Devices, Female , Research , Economics , Family Planning Services , Technology
6.
Contracept Technol Update ; 20(11): 127-9, 1999 Nov.
Article in English | MEDLINE | ID: mdl-12295327

ABSTRACT

PIP: Organon has developed the Reminder Card to help women patients remember their regular intake of oral contraceptive (OC) pills. About 50% of women take birth control pills as prescribed, 25% miss a pill per month, and 25% miss two or more pills in the same time frame. The plastic card, about the size and shape of a credit card, contains a microchip timer. Reminder cards are available to providers who use the Starter Kits issued by the company for new-start patients on the Mircette OC. When patients begin their first pack of pills, they select the time of day they prefer to have the Reminder Card emit its tiny beep. The time is set into the microchip timer and the card is programmed to sound automatically at the pre-set time each day for the next three months. The direction for using the Reminder Card is outlined.^ieng


Subject(s)
Contraceptives, Oral , Equipment and Supplies , Family Planning Services , Research , Americas , Contraception , Developed Countries , North America , United States
7.
ORGYN ; (4): 2-5, 1994.
Article in English | MEDLINE | ID: mdl-12288144

ABSTRACT

PIP: The Alan Guttmacher Institute emerged from the Planned Parenthood of America's Center for Family Planning Program Development in 1968. It split from Planned Parenthood in 1977 because some foundations would not fund an entity linked to Planned Parenthood. The Institute originally focused on women and contraception but has expanded to include abortion, sexually transmitted diseases, and the changing family. Its mission is to influence public policy to work towards reproductive freedom and to be an unimpeachable source of accurate data on reproductive and sexual health. Its 55-member staff works out of New York City and Washington D.C. Its 1993 budget was only $4.7 million. Its 3 divisions cover public policy, research, and publishing. The Institute determines what research projects to undertake based on what question it wants to answer. The goal of research revolves around changing public policy or public opinion. It obtains funding from a foundation or the government for each research project. Possible donors are not always willing to fund projects, however. For example, the Institute wanted to examine funding of reproductive health care by private medical insurance and first went to possible donors 5 years ago. It was finally funded in 1994 because of the interest in health care reform. Much of staff time is spent writing proposals rather than on research. The Institute does not accept money from any organization that may gain financially from the outcome of the research. Its research activities allow the Institute to achieve its goal of providing thorough information on reproductive health. The Institute has 2 staff members who deal only with requests for information, which they can usually provide or help to provide. The Institute is becoming more international. The staff is rather young and has high morale and a high energy level.^ieng


Subject(s)
Health Planning , Organizations , Public Policy , Reproductive Medicine , Americas , Developed Countries , Family Planning Services , Health , North America , United States
8.
Contracept Technol Update ; 13(8): 120-1, 1992 Aug.
Article in English | MEDLINE | ID: mdl-12317694

ABSTRACT

PIP: Oral contraceptive (OC) manufacturers stated that they would comply with the US Food and Drug Administration's (USFDA's) new labeling, as not responding might cause an unwanted delay in the new drug applications. New instructions on how to handle missed pills and what day to start a new cycle package concerns both manufacturers and family planning clinicians. The final version of the instructions was very different from those that Organon Inc. had drafted: the new instructions include 2 options for start days. Several confusing scenarios exist concerning missed pills, dependent upon the day a woman decided to start her package and in which week she missed the pills. A senior research associate at Family Health International in Research Triangle Park, N.C., who helped develop the guidelines, said the manufacturers' suggestions were taken into account and incorporated into a message at then end of the section on missed pills. The vice president for clinical affairs at Ortho Pharmaceuticals in Raritan, N.J., deemed the recommended approach reasonable. However, the new instructions of patient package inserts (PPIs) relating to missed pill scenarios may be too complex for some women because of USFDA's scientific thoroughness. Most individuals involved with the new guidelines believe these instructions can be amended without time-consuming problems as new information on pill use becomes available.^ieng


