The quality of abortion services in Turkey.

The quality of abortion in Turkey's public sector hospitals is investigated using multiple research methods including observations of actual procedures, interviews with medical staff and clients, and an inventory of materials and equipment. The results suggest that women who obtain abortions in public sector hospitals have a higher abortion rate than the general population. They are likely to receive a vacuum aspiration with minimal pain control medication. Clinical infection control procedures are insufficient, as are interpersonal communication practices including counseling on reproductive health issues and providing factual information. Links with family planning services are strong and the majority of abortion patients who desire family planning receive a contraceptive method, either through direct provision of postabortion contraceptives or referral.

Operational research for an effective information and training approach for surgical contraception knowledge and attitude in Turkey.

PIP: Although 70% of all currently married women in Turkey state that they do not want to have any more children, only 34.5% use modern contraceptive methods and 28.1% use traditional methods such as withdrawal. Women in Turkey have 17 induced abortions for every 100 pregnancies. Voluntary surgical contraception (VSC) was legalized in 1983, but it was inadequately and poorly presented to the public as a viable contraceptive option. VSC is therefore less well-known than other contraceptive methods. The 1993 Turkish Demographic and Health Survey and the 1988 Turkish Population and Health Survey found that only 1.3% of couples in Turkey used tubal ligation and/or vasectomy in 1983, 1.8% in 1988, and 2.9% in 1993. A study was conducted in the Etimesgut and Golbasi districts of Ankara, rural and semi-rural areas which consist of 27 villages, to identify the most effective information and education approach to increase knowledge and change attitudes toward surgical contraception. 850 of the 1176 couples included in the intervention study were accessible for the follow-up study. The following approaches were applied to three intervention groups: wives were informed by a midwife, husbands were informed by a male health officer, and both were informed concurrently by the respective trainers. Increase in knowledge scores on surgical contraception was higher in groups in which women were trained directly. However, although the scores of knowledge increased, the training intervention caused no significant change in attitude.^ieng

[Is adolescent fertility a problem in Turkey?]. / Turkiye'de gencler arasinda dogurganlik bir sorun mudur?

PIP: The population of Turkey was about 50 million in 1985, and the 15-19 age group was 5.5 million, 10.7% of the total population. Almost half of this 5.5 million were females, the mean age at first marriage was 18.2 years and 15.6% of this group were married. The fertility rate of the 15-19 age group was 64.1 per thousand. These figures show that early marriage and early pregnancy are the main problems. The prenatal care in adolescent pregnancies which present high risks for the mother and the child usually starts in the last trimester (average: 7.15 months) and 31.6% of the deliveries take place under unsuitable conditions. The use of contraceptives in this age group is 34.5% (23.4% traditional methods, 11.1% modern methods). The main solution of the problem, that is, adolescent pregnancy, is increasing the age at first marriage. But until this goal is reached, for healthier mothers and children, prenatal care should be given earlier in adolescent pregnancy and deliveries should take place under the supervision of health personnel. (author's)^ieng

[An epidemiologic study of the antibiotic susceptibility of bacteria isolated from patients with urinary tract infections]. / Uriner sistem infeksiyonlarindan izole edilen bakterilerin antibiyotik duyarliliklari ile ilgili epidemiyolojik bir çalisma.

This epidemiological Study is held in Saglik Sosyal Yardim Bakanligi--Hacettepe Universitesi Tip Fakültesi Cubuk Research and Training area to find out the prevalence of urinary tract infections and to determine the antibiotic susceptibility of the causitive organisms. The prevalence of urinary tract infections in the area is 10%. E. coli is the most frequently isolated bacterium (40%). Amikacin, Cephotaxime, and Ofloxacine are the most effective antibiotics.

Can midwives be trained to insert IUDS? Results from Turkey.

PIP: Beginning in the 1960s, the Turkish government placed a emphasis on the importance of family planning in an effort to improve maternal and child health (MCH) services. While the IUD has proven adequate for women in Turkey, insertion and proper use have created problems. The IUD program has had difficulty in gaining the acceptance of male physicians in Turkey, and because there are few female physicians in the country, a problem with implementation of the program arose. 1 solution suggested that non-physician personnel learn to insert the IUD and be able to examine IUD patients. Assistant nurse-midwives were surveyed in a 3-phase project carried out by the staff of the Department of Public Health of Hacettepe University in Ankara with WHO. In the 1st phase, a training method was created with competence comparison of the assistant midwives to physicians following in the 2nd phase. The 3rd phase of the project studied the use of non-physician services throughout the country. It was found that assistant nurse-midwives were equally capable of IUD insertions and check-ups and that IUD services can now reach rural areas of the country beyond the range of traditional medical services.^ieng