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PubMed1991

Survey report: Jordan.

Preliminary results from the 1990 Jordan Population and Family Health Survey show a 20% decline in fertility since the early 1970s. The total fertility rate (TFR, or average lifetime births/woman) declined from 7.7 births in the 1971-1975 period, to 6.6 in 1980-1983, to 5.6 in 1987-1990. A national sample of 6462 evermarried women of childbearing ages were interviewed. More than 1/2 (58%) of respondents had ever used a method of contraception. 35% of married women reported currently using some method of contraception, up from 26% in 1983. The IUD was the most popular modern method--used by 15% of women. Female sterilization (6% of respondents) edged out the pill (5%). These findings show a shift in contraceptive use from the pill to the IUD and female sterilization compared with 1983. In general, older women, those living in big cities, women with a formal education, and those who have children are more likely to use contraception. Compared with other countries, the level of fertility in Jordan is high for the level of contraceptive use. Reliance on traditional methods may account for this difference: 27% were currently using modern methods and 8% traditional. Knowledge of contraceptive methods is high. Almost all women knew of at least 1 method of family planning, either modern or traditional. The pill and IUD were the best-known methods; 98% of the women knew at least 1 of these. The next best-known were traditional methods: periodic abstinence (77%) and withdrawal (69%). Most women who knew a family planning method also knew where to obtain it. For example, more than 94% of those surveyed knew about female sterilization, of whom 85% knew where to go to have it done. The survey showed infant mortality in Jordan had declined to 27/1000 livebirths. Almost all children under 2 had received some vaccinations, and almost all are breastfed for at least some time. There seems to be a strong program prompting diphtheria/pertussis/typhoid, polio, and measles vaccination in Jordan, according to the report. Of all children 12-23 months, 88% had received these vaccinations, although coverage declined with successive doses.

Asia↗
PubMed1993

3-month contraceptive injection approved.

FDA has approved medroxyprogesterone acetate as Depo Provera Contraceptive Injection, effective for 3 months in preventing pregnancy in women. In clinical studies, the drug's failure rate was less than 1%. However, physicians must ensure that patients receive injections on schedule to prevent pregnancy. The recommended dose is 150 mg administered every 3 months by deep, intramuscular injection in the gluteal or deltoid muscle. Most women in clinical studies of Depo Provera experienced menstrual irregularities. As use continued, amenorrhea became common, reported by 57% of the women by the end of a year of treatment. Other side effects included weight gain, headache, nervousness, abdominal pain or discomfort, dizziness, and asthenia. Physicians should administer the drug only to women found not to be pregnant, because fetal exposure may lead to low birth weight and other problems. Recent data have demonstrated that longterm use may contribute to osteoporosis, and the drug's manufacturer, the Upjohn Company of Kalamazoo, Michigan, will conduct additional research to study this possible side effect. Contraindications are similar to those for other contraceptives and include undiagnosed vaginal bleeding, known or suspected malignancy of breast, thromboembolic disorders, cerebral vascular disease, and liver dysfunction. Depo Provera was developed in the 1960s and has been approved for contraception in many other countries. When FDA first reviewed data on the drug in the 1970s, animal studies raised questions about its potential to cause breast cancer. Since then, longterm controlled clinical studies in other countries have shown a risk of breast cancer comparable to oral contraceptives, and no increased risk for ovarian, liver, or cervical cancer. The studies also showed that the contraceptive injection reduced the risk of endometrial cancer. FDA approved the drug October 29, 1992.

Contraception↗
PubMedDate not supplied

Evaluation of Norplant use among Bangladeshi women.

Among 600 women in Bangladesh who initiated use of Norplant, 38% still had their implant at the end of its 5-year life span. To evaluate the contraceptive effectiveness, safety and acceptability of the implant, researchers recruited 200 women from each of 3 clinics in Dhaka who began using the method in 1985. Most of the participants were young (mean age 27), had had little or no formal education and had had an average of 3.4 live births. Participants were followed up at 1, 3, and 6 months after insertion, then every 6 months after insertion, then every 6 months until removal. The 5-year study was completed by 228 (38%) participants; 31 were lost to follow-up. 2 pregnancies were reported during the study; these were believed to have occurred prior to insertion of Norplant. Of the 340 removals during the course of the study, 45% were requested because of menstrual problems, 15% because of other side effects or medical reasons, 20% because the women desired the pregnancy and 20% for other personal reasons. Most of the women (86%) who completed the study planned to continue using a contraceptive method; of these, one-third planned to use Norplant again.

Asia↗
PubMed1965

Conception control.

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Contraception Behavior↗