Subject(s)
Communication , Contraceptives, Oral , Patient Compliance , Americas , Behavior , Contraception , Developed Countries , Family Planning Services , North America , United States
9.
Contracept Fertil Sex (Paris) ; 21(11): 837-8, 1993 Nov.
Article in French | MEDLINE | ID: mdl-12287400

ABSTRACT

PIP: Some scientists added the progestin levonorgestrel to the vaginal ring which must be removed every 3 weeks to address the problem of irregular bleeding, but it adversely altered lipoprotein levels and caused too many hemorrhaging problems. On the other hand, scientists in the laboratory at Organon have conducted various studies of a vaginal ring with ethinyl estradiol and 3-keto-desogestrel at different doses which have yielded favorable results. A multicenter European study was conducted with 400 women aged 18-40 years wearing a vaginal ring with 0.120 mg keto-desogestrel and 0.015 mg ethinyl estradiol every day for 9 months. 10% had slight bleeding 15 days after insertion of the vaginal ring. In 10 women tested, the plasmal levels of progesterone and estrogen decreased by 4 nmol/l and 0.010 nmol/l, respectively. The first French study was conducted at the Gynecology College of Bordeaux and the South-West in 1988 and included 40 women followed for 9 cycles. The vaginal ring consisted of 2 compartments: the biggest compartment contained only 3-keto-desogestrel and the other also contained ethinyl estradiol. It remained in the vagina for 21 days, then was removed to be rinsed, dried, and placed in a box. It was reinserted on the 5th or 7th day of the cycle. This ring reduces the volume of blood during menses and eliminates abdominal cramps, nausea, and headaches. Women tolerate the vaginal ring better than they do oral contraceptives (OCs); for example, it does not cause them to gain weight, they tolerate glucose well, it brings about favorable changes in lipoproteins, it does not bring about conditions favorable to thrombophlebitis, and it can improve the skin for acne-sufferers. Young women accept vaginal rings enthusiastically. The efficacy of vaginal rings with 2 steroids is the same as that of OCs.^ieng


Subject(s)
Clinical Trials as Topic , Contraceptive Devices, Female , Desogestrel , Ethinyl Estradiol , Metabolism , Ovulation , Biology , Contraception , Contraceptive Agents , Contraceptive Agents, Female , Contraceptives, Oral, Hormonal , Developed Countries , Europe , Family Planning Services , France , Physiology , Research
10.
ORGYN ; (1): 36-7, 1995.
Article in English | MEDLINE | ID: mdl-12288953

ABSTRACT

PIP: For the past 4 decades, the world's population growth has threatened to outstrip the planet's ability to sustain it. According to recent projections, an end to the growth of world population is finally in sight. Dr. Joseph van Arendonk, deputy executive director of the United Nations Population Fund, told an international press conference that population growth is likely to begin falling before the mid-21st century. Currently, some 87 million couples worldwide wish to use contraception but have no access to services. Van Arendonk argued that 4% of overseas aid set aside for population programs would satisfy this unmet need. He also predicted that the average family size in developing countries would stabilize at 2.1 children within the next 55 years if these needs were met. This would still mean a global population of 10 billion in the year 2050, rising to a plateau of 11.6 billion within the following century. In developing countries fertility rates fell from 6.1 to 3.3 children per woman between the mid-1960s and the mid-1980s, while use of contraception increased from 10% to 50%. However, contraceptive users in the developing world must increase from 446 million in 1994 to 603 million in 2005 to keep population growth within such projected limits. The costs of providing the contraception will increase from US $528 million to US $752 million. The contraceptive needs of 603 million users in 2005 will require: 196 million sterilizations, 436 million IUD insertions, 898 million injectables, 12.3 billion cycles of OCs, and 55 billion condoms. To this end, IPPF plans greater accessibility of services, a wider range of effective methods, and the involvement of the male partner.^ieng


Subject(s)
Contraception Behavior , Health Services Accessibility , Population Growth , Contraception , Family Planning Services , Statistics as Topic
11.
Arch Gynecol Obstet ; 257(1-4): 541-7, 1995.
Article in German | MEDLINE | ID: mdl-8579440

