RESUMEN
PIP: From November 1997 to February 1998, a survey was conducted to evaluate postpartum family planning (FP) services in the Philippines. Data were gathered from records at 86 clinics in 28 provinces and from interviews with 338 FP providers and 3452 clients who began to use FP within 6 months of delivery. Only 7% of women began using FP within 6 months of delivery, and most postpartum attention was devoted to child care issues. Among the women surveyed, most resumed sexual intercourse at 2.4 months postpartum and experienced a return of menses at 4.4 months postpartum despite breast feeding for 6.2 months. The most commonly recommended method to space births was the IUD followed by the injectable contraceptive. Very few providers recommended use of barrier methods. The results indicate that many breast-feeding women are receiving hormonal contraceptives too soon and that IUD insertion may not be occurring at the ideal time postpartum. While a significant percentage of providers recommended use of the lactational amenorrhea method (LAM) and 16% of the women relied on it, the providers lacked sufficient understanding of LAM. In addition, many women switched or discontinued methods. The study led to the recommendations that postpartum FP services be promoted as an essential part of maternal-child health care and that FP providers receive improved training about contraception and LAM.^ieng
Asunto(s)
Recolección de Datos , Servicios de Planificación Familiar , Periodo Posparto , Asia , Asia Sudoriental , Países en Desarrollo , Filipinas , Reproducción , Investigación , MuestreoRESUMEN
PIP: The 1993-94 Bangladesh Demographic and Health Survey (DHS) reported substantial declines in vital rates, especially the fertility rate, which needed confirmation. The demographic database of the International Center for Diarrheal Disease Research, Bangladesh (ICDDR,B) contains the birth and death records for 200,000 people whose households have been visited every 2 weeks since 1966. In addition, the system kept records on the pregnancy and contraceptive use status of women of reproductive age since 1977. A validation study was conducted, which entailed the comparison of fertility and infant mortality rates from a special DHS survey conducted in the Matlab treatment area in 1994, with rates obtained by the Demographic Surveillance System (DSS) over the 5 years prior to the survey and also the comparison of the current contraceptive use rate. The records of 2628 women were examined. The Matlab DHS was found to be accurate in estimating fertility both in the treatment and comparison areas. The Matlab DHS infant mortality rates for the 5 years prior to the survey were also consistent with the estimates derived from the DSS. However, the Matlab DHS seemed to have underestimated contraceptive prevalence, which underestimate was substantial for modern temporary methods, especially pills and injectables. Since contraceptive prevalence may also be higher at the national level as a result of this, the total fertility rate for Bangladesh of 3.4 children/woman may be plausible. Although the Matlab DHS figures on vital rates seem to be reliable, the national level DHS estimates may not be as reliable, because women elsewhere in the country may not have reported their children's births and deaths as accurately as did women in the Matlab area.^ieng
Asunto(s)
Certificado de Nacimiento , Tasa de Natalidad , Certificado de Defunción , Demografía , Estudios de Evaluación como Asunto , Necesidades y Demandas de Servicios de Salud , Reproducibilidad de los Resultados , Población Rural , Estadísticas Vitales , Asia , Bangladesh , Países en Desarrollo , Fertilidad , Planificación en Salud , Organización y Administración , Población , Características de la Población , Dinámica Poblacional , Investigación , Proyectos de InvestigaciónRESUMEN
PIP: Data from the 1993 National Demographic Survey and the Safe Motherhood Survey have filled gaps in knowledge about the accessibility and use of reproductive health services in the Philippines. Analysis of the data by the East-West Center's Program on Population has revealed that the number of women using family planning (FP) and maternal health services has risen to 40% in 1993 from 17% in 1973. Modest gains were also seen in the past five years despite disruption to program efforts. Prenatal care showed the greatest maternal care coverage rate increase, but 70% of births occurred at home, with only 51% attended by a trained person, and only 32% of postpartum women received care. Adolescents and women who are over age 40, uneducated, Muslim, and/or live in a rural setting have the most unmet need. In addition, less than half of the women reporting symptoms of a sexually transmitted disease sought treatment from a trained practitioner. Most women use public sector services, including 71% of those using modern contraceptives. While trained midwives provided 58% of prenatal care, traditional birth attendants delivered 52% of all births, and a high incidence of maternal mortality persists (209/100,000). Recommendations arising from this analysis include 1) improving prenatal and delivery care, 2) strengthening postpartum FP services, 3) expanding the program to reach more women, 4) extending the range of reproductive health services offered, 5) integrating traditional practitioners into the reproductive health system, and 6) balancing cost and service variations between the public and private sectors.^ieng
