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ORIGINAL ARTICLE. Family Planning in a Family Health Unit. Luzia Aparecida dos Santos PierreI; Maria José ClapisII. INurse-Midwife, Master's Student in.
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The new data systems will use standard metrics and provide reliable data at the national and sub-national levels. Better data and monitoring are crucial to holding donors, governments, programs, and providers accountable. Better service delivery is critical to expanding access to and use of contraceptives, particularly in the poorest countries with the weakest health service infrastructure. We build evidence about what works to address supply and demand barriers on a large scale and in multiple countries, promote collaboration between the public and private sectors on delivery solutions, and synthesize and communicate research findings to donors, countries, and partners.
Some women do not access or use contraceptives for a variety of reasons, even when they want to avoid pregnancy. They may have misconceptions about their risk of becoming pregnant, or be deterred by the cost, inconvenience, or concerns about side effects.
In some cases, opposition from family members or a limited range of available methods can be a key factor in non use. Continued innovation in contraceptive technology is needed to address these barriers and meet the demands of women in different circumstances and at different stages of their lives.
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We support the discovery, development, and distribution of new technologies that address reasons for non-use, with a focus on improving acceptance and continued use among priority user groups: women who have achieved their desired family size, women who are not using an existing methods due to side effects, and young women. Seattle, WA ext. Open: Tues - Sat 10 a. Admission: Free. All Rights Reserved. Foundation Cares Resources for Volunteering. By continuing to use this site, you agree to the placement of these cookies and similar technologies.
Resources Press Releases 5.
At A Glance up. The Opportunity Share Share. A mother and son at a health center in Dakar, Senegal. Eligible participants were all literate respondents older than 18 years, who were part of the multidisciplinary counseling group of the family planning service. Pregnant women and participants who signed informed consent form but did not complete all survey forms were excluded. The multidisciplinary team of our outpatient clinic comprises social workers, nurses, gynecologists, and psychologists.
The team is involved in counseling activities on contraceptive methods via the provision of lectures and audiovisual material.
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Our family planning service is freely available to the local population. Contraceptive counseling lectures Contraceptive counseling lectures were held once a month in rooms for a maximum of 20 participants, with available audiovisual resources. Throughout the study period, the same multidisciplinary team not involved with the researchers was responsible for administering information on the counseling lectures with the use of audiovisual resources and educational material available for handling.
Lecturers addressed all legal and practical information on the contraceptive methods offered by the national public health services, with emphasis on methods considered efficacious or very efficacious oral and injectable hormonal contraceptives, copper intrauterine device, as well as irreversible methods, including tubal ligation and vasectomy.
Family Planning - Bill & Melinda Gates Foundation
Counseling covered in the lectures followed recommendations of the World Health Organization WHO 4 and the Brazilian regulations on family planning Lectures included information on the efficacy of all contraceptive methods spermicides, fertility awareness, withdrawal, male and female condom, diaphragm, hormonal oral and injectable contraceptives, intrauterine devices, etonogestrel implant, male and female sterilization their proper use, mechanisms of action, side effects, risks and benefits, return to fertility, and their efficacy in the prevention of sexually transmitted diseases.
Additional information was provided according to questions raised by the participants. Lectures lasted as long as two hours. In this study, only the contraceptive methods considered very efficacious or efficacious hormonal oral and injectable contraceptives, intrauterine devices, male and female sterilization by the World Health Organization WHO 4 and offered free of charge in our country were included for analysis. Questionnaires Participants who agreed to participate in the study signed an informed consent form before attending the counseling lecture.
Before the lecture, participants individually answered a questionnaire on sociodemographic data age, sex, marital status, education, number of pregnancies, number of abortions, and number of children , contraceptive method of choice, and individual opinion about the efficacy of each method. After the lecture, participants answered another questionnaire with items on the contraceptive method chosen at the end of counseling.
All questionnaires were answered by self-report. Details of the survey forms were known only by a single member of the research team and were coded with random and sequential paired numbers pre- and post-counseling. We used descriptive statistics to analyze the sociodemographic characteristics of the study participants and chi-square tests to determine differences in the sociodemographic characteristics according to gender.
For paired dependent variables, we used the marginal homogeneity test to evaluate differences of opinion in regards to the efficacy of the contraceptive methods and the choice of the method before and after the lecture. For independent variables, we used the G-test to evaluate differences of opinion in regards to the efficacy and choice of the methods according to gender. We conducted binary logistic regression to identify the sociodemographic predictors of contraceptive options.