ABSTRACT

PIP: Only 40% of the 1.2 billion couples in reproductive age have access to effective contraceptive methods, although only $3.0 per couple per year would suffice for contraception worldwide. Abortions are performed for 40-60 million women annually. More than 200,000 women die as a result of abortions, and another 500,000 die due to labor complications. Contraception for women comprises the following: 1) agents that prevent ovulation; prolonged breast feeding (98% safe contraception within the first 6 months); oral contraceptives containing estrogens and gestagens (60-80 million women use them worldwide; in 1968 the 50 g estrogen containing pill, in 1972 the micropill with 30 g of ethinyl estradiol [EE], and in 1992 the ultra-low-dose pill with 20 g of EE were introduced); and future developments (third generation progestagens, antigestagens, nonsteroidal natural substances, melatonin, the combination of gonadotropin-releasing hormone analogs and natural estrogens); 2) prevention of fertilization: mechanical methods (diaphragm, sterilization methods by laparoscopy or chemical means); chemical methods (spermicides such as nonoxynol); behavioral methods (temperature methods using refined measurement of the body temperature, cervical mucus resistance); hormonal methods (implants such as Norplant containing levonorgestrel [LNG], Implanon containing 3-ketodesogestrel, the vaginal ring [the WHO-ring and the Organon ring], the minipill with pure gestagen, one-month injection with Cyclofem), IUDs (copper-containing IUDs, LNG-containing IUDs with a Pearl Index of 0.2-0.5 and reduction of dysmenorrhea); and immunological contraception (ovum and spermatozoon antigens); 3) the prevention of implantation: hormonal methods (the morning-after pill with high-dose EE or the combination of estrogen and gestagen); insertion of an IUD up to the 6th day after coitus; immunological methods (human chorionic gonadotropin antibodies, antibodies against the zona pellucida glycoproteins, implantation inhibition through interaction with interleukin IL-1 receptor, and antibodies against specific proteins of the endometrium influencing implantation). Contraception for men consist of the condom, vasectomy, coitus interruptus, and medical inhibition of spermiogenesis (testosterone ester and gossypol).^ieng


Subject(s)
Contraception/trends , Family Planning Services/trends , Population Control/trends , Contraceptives, Oral, Hormonal/administration & dosage , Female , Forecasting , Humans , Infant, Newborn , Intrauterine Devices, Copper , Intrauterine Devices, Medicated , Male , Pregnancy
12.
Contracept Technol Update ; 20(9): 110-1, 1999 Sep.
Article in English | MEDLINE | ID: mdl-12290379

ABSTRACT

PIP: The increased use of the contraceptive injectable Depo-Provera (depot medroxyprogesterone acetate or DMPA) poses a financial problem for health maintenance organizations. Providers are educating themselves about the use of complementary and alternative medicines to deal with this problem. The contraceptive survey conducted helps identify suitable alternative therapies. The survey shows that a number of health facilities are incorporating alternative therapies into their practice; these include herbal medicine and massage therapy. A 1997 national telephone survey of randomly selected households revealed that use of at least one of 16 alternative therapies increased to 42.1% from 33.8% in 1990. Among the 16 therapies are herbal medicine, massage, megavitamins, self-help groups, folk remedies, energy healing, and homeopathy. Health providers are trying to keep an open mind about these alternative therapies as they confront the problem of an escalating budget for DMPA.^ieng


Subject(s)
Contraception , Health Facilities , Medicine, Traditional , Medroxyprogesterone Acetate , Americas , Contraceptive Agents , Contraceptive Agents, Female , Delivery of Health Care , Developed Countries , Family Planning Services , Health , Health Services , Medicine , North America , United States
13.
Contracept Technol Update ; 20(8): 87-9, 1999 Aug.
Article in English | MEDLINE | ID: mdl-12295255

