SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Over the past 30 years, family planning programs have helped millions of people to have the smaller families that they want. As programs have learned how to meet people's needs, contraceptive use has spread rapidly.
Interviews wih women in six villages in India and with educated, working women selected to be trained as interviewers in five states, and evidence from formal studies are discussed to support the conclusions that (1) the low overall rates of contraceptive use in India are at least partly due to low levels of knowledge about different methods of birth control, especially of the modern reversible methods; and (2) the low use of all methods except sterilization is a good proxy for lack of knowledge about these methods. It is suggested that, both in the interests of achieving demographic targets and in the interests of the clientele of the family planning program, much greater emphasis must be placed on spreading practical information about reversible contraception. The information dissemination activities of the program so far have tended to concentrate on the why of family planning and neglect the how, except in promoting sterilization.
The 1985 Jordan Husbands' Fertility Survey (JHFS) was designed to assess husbands' attitudes and behavior toward fertility and family planning. The 1985 JHFS was a follow-up survey to obtain data from husbands of women who were currently married in the 1983 Jordan Fertility and Family Health Survey (JFFHS). The results from the 1985 JHFS point to the usefulness of collecting fertility and family planning information from husbands. These findings showed that nearly 40 percent of the husbands do not believe in practicing contraception, and more than 50 percent of the husbands report that family size should be "up to God." How program officials address these issues will be important for the future success of the family planning program in Jordan.
A methodology previously used to calculate the number of unintended pregnancies averted nationally through publicly funded contraceptive services has been adapted for a state-level analysis in California. An estimated 136,800 unintended pregnancies--which would result in approximately 36,000 births, 85,100 abortions and 15,700 miscarriages--are averted each year because publicly funded contraceptive care is available from clinics and private physicians in California. Federal and state expenditures of $46 million for contraceptive services in California in FY 1989 resulted in an estimated savings of $232-$509 million in public costs for abortions, for prenatal and maternity care and for medical care, welfare and supplementary nutritional programs during the first two years after a birth. These savings represent an average of $7.70 saved for each dollar spent to provide contraceptive services. This savings/cost ratio is 75 percent higher than that previously estimated for the United States as a whole.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Sex differences in the delivery of fertility control services were explored in a national survey of 1420 recently trained obstetrician-gynecologists in active practice. Women were found to be more likely than men to provide abortion services but less likely than men to provide amniocentesis and certain infertility services. Women were found to contribute less than their proportionate share of two services for which volume was measured: artificial inseminations and sterilizations. Physician gender, however, was a less important predictor of volume of sterilizations delivered than were a set of practice-related variables. Overall our findings suggest that the increased representation of women among obstetrician-gynecologists could influence the delivery of a few specific services.
This study examines contraceptive delivery characteristics and their association with contraceptive behavior. Data were collected in telephone interviews from a national sample of 1057 women who were using female contraceptives. The overwhelming majority of the sample obtained contraceptive services from gynecologists and other physician specialists and were seen in private facilities. Whereas nearly half of the providers recommended use of specific methods, only one-fourth discouraged use of particular methods. The pill was both the most frequently recommended and most commonly discouraged method. With regards to the provision of contraceptive information, practitioners were most likely to discuss the effectiveness of a method. In three of the four categories examined, a higher percentage of non-MDs than MDs gave information to their patients. Although the majority of women reported they were satisfied with the quality of care, mean satisfaction ratings were higher for female providers compared to male providers.
A new contraceptive clinic for teenagers was developed in the centre of Nottingham from 1987 to 1992 and provided care for over 1500 young people in its first three years. Twenty-five percent of clients were aged 16 years and 32% aged 15 or younger. Sixty-seven percent were in full-time education and young unemployed people were under-represented. The majority were young women, who came for routine contraception, usually the oral contraceptive or condom. Seventeen percent came for emergency contraception and 8% for abortion counselling and referral. Over the period 1986 to 1992, data on conceptions for teenage women and women aged over 20 years, who were resident in Nottingham Health district, were compared and when corrected for the estimated population showed that there had been no reduction in teenage conception rates; reasons for this are discussed. The value of conception rates as a measure of quality of sexual health care for teenagers is questioned and other more qualitative methods suggested.
