The impact of contraceptive side effects on family planning use among female clients of the public health services in Jamaica

OBJECTIVES: To examine (i) the experience of contraceptive side effects among women (ii) the role of side effects in method continuation, and (iii) the counselling regarding such side effects. METHODS: The study consisted of 463 women who utilised public health centres and were either new users of contraceptives or were switching contraceptive methods. They attended government health centres in Kingston and were recruited over a two-month period in 1998 and followed for 1 year. All follow-up interviews were done at the women's homes and complete interviews were obtained for 323 women. Information was collected about socio-economic characteristics, contraceptive history, service factors, experience with method and length of use. RESULTS: Forty-eight per cent of the women experienced side effects with the method accepted on recruitment to the study. Common side effects were irregular bleeding/no period, headaches, nausea/dizziness and weight gain/loss. The side effects occurred mainly among pill and injection users. The occurrence of side effects had a significantly negative impact on continuation rates. Forty-seven percent of women stated that they had received counselling regarding side effects. CONCLUSIONS: The level and impact of side effects among family planning acceptees at public health centres in Jamaica is of significance to the public health family planning programme. Method choice needs to be widened and counselling needs to be improved to ensure that women make informed choices about contraception.(Au)

Patterns of contraceptive use among female clients utilizing the public health services in Jamaica

OBJECTIVE: To determine the factors which influence continued use of a family planning method. DESIGN AND METHODS: Primary data were collect from 463 women utilizing the public health services in Kingston, Jamaica. The women were interviewed at six-mon th intervals during one year to determine their patterns of contraceptive use. They were recruited fro eight health centers. RESULTS: The overall continuation rate of the sample of respondents at the end of 3 months, 6 months, 9 months and 12 months were 90 percent, 70 percent, 60 percent and 56 percent, respectively. The short- term method with the highest continuation rate (65 percent) was the injection; the pill registered the lowest continuation rate (39 percent). A respondent was more likely to use a family planning method if her partner was in favour of contraception. She was likely to continue if the method was the condom or the pill. CONCLUSION: The use of the injection should be encouraged in order to improve overall continuation rate. Efforts should be made to include the partner in the counselling of a female client.(AU)

A profile of health research in Jamaica 1991-1995

A profile of health research in Jamaica between 1991 and 1995 was prepared in order to examine research capacity and needs as part of the process of promoting essential national health research. Of 43 organisations and research groups surveyed, 29 met the criterion of at least one peer reviewed publication between 1991 and 1995, and there were 201 health researchers. Most of the research groups had fewer than 20 professional staff with less than 10 enagaged in health research. Institutional objectives and funding opportunities largely determined research priorities. 704 research papers were published over the period with 10 of the organisations responsible for 469 (66.6 percent). The number of research papers is overestimated because the same paper may be reported by more than one research group due to multiple authorship. On the whole, local research groups appear to be small, vulnerable, under-funded and deficient in basic equipment as well as trained and experienced researchers and support staff. These are compelling reasons for health researchers to come together to tackle common problems, promote collaboration and forge a joint strategy to strengthen health research capability in Jamaica. (au)

A profile of health research in Jamaica 1991-1995 - abstract

A Profile of health research in Jamaica 1991- 1995 was prepared. Of 43 organizations or research groups surveyed, 31 met the criteria of at least one peer review publication between 1991 and 1995. Most had fewer than 20 professionals staff, and less than 10 engaged in health research, with a total of 227 health researchers. Institutional objectives and funding opportunities largely determined research priorities. A total of 704 research papers were published over the period with one-third (10) of the organizations responsible for 459 or 65 percent of all publications. On the whole, local research groups appear to be small, vulnerable, under-funded and deficient in basic equipment as well as in trained and experience researchers and support staff. These are compelling reasons for health researchers to come together to tackle common problems, promote collaboration and forge a joint strategy to strengthen health research capability in Jamaica(AU)