ABSTRACT

PIP: This article reports on a new single-rod progestin contraceptive implant (Implanon) produced by Netherlands-based Organon NV for market introduction in the US. While Organon considers the timing of Implanon's entrance in the federal Food and Drug Administration (FDA) approval process, Wyeth Ayerst Laboratories of Philadelphia has already FDA clearance in hand to market its two-rod levonorgestrel implant system. However, Wyeth Ayerst continues to conduct additional research. The company's research includes an assessment of potential design, with changes in the trocar insertion device for the two-rod implant being under consideration. Insertion and removal of the single-rod implant system is easier and quicker than with the original six-implant Norplant system. US clinicians and their patients are looking forward to the availability of Implanon.^ieng


Subject(s)
Clinical Trials as Topic , Consumer Product Safety , Desogestrel , Evaluation Studies as Topic , Marketing of Health Services , Americas , Contraception , Contraceptive Agents , Contraceptive Agents, Female , Developed Countries , Economics , Family Planning Services , Legislation as Topic , North America , Research , United States
14.
Homeopath Fr ; 73(5): 299-305, 1985.
Article in French | MEDLINE | ID: mdl-12281246

ABSTRACT

PIP: This work describes a study of the effects of combined oral contraceptives (OCs) on lipid biosynthesis in platelets of female rats and women. A highly significant hypercoagulability due solely to increased activity of platelet factor 3 can be observed in women using combined OCs. The phospholipidic nature of factor 3 has been demonstrated. Phospholipids are implicated in the aggregation of platelets because they are the essential constituents of the platelet membranes and the precursors of prostaglandins. Platelets actively synthesize their own lipids, and combined OCs modify serum lipid metabolism. In each experiment, a control group of rats weighing 180-200 g received .5 ml/g body weight of olive oil once daily for 4 days. 3 groups of experimental rats received .5 ml of olive oil containing 10 mcg of ethinyl estradiol (EE) and 250 mcg of lynestrenol or 10 mcg of EE alone or 250 mcg of lynestrenol alone per 100 g of body weight. The doses were the equivalent of 1/2 that required to block ovulation in adult female rats. Platelets were studied on the 5th day. In another experiment a group of rats was given a triple dose of EE and lynestrenol on the 1st study day. Platelets were studied on days 1, 3, 5, and 8. Lipid biosynthesis was studied by incorporation of carbon 14 labelled acetate and mevalonate precursors. Radioactivity was measured for the lipids as a whole and for different lipid fractions separated by chromatography. Incorporation of carbon 14 labelled acetate was augmented by 44.6% in animals receiving EE and lynestrenol and by 43% in animals receiving EE alone, but was not modified in animals receiving lynestrenol alone. In animals receiving a triple dose of hormones, incorporation was maximal on the 3rd day, diminished on the 5th day, and normal after 8 days. The EE component thus appears to be responsible for modifications in platelet lipid metabolism during OC use. The response appears after a latency period and seems to be irreversible, since the duration of life of platelets is 4-5 days. The increased synthesis occurs mainly in cholesterol and its precursors lanosterol and dihydrolanosterol. Supplemental in vitro experiments suggested that lanosterol was responsible for the increased platelet activity. 17 nonsmoking women aged 32 years on average who took no medications were compared to 18 women aged 30 years on average who took OCs with estrogen doses of 30-40 mcg for at least 6 months. As in the rat studies, lipid biosynthesis was analyzed by incorporation of carbon 14 labelled acetate or mevalonate in the platelets. Compared to control women, the women on OCs showed an augmentation of 37% in incorporation of mevalonate and 28% of acetate. The labelled acetate showed a higher incorporation at the level of each of the lipid fractions. Mevalonate showed the highest augmentation in the lanosterol fraction. 43% of the women taking OCs showed an increased platelet sensitivity to thrombine. The increased sensitivity was correlated with increased lanosterol synthesis, but the relation was only observed in women taking OCs. The phenomenon is of interest because of its possible relationship to the increased risk of thromboembolic accidents in women taking OCs.^ieng


