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PubMed2003

The use of family planning methods in an administrative district of Istanbul.

In Turkey, the first population and family planning law was accepted by the government in 1965, and this law was revised in 1982. This study was carried out to evaluate the family planning methods of women who applied to rural health centers of Küçükçekmece and were willing to use the health-care service and consultancy about birth control methods. The data of the study were gathered by means of an appropriate inquiry form and face-to-face interview with the women willing to use the family planning service between September 1998 and June 1999 at the health-care centers of Küçükçekmece of Istanbul. There were 699 women participants in the study. The last pregnancy of 27.2% (n = 175) of the women had been undesired; 86.8% of all the women who participated in the study declared that they did not desire any more children, but only 81.3% (n = 568) out of these were using a method to protect from pregnancy. The most frequently known (84.8%) and used (45.9%) method of the participants was an intrauterine device (IUD), and 80.8% of the women using an IUD wanted to continue using that method. A total of 223 women (39.3%) using any method protecting from pregnancy became pregnant. Approximately half (57.8%) of those occurred during the use of withdrawal. According to the findings of this study, the level of knowledge about family planning and the consequent behavior of the women within the fertile age group are better than the average of Turkey, but still not satisfactory.

Adult↗
PubMedDate not supplied

Introductory small cash incentives to promote child spacing in India.

The Ammanpettai Family Welfare Program began in 1985 as a pilot program to determine whether offering small monthly cash incentives for a limited period would be a cost-effective way to increase the use of modern temporary methods of contraception among rural Indian women who do not want to become pregnant but are not ready to adopt sterilization. The program has demonstrated that a modest cash incentive for 3-5 months attracts very large numbers of women to a clinic where they learn about and are provided with the pill, condoms, or the IUD. In catchment areas where official government reports showed temporary-methods prevalence rates of 3-5 percent at best, the Ammanpettai incentive program has attracted up to 70 percent of eligible women to join the program and try the method of their choice. By requiring that participants bring their youngest child to the clinic, the program provides for mother and child health surveillance, including immunizations. The great majority of rural women who join the program work as field laborers, have little or no schooling, and have little knowledge of or experience with modern contraceptive methods. Continuation rates are 25-50 percent at one year if follow-up is maintained by village resident women distributors. The program has been extended to several rural primary health centers in Thanjavur District, to 14 government health posts in the city of Madras, and to a semiurban area and several rural areas in Bihar. The cost-effectiveness of this program compares favorably with that of the current government family welfare program.

Adult↗
PubMedDate not supplied

Public funding of contraceptive, sterilization and abortion services, fiscal year 1990.

In FY 1990, the federal and state governments spent $504 million to provide contraceptive services and supplies, according to results of a survey of state health, social services and Medicaid agencies conducted by The Alan Guttmacher Institute. Medicaid accounted for 38 percent of all public funds spent on contraceptive services, Title X provided 22 percent, and two federal block-grant programs--Social Services and Maternal and Child Health--together were responsible for 12 percent of public expenditures. State governments accounted for the remaining 28 percent of public funding. Although public expenditures for contraceptive services have risen by $154 million over the past decade, when inflation is taken into account, expenditures have actually fallen by one-third. Since 1980, the proportion of public contraceptive expenditures contributed by Title X has been cut virtually in half, while the proportion contributed by state governments has nearly doubled. When inflation is taken into account, Title X expenditures for contraceptive services have fallen by almost two-thirds since 1980. The federal and state governments together spent $95 million to subsidize sterilization services in 1990, and $65 million to provide abortion services. The federal government was the major source of funding for sterilization services but provided less than one percent of the cost of abortion services. Because of changes over time in survey methodology and the difficulties some states had in separating out expenditures by type of care, these data are approximations.

Abortion, Legal↗
PubMedDate not supplied

Marriage law and practice in the Sahel.

The legal systems of Sahelian African countries combine customary law, Islamic law, French colonial law, and civil law introduced since independence in 1960. Utilizing a framework developed by the Faculty of Law, University of Dakar, Senegal, and the Development Law and Policy Program, Center for Population and Family Health, Columbia University, the Sahel Institute undertook a comprehensive study of the legal and social status of women in Burkina Faso, Mali, Niger, and Senegal. Since 1960, Burkina Faso, Mali, and Senegal have replaced French family law with national marriage codes. Niger has not yet adopted a family code; the laws on the family inherited from the French remain in force. The postindependence marriage codes have attempted to give young women more say in choosing a husband, to regulate the practice of bride price, and to limit the practice of polygyny. They have done this by integrating customary law and government-passed civil law. Mali, Niger, and Senegal have repealed provisions in their codes prohibiting the distribution of contraception, based on a 1920 French law. Although it has taken no formal legal action, Burkina Faso has adopted family planning policies that effectively nullify the 1920 law.

Burkina Faso↗
PubMed1991

New Jersey high school students' knowledge, attitudes, and behavior regarding AIDS.

In 1988 a questionnaire was administered to 1,793 urban and suburban New Jersey high school students to survey their knowledge, attitudes, and behavior related to the acquisition of acquired immunodeficiency syndrome (AIDS). Knowledge about the disease was high, but exaggeration of risk from social contacts was common. Although fear was associated with misperceptions, it was not always dispelled by knowledge. Nearly half (49%) of all participants reported having used condoms, indicating that condom use is somewhat familiar and acceptable to them. Over 80% thought that condoms offer some protection against AIDS. However, knowledge did not always result in recognition or practice of risk-reduction behaviors. Student suggestions for slowing the spread of AIDS stressed personal responsibility and education. Follow-up assemblies that used survey results to address gaps in knowledge appeared necessary to counter misperceptions that might have arisen from the survey.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Consent requirements for treatment of minors.