Little attention has been paid to the diaphragm as a contraceptive option for adolescents. To compare diaphragm and birth control pill use by adolescents, 124 females (aged 13-20 years) in a suburban-based adolescent health service were interviewed at least one year after receiving a contraceptive prescription. The 73 diaphragm choosers did not differ from the 51 pill choosers in age, race, or reason for their original visit to the health service. Diaphragm choosers, however, were better students, of higher socioeconomic status, and had had fewer prior pregnancies. In the year following prescription, continuous use for 12 months was reported by 43% of diaphragm choosers and 45% of pill choosers, with significantly more pill (26%) than diaphragm (8%) choosers reporting discontinued use for at least one month while remaining sexually active. Regular use (diaphragm every intercourse, missing less than or equal to 1 pill/month) was reported by 36% of diaphragm choosers compared to 88% of pill choosers; and at least one pregnancy during the year was reported by 15% of diaphragm choosers and 18% of pill choosers. At follow-up interviews, diaphragm subjects disliked the immediate annoyances of the diaphragm, and pill users expressed concern about the potential side effects of the pill. No single factor or set of factors correlated with continuous and regular use of either method. Because both methods present specific problems for certain patients, we suggest that in addition to the pill, the diaphragm should receive serious consideration as a contraceptive option for adolescents.
We evaluated whether family planning counseling (FPC) in an adolescent clinic promoted the onset of sexual activity among the non-sexually active teens and/or increased contraceptive use among the sexually active teens. The FPC focused on the teens' establishing sexual values, the right to say "no," abstinence and alternate forms of intimacy, consequences of intercourse, and the various contraceptive methods. Data for one year were collected on the adolescents' first and subsequent visits to a medically oriented, municipal outpatient adolescent clinic. There were 383 teenagers who qualified for the study. Of these, 35% (134) reported premarital sexual activity. During the study period, 3% (8) of the 249 nonsexually active teens reported becoming sexually active. Among the 134 sexually active teens at clinic entry, 27% reported using a contraceptive method at their most recent sexual encounter. Among the 142 sexually active adolescents at the conclusion of the study, 76% reported contraceptive use at their most recent sexual encounter (p less than 0.001). We conclude that the provision of FPC to nonsexually active and sexually active teens does not appear to promote the onset of sexual activity significantly among the non-sexually active group, although it significantly increases contraceptive use among the sexually active group.
One hundred thirty-five young, black, inner-city, pregnant women assessed the usefulness of a videotape designed by community health nurses to increase the self-care practices of low-income minority women with regard to their prenatal, pediatric, and family planning health needs. Seventy percent of the women rated as very useful information on the availability of health care and the protocols of public health clinics. The women also stated that they would tell others about public health care services and intended to make use of these services themselves as a result of viewing the videotape. The viewers' responses help clarify the preferred modality, content, and length of patient education for medically and socioeconomically high-risk pregnant women who tend to underuse preventive and primary health care.
Out-patient sterilization services were introduced by the Family Planning Clinic of the Department of Obstetrics and Gynaecology, College of Medicine, Lagos, in September, 1981. This paper reviews the results of the first five years of its availability. There were 96 out-patient interval sterilizations, 47 were by the laparoscopic and 49 by the minilaparotomy procedures, representing 0.7% of maternities. Both local and general anaesthesia was used for the procedures. The patients' ages ranged from 28-52 years, all but three being above 31 years. Their parity ranged from 2-15 with between 2-10 living children. Only five patients had less than four children. 37.5% had used no contraception before. Termination of pregnancy was performed at the same time as tubal ligation in 12.5%, and 75% of these were secondary to contraceptive failure. Three patients had emergency laparotomy although in only one was it related to the sterilization procedure. Three patients were observed for 24 hours with no complications. Two patients were re-admitted after one week with pelvic peritonitis. The major complication rate was 3.1%. The failure rate was one per cent. There have been no requests for reversal. The results are compared with those of patients having puerperal sterilization during the same period, who totalled 2% of the maternities.
Explore the source record for details and available documents.
Data were collected on abortion referral rates, single young maternity rates and uptake of contraceptive services in order to identify specific areas of unmet need in the Nottingham Health District. Comparisons were made between boroughs and in the City of Nottingham between electoral wards. There was a direct relationship between abortion rate, single young maternity rate and social disadvantage. Analysis of contraceptive usage suggested a more ineffective service in the inner city, which has implications for the more efficient use of resources in the future. Targeting of consumer acceptable services to residents of the inner city and teenagers in general was recommended as a result of the study. For future planning a more useful routine data set was developed to record the activity at family planning clinics.
Explore the source record for details and available documents.
Adolescents are assuming greater responsibility for their own health care, yet have a high rate of broken appointments. The importance of satisfaction with their health care in determining appointment compliance has been demonstrated for adult patients. The purpose of the present study was to explore patient satisfaction among teenagers and its relationship to appointment keeping. A short, reliable instrument was developed to assess adolescent patients' satisfaction with their clinic care. The patient's satisfaction was highly correlated with subsequent compliance in coming for appointments. Satisfaction, hence, appointment keeping, was higher in females, older adolescents, those making their own initial clinic appointment, those with a positive body image, and those scoring high on a test of personal freedom.
Explore the source record for details and available documents.