Subject(s)
Blood Coagulation , Blood , Cholesterol , Contraception , Contraceptive Agents, Female , Contraceptives, Oral, Combined , Contraceptives, Oral , Disease , Family Planning Services , Lipids , Metabolism , Organic Chemicals , Platelet Aggregation , Research , Biology , Cardiovascular System , Cerebrovascular Circulation , Chemical Phenomena , Chemistry , Contraceptive Agents , Economics , In Vitro Techniques , Physiology , Technology , Thromboembolism , Thrombosis , Vascular Diseases
15.
Family Plan World ; 3(4): 7, 21, 1993.
Article in English | MEDLINE | ID: mdl-12288090

ABSTRACT

PIP: The discussion focused on the variations in purchasing agreements for the injectable Depo-Provera. Negotiations are in process between the manufacturer in the US (the UpJohn Company) and USAID regarding size of purchase, prices, and time schedules. A glitch is that the US production plant provides a two-year shelf life for the product, while the Belgian plants provide a three-year shelf life. The one year difference could be significant in the distribution to hard-to-reach places, but the balancing point is that USAIDs effort are a positive development for expanding distribution. The UN Population Fund (UNFPA) and the International Planner Parenthood Federation (IPPF) already distribute Depo-Provera and were charged 72 and 75 cents, respectively; UpJohn recently increased the prices to 80 and 85 cents. The UNFPA prices were slightly lower due to larger purchases, and both concerns will be awaiting the outcome of USAID's price negotiations. Other manufacturers are a company in Indonesia, which sells only within the country, and Organon in Holland, which produces the drug under the name Megstron. UpJohn has the major share of the market. The cost of supplying Depo-Provera also includes the purchase of needles and syringes. Other international agencies are not limited by anything other than finding the lowest cost. UNFPA buys its supplies in Belgium at low cost and its contraceptives in Holland. USAID, however, must purchase needles and syringes from American facilities. IPPF will be watching to assure international organizations that no duplication of effort will occur with the USAID distribution and expects the shelf life problem to be resolved. The issue may be cleared up when UpJohn has sufficient time to resubmit its application with enough research to support the 3-year shelf life; the FDA had rejected Depo-Provera repeatedly since 1961, and the approval was granted on a rushed application that only included some of the Belgian research and could empirically only support a 2-year shelf life.^ieng


Subject(s)
Commerce , Evaluation Studies as Topic , Government Agencies , Health Services Accessibility , Injections , Medroxyprogesterone Acetate , United Nations , Americas , Contraception , Contraceptive Agents , Contraceptive Agents, Female , Developed Countries , Economics , Family Planning Services , International Agencies , North America , Organizations , United States
16.
Integration ; (32): 16-8, 1992 Jun.
Article in English | MEDLINE | ID: mdl-12285550

ABSTRACT

PIP: The Turkish Family Health and Planning Foundation initiated the commercial marketing of contraceptives in 1989 as part of a Contraceptive Social Marketing (CSM) program to make available low-cost contraceptives. In 1988 modern methods were used by 31% and traditional methods by 32.3%, while 36.6% used no contraceptives. Only 6.2% were current pill users mainly because of health reasons since high-dose pills dominated the market. A 1990 survey among urban consumers indicated a 94% awareness of contraceptive methods, 76.1% of current use, and preference for the IUD. The side effects of the pill were cited for disliking it, and the condom was rated higher. The CSM project aims at popularizing low-dose pills by explaining the differences and benefits regarding high-dose pills. It collaborated with manufacturers: Schering, Wyeth, Organon, and Eczacibasi Ilac. In 1991 a TV and radio advertisement campaign started that involves the low-dose products Microgynon, Triquilar, Desolet, Lo-Ovral, and Tri-Nordial. The introduction of the Okey condom by Eczacibasi Ilac. In June 1991 also entailed extensive promotion with newspaper ads and TV spots after getting official permission. 1.3 million condoms were sold in the 1st 2 months in 13,000 retail outlets, and 4 million more were projected to be sold. A shift of the attitude of supermarket owners allowing stocking of condoms and the support of the Turkish Ministry of Health, USAID, and the Turkish Radio and Television Bureau has facilitated the CSM project implementation that will profoundly affect family planning in Turkey.^ieng