Results During the period of the study, men and women participated in the counseling lectures. All of them accepted participation in the study, but two did not complete the post-counseling forms, which resulted in a total of respondents. The sample consisted mostly of women Among participants aged more than 35 years, men are the majority Women had a higher educational degree compared to men For female participants, tubal ligation was considered the most efficacious method of contraception both before For the male participants, vasectomy was chosen as the most efficacious method both before Male participants changed their opinion after the lecture as to the most efficacious contraceptive method; a higher percentage of responses were related to the choice of vasectomy as the most efficacious method, while a smaller proportion of respondents reported not knowing which method was more efficacious after counseling After counseling, a lower percentage of women Among men, a significantly lower percentage of participants did not know their choice for contraceptive method after the lecture Gender comparisons indicated that women chose tubal ligation more often than men p Most women The analysis of sociodemographic variables by binary logistic regression indicated that for each child the participants had, the likelihood of choosing a definitive method increased 5.
Being female significantly decreased OR, 0. They are directed to help with the decision as to the interval between births, and to develop conscious and safe sexual relations6. Ideally, such actions should focus on men and women in childbearing ages, especially young adults and adolescents. However, the development of efficient educational strategies for the guidance of young adults and adolescents is still limited in our country At the beginning of their sexual lives, young individuals usually have no or misleading contraceptive information, and this information is not sufficient to prevent an unwanted pregnancy2.
Our results reinforce this reality, considering that the minority of participants of the family planning service belonged to younger age groups. Our sample is consistent with the characteristics of the users of public family planning programs in our country: most of them are women, in a stable union, with more than a child and are in the third decade of life5, Gender issues within family planning are important to understand power relations within family and social groups. In our country, due to cultural and historical reasons, childbearing is considered a social demonstration of virility among men and pregnancy, childcare, and child education are transferred to the responsibility of women Changes in familiar structures and the need of women to get into the workforce have increased responsibilities and social demands on women.
This patriarchal culture places women at the center of birth control This may justify a higher proportion of women participating in our family planning service. Women have achieved autonomy in terms of the choice of contraceptive methods probably due to their ability to maintain a dialogue and negotiate within the family unit. They seem to consider that tubal ligation is the most efficacious solution to limit the number of children they have, despite their knowledge of the efficacy of other methods This may explain our results as we observed that women remained opting for an irreversible method to themselves, even after receiving information on more efficacious methods through the counseling lecture.
At a glance: facts about natural family planning
In other words, women take the responsibility for contraception. Furthermore, we should consider the difficulty in access to very efficacious methods in the public health system23 and the dissatisfaction of women with the reversible methods that are currently available22 as contributing factors to these results.
This dissatisfaction may be related to the possible failure of a reversible method used previously. Women who are actively involved in family composition choose tubal ligation after their ideal family size is achieved, especially in cases in which they have experienced a failure in the previous planning of family size24,25, We also need to consider the unwillingness of women to continue to assume the responsibility for reversible contraception and their decision to interrupt the reproductive cycle and enjoy sexual freedom without the fear of unwanted pregnancy Men rarely seek family planning services, probably because of their lack of concern with contraception, considering that the only methods available to them are male condom, abstinence, and vasectomy27, Figure 2 shows the probability of becoming pregnant by 30 months was Learning from the Healthy Fertility Study has influenced several at-scale programs in Bangladesh, including the MaMoni project.
The article is based on a retrospective case series of over 3, postpartum IUD insertions. Findings from this study indicate that the expulsion rate for PPIUDs is much lower than reported in previously published literature. A plausible explanation for this is an improved clinical technique, and the same technique has been currently introduced in supported countries in Afghanistan, Ethiopia, Guinea, India, Mali, Mozambique, Pakistan, Philippines, Rwanda, Tanzania and Uganda.
In particular, India is making great strides in scaling up services with strong leadership from the Ministry of Health and Family Welfare. Seventy-one hospitals and medical colleges in 19 states of India now offer the method to women who have given birth in facilities. Furthermore, important policy changes have taken effect in India, for example to allow nurses and midwives to insert IUDs in the postpartum period, to engage dedicated PPFP counselors, and to target resources to six high priority focus States for further expansion of the services.