The American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the Nurses Association of the American College of Obstetricians and Gynecologists, and the National Medical Association recently released guidelines aimed at protecting the privacy of adolescent patients. The organizations stated that, in many cases, young people will not confide in health professionals if the young people feel that these discussions will be reported to their parents. Ultimately, the organizations said, health risks to adolescents are so impelling that legal barriers and deference to parental involvement should not stand in the way of needed health care. In Texas there is a statute regarding consent for medical treatment of minors, which responds to the above organizations' concerns about confidentially treating children for substance abuse, sexually transmitted diseases, and suicide prevention. However, the statute is silent in regard to medical treatment involving prescription contraceptives. By negative inference, the statute would preclude a minor on her own from making a decision about abortion. This article examines Texas statutes dealing with consent for medical treatment for minors and discusses US Supreme Court decisions on a minor's rights to abortions and contraceptives.

Abortion, Spontaneous↗
PubMedDate not supplied

First family planning visits by young women.

Data from the 1982 National Survey of Family Growth indicate that among sexually active women aged 15-24, friends and parents are the main sources of referral for first family planning visits. Friends are the leading referral source for women who attend clinics, and parents are the leading referral source for those who go to private doctors. Despite the importance of confidentiality to many teenagers, women who make their first family planning visit before the age of 17 are more likely to be referred by their parents than are those whose first visit occurs when they are 17 or older. Race, age at first visit and income influence women's choice of a provider (clinic or private doctor). Black women, low-income women and younger women are considerably more likely than their counterparts to use a clinic at first family planning visit. At their first visit, sixty-seven percent of women receive birth control counseling, and only 50 percent begin using a contraceptive method. Among clinic users, white women are more likely than black women to begin a birth control method (50 percent vs. 40 percent). Women whose first visit takes place before their first conception (including those who have never been pregnant) are much more likely than women whose first visit occurs after their first pregnancy ends to begin a method. Women who make their first visit during their first pregnancy are more likely than those who are not pregnant to receive a pregnancy test or counseling on matters other than birth control.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

The availability of reproductive health services from U.S. private physicians.

Data on the provision of seven types of reproductive health care were collected from private physicians in four specialties: general/family practitioners (GP/FPs), general surgeons, obstetrician-gynecologists and urologists. All ob-gyns, and eight in 10 GP/FPs, provide the pill, IUD or diaphragm. Over nine in 10 ob-gyns provide infertility and obstetric care and prenatal genetic screening; but only one-third or fewer of GP/FPs do so. Ob-gyns and urologists are far more likely to perform sterilizations than are GP/FPs and surgeons (nine in 10, compared with one-fifth to one-half). Although ob-gyns are the most likely to perform abortions, only four in 10 do so. Among ob-gyns who do not perform tubal sterilizations or abortions, and among urologists who do not perform vasectomies, the primary reason is moral or religious objections (reported by 59-71 percent). For GP/FPs and surgeons who do not perform the three procedures, the leading reason is that they do not perform surgery or that type of surgery; however, 34 percent of nonproviders in these specialties report moral or religious opposition to abortion. Eight in 10 ob-gyns will provide contraceptives to minors without parental consent, but only six in 10 GP/FPs will do so. One-half of doctors who perform female sterilizations, and eight in 10 of those who do vasectomies, require spousal consent. Among those who perform abortions, half require parental consent for minors. Access to private reproductive health care is quite limited for the poor, because many physicians will not accept Medicaid reimbursements or reduce their fees for low-income patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Legal↗
PubMed1977

[Etiology of perioral dermatitis].

The studies of Röckl und Schubert supported the theory that fusobacteria are often found in perioral dermatitis. When we characterize perioral dermatitis as fusobacteriosis, we do not have any doubt that fluorinated corticosteroids represent a very important pathogenetic factor. Corticoids enable opportune fusobacteria to become pathogenic. In our opinion without these bacteria the beginning of the perioral dermatitis seems impossible. Other supporting causes, which are relevant to sex distribution (oral contraceptives, moisturizing creams) are described.

Contraceptives, Oral↗
PubMed1983

Laparoscopy in women with chlamydial infection and pelvic pain: a comparison of patients with and without salpingitis.

A review was made of clinical and laboratory findings in 104 women who, during 1978 to 1981, were subjected to laparoscopy because of symptoms suggestive of acute salpingitis, and who harbored Chlamydia trachomatis but not Neisseria gonorrhoeae in the genital tract. The patients with acute salpingitis (N = 76) did not differ significantly from those with visually normal fallopian tubes (N = 28) in regard to age distribution, parity, contraceptive method used, proportion of women with urethritis symptoms, increased vaginal discharge, vomiting, diarrhea, elevated rectal temperature, elevated white blood cell count, and palpable pelvic masses. The acute salpingitis patients more often had irregular bleeding and an elevated erythrocyte sedimentation rate, whereas the patients without acute salpingitis more often had a short history of pelvic pain. The two groups overlapped considerably with respect to the number of symptoms and clinical signs of pelvic infection. The results emphasize the value of laparoscopy in the diagnosis or exclusion of a tubal infection in association with a chlamydial genital infection and pelvic pain, even if there are comparatively few additional symptoms of ascending infection.

Chlamydia Infections↗