Setting health research priorities in Jamaica: a preliminary review

An Essential National Health Research (ENHR) strategy calls for the strengthening of the links between research, policy and action. The setting of research priorities should be a collaborative effort of policy makers and researchers. This study forms part of the ENHR process in Jamaica. Using data collected by the ENHR Task Force, the current research foci and publications (1980-1995) of 45 health research institutions were reviewed. Secondary data analysis was carried out to examine the health research priorities documented by 23 organizations (international, local governmental and non-governmental) in Jamaica. A health situational analysis was conducted in order to provide a contextual base for the discussion. The study showed that research is indeed influenced by the current health situation in the country. Ten research priorities were identified from this preliminary review. They were: (1) poverty and health; (20 chronic diseases; (3) infant mortality; (4) sexually transmitted diseases; (5) maternal and child deaths; (6) violence and accidents/injuries; (7)identification of gaps in the provision of basic services; (8) data on all health indicators; (9) health sector administration/health policy; (10) reproductive health. These priorities are relevant given the current health situation in Jamaica. However, there were some research gaps. Two of them were; (1) health financing and health economics; and (2) research on healthy lifestyles with a focus on how to change individual attitudes and behaviour (AU).

Is there a relationship between socioeconomic factors and self-reported illness? The case of St. Lucia

Much research in the developed world has attested to the regularity with which a relationship exists between health status and socioeconomic status. There is a dearth of such research in the Caribbean. This paper reports on some of the findings of a household sample-based survey carried out in St. Lucia in 1990. A total of 2 219 respondents from 510 households throughout the country were interviewed. In the study, poor health status was measured by the presence of a self-reported illness/injury in the last three months and/or a permanent disability. In this paper, health status is measured only by self-reported illness/injury. Socioeconomic status was measured by age, sex, total household expenditure (a proxy for income), education and occupation. The relationship between self-reported illness/injury and socioeconomic status was examined. Generally, those at the bottom of the socioeconomic ladder recorded worse health status. Those in the highest educational category and occupational group had the largest proportion of ill respondents (17.4 percent) and (47.5 percent), respectively. More women (19.3 percent) than men (16.6 percent) reported illness. Illness increased with age with the youngest (0-4 years) and the oldest (65-years and older) having the largest proportion of ill persons among their members; 28.3 percent and 35.3 percent, respectively. The data findings showed that access to health education, the use of preventive health care measures and a difference in definitions of "illness" account for the variation in the incidence of illness/injury among the educational and occupational groups. The presence or absence of permanent disabilities should also be used with clinical verifications, wherever possible, to measure health status (AU)

Health and socioeconomic status in St. Lucia

This dissertation examines the relationship between health status and socioeconomic status in St. Lucia. Data for the study were collected during a nationwide survey carried out in St Lucia in 1990. Using bivarite and multivariate analyses, the pattern of relationship between health and socioeconomic status was examined and defined. The analyses showed that there was a persistent pattern in the relationship between health and socioeconomic status generally, the higher the socioeconomic status of an individual, the better the health status. Recognizing that the link between health and socioeconomic status is the access to health facilities, the accessibility and utilization of the private and public health facilities by the various socioeconomic groups are also examined. The study reveals that the disadvantaged socioeconomic groups generally have more diabilities, possess less access to better quality care and utilize the public health care facilities more than the other socioeconomic groups. The study ends with some guidelines for future research in the Caribbean. (AU)

Health and socioeconomic status in St. Lucia

This dissertation examines the relationship between health status and socioeconomic status in St. Lucia. Data for the study were collected during a nationwide survey carried out in St Lucia in 1990. Using bivarite and multivariate analyses, the pattern of relationship between health and socioeconomic status was examined and defined. The analyses showed that there was a persistent pattern in the relationship between health and socioeconomic status generally, the higher the socioeconomic status of an individual, the better the health status. Recognizing that the link between health and socioeconomic status is the access to health facilities, the accessibility and utilization of the private and public health facilities by the various socioeconomic groups are also examined. The study reveals that the disadvantaged socioeconomic groups generally have more diabilities, possess less access to better quality care and utilize the public health care facilities more than the other socioeconomic groups. The study ends with some guidelines for future research in the Caribbean.