Subject(s)
Advertising , Condoms , Contraceptives, Oral, Combined , Contraceptives, Oral , Intrauterine Devices , Marketing of Health Services , Newspapers as Topic , Radio , Television , Asia , Asia, Western , Communication , Contraception , Developing Countries , Economics , Family Planning Services , Mass Media , Turkey
17.
ORGYN ; (1): 16-9, 1995.
Article in English | MEDLINE | ID: mdl-12288952

ABSTRACT

PIP: Since the advent of oral contraceptives (OCs) some 30 years ago, Japanese women have been receiving mixed messages about their safety. Dr. Shoichi Sakamoto, president of the Japanese Association of Obstetricians and Gynecologists, believes the time has come for Japanese women to decide on contraception. In Japan, the overall birth rate was 1.48 in 1992. As more women pursue higher education, the average age at first marriage has become 26 years. Almost 70% of Japanese women work, which definitely contributes to women having fewer children. The Equal Employment Opportunity Law has allowed for women to pursue a career, but it is still very difficult to raise children owing to the unavailability of maternity leave and lack of day-care centers. Some 60% of married women use some kind of contraceptive, of whom 3/4 use the condom. Half of the Japanese women who have had an abortion used the condom as a contraceptive. The number of abortions stood at 440,000 in 1991 and has been falling steadily every year, although an increasing number of teenagers and women in their forties have had abortions. The ratio of aborted pregnancies to total pregnancies is 18% among women in their twenties and 29% among women in their thirties, whereas it is 81.3% among women in their forties. In 1992, some 30% of married women had abortions and over 12% of these aborted more than twice. One reason is that Japanese women have become more sexually active. In the 1960s OCs were not authorized because of the potential long-term side effects. Research on the safety and efficacy of the OC was completed in the summer of 1992, but the government shelved the matter when in 1991 the number of HIV infections had increased by 250% over 1990 through heterosexual intercourse. Women must have a reliable means of contraception, and the authorities will be required to approve OCs.^ieng


Subject(s)
Abortion, Induced , Communication , Contraceptives, Oral , Employment , Evaluation Studies as Topic , Asia , Contraception , Developed Countries , Economics , Family Planning Services , Asia, Eastern , Japan
18.
Shengzhi Yu Biyun ; 10(1): 65-7, 1990 Feb.
Article in Zh | MEDLINE | ID: mdl-12316201

ABSTRACT

PIP: In order to study the effectiveness of different IUDs on women who had previously experienced IUD failure, 398 women were included in a clinical follow-up study using Multiload Cu 250 (MLCu) produced by Organon Company in the Netherlands, and VCu200 (VCu) produced in Shanghai, China. Among the cases, 85.6% experienced one IUD failure including 23.3% expulsion and 76.7% pregnancy with IUD in situ. 53 women had two IUD failures, and 4 had three failures. The accumulated continuation at the end of 12 months was 92.42% for MLCu and 91.41% for VCu. The accumulated expulsion at the end of 12 months was 5.07% for MLCu and 4.58% for VCu. Accumulated pregnancy with IUD in situ was 2.04% for MLCu and 1.02% for VCu. One woman using MLCu and 6 using VCu had the IUDs removed due to heavy menstrual bleeding. Age did not have a significant effect on discontinuation for either kind of IUDs. There is no significant difference on failure between the two groups, whether the IUD was inserted after menstruation or at the time of abortion. The effectiveness of these two kinds of IUDs is satisfactory. The problem of heavy bleeding resulted from VCu use needs to be solved. The insertion procedure of MLCu is relatively easy, while for VCu, it is more complicated and requires more skill. The study also showed that the expulsion of the VCu is associated with occupation and posture at work. Farmers and workers who squat a lot experience a higher rate of expulsion. Among the cases who have had one previous IUD failure, the effectiveness of these 2 IUDs is similar to that reported in the general population. While for those who have had two or more previous expulsions, the probability of another expulsion is significantly higher even with copper IUDs then in cases who had one expulsion.^ieng


Subject(s)
Contraception , Intrauterine Devices, Copper , Research , Rural Population , Asia , China , Contraception Behavior , Demography , Developing Countries , Family Planning Services , Asia, Eastern , Intrauterine Devices , Population , Population Characteristics
19.
ORGYN ; (3): 2-6, 1994.
Article in English | MEDLINE | ID: mdl-12345543

ABSTRACT

PIP: The views and background of the 1992 recipient of the Organon Family Planning Scholarship, the Egyptian El Mouelhy, were summarized; a report was also provided on the population views of Egyptian Dr. Maher Mahran, a professor of gynecology and obstetrics at Ain Shams University and director of the Egyptian National Population Council (NPC). El Mouelhy stated that the population problem in Egypt is a reflection of 98% of the population being settled on only 4% of the land area. The average number of children per family is 4, and the growth rate is 2.4%. Population growth is expected to reach 93 million, a doubling by 2025. Illiterates have the highest fertility; illiteracy in rural areas can be as high as 6.4%. Her solution is to rely on the cooperative efforts of government and nongovernmental groups to improve the status of women. Dr. Mahran reports that one goal of the NPC is to encourage redistribution of the population along the northern coast and Red Sea areas and to develop satellite communities outside Cairo. There are currently 14,000 societies in Egypt devoted to the goals of family planning and better health care for women and children. Local health motivators have also been successful at outreach. The location of the Third UN World Population Conference in Cairo this year is a positive impetus to the family planning effort. Egypt is the first Muslim country to reach 50% contraceptive use. NPC will be directing efforts to underserved rural areas. El Mouelhy on her return will be preparing a national population plan of action.^ieng


Subject(s)
Health Planning , Public Policy , Africa , Africa, Northern , Behavior , Developing Countries , Economics , Educational Status , Egypt , Family Planning Services , Middle East , Research , Social Behavior , Social Class , Socioeconomic Factors
20.
Plan Parent Chall ; (1): 35-8, 1994.
Article in English | MEDLINE | ID: mdl-12345740

ABSTRACT

PIP: By offering contraceptives at subsidized prices through pharmacies, drugstores, grocery shops, and other conveniently-located retail outlets, and promoting them with modern marketing techniques, social marketing programs can do much to reduce the unmet need for family planning. Users obviously benefit, while the family planning program benefits from advertising and marketing skills and some cost recovery. The Philippine Contraceptive Social Marketing Project (PCSMP) was formally launched in the Philippines in 1993 in response to the large unmet need in the country, and initial results are promising. The project was started with funding from the US Agency for International Development to provide affordable, quality contraceptives through the private sector to Filipino couples who choose to practice family planning. A 1988 survey found that only 22.4% of women aged 15-44 years were using modern methods of contraception and 13.8% were using traditional methods; approximately three million women therefore had unmet need for family planning. The PCSMP established an AIDS prevention component and a birth spacing component, enlisting the participation of oral contraceptive manufacturers Wyeth, Organon, and Schering, along with one condom distributor, Philusa. These companies lowered their product prices by 20% for the program. Despite objections from the Catholic church, sales of both oral pills and condoms increased in the first year. In its second year, the program will advertise Sensation condoms and the Couple's Choice Pills via television, through intensive distribution drives, consumer and trade promotions, and the continuous training of health professionals. The contraceptive injectable DMPA will be added to the Couple's Choice product line in April 1994. This method, too, will be heavily promoted.^ieng


Subject(s)
Condoms , Contraceptives, Oral , Delivery of Health Care , Health Planning , Marketing of Health Services , Private Sector , Research , Asia , Asia, Southeastern , Contraception , Developing Countries , Economics , Family Planning Services , Philippines
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