Asunto(s)
Directrices para la Planificación en Salud , Accesibilidad a los Servicios de Salud , Sector Privado , Política Pública , Sector Público , Medicina Reproductiva , Asia , Asia Sudoriental , Países en Desarrollo , Economía , Salud , Organización y Administración , Filipinas , Evaluación de Programas y Proyectos de SaludRESUMEN
Twenty-one male managers who normally drink moderate amounts of alcohol participated in a placebo-controlled, double-blind, cross-over experiment. Subjects consumed either placebo or alcoholic drinks to attain a breath alcohol level of 0.10 during the evening before participation in Strategic Management Simulations. By the time of arrival at the simultaion laboratory on the following morning, breath alcohol levels were measured at 0.00. Questionnaire responses indicated considerable hangover discomfort. Responses to semantic differential evaluative scales suggested that research participants evaluated their own managerial performance in the simulation setting as impaired. However, multiple (validated) measures of decision-making performance obtained in the simulation task did not show any deterioration of functioning. Previous research had shown considerable performance decrements in the same task setting, while blood/breath alcohol levels ranged from 0.05 through 0.10%. Apparently, complex decision-making competence by persons who normally consume moderate amounts of alcohol may not be impaired by hangover caused by intoxication during the previous evening that remains at or below a blood alcohol level of 0.10.
Asunto(s)
Consumo de Bebidas Alcohólicas/efectos adversos , Intoxicación Alcohólica/psicología , Evaluación del Rendimiento de Empleados , Etanol/efectos adversos , Síndrome de Abstinencia a Sustancias/psicología , Adulto , Consumo de Bebidas Alcohólicas/psicología , Estudios Cruzados , Método Doble Ciego , Etanol/farmacocinética , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Effects of alcohol intoxication at .05 and .10 breath alcohol concentration upon a number of validated indicators of managerial performance were investigated in a double-blind crossover placebo-controlled simulation design. Managers (N = 48) spent 2 days handling quasi-experimental (partially event-controlled) tasks that permitted realistic managerial decision making under both "normal" and "emergency" conditions. The data showed that speed and frequency of managerial action were affected by alcohol at the .10 but not the .05 level. Strategy and planning deteriorated at both levels. Limited improvement of performance was observed for one simpler component of managerial functioning at the lower intoxication level, possibly due to myopia and/or a motivated "strain" toward better performance induced by the perception of impairment.
Asunto(s)
Intoxicación Alcohólica/psicología , Atención/efectos de los fármacos , Toma de Decisiones/efectos de los fármacos , Política Organizacional , Adulto , Pruebas Respiratorias , Método Doble Ciego , Etanol/farmacocinética , Humanos , Masculino , Solución de Problemas/efectos de los fármacos , Tiempo de Reacción/efectos de los fármacosRESUMEN
Adult men (N = 44) participated for 2 days (alcohol vs. placebo treatment) in a double-blind, crossover experiment. Performance on the Digit Symbol Substitution Task (DSST) and a visuomotor (VM) task was measured 4 times each day. On the alcohol-treatment day, data were obtained once during ascending breath alcohol levels (BALs), once during maximal BALs (0.05 or 0.10), and twice during descending BALs. Data were collected at the same time points on the placebo-treatment day. Limited evidence for acute tolerance was obtained with the DSST, but error rates on the VM task were higher during maximal and descending BALs. Error rates remained near placebo values, and participants displayed slightly greater caution, while BALs were ascending. Strategy scores on the VM task exceeded placebo scores during maximal intoxication. Data interpretation is focused on individuals in higher level (e.g., professional) positions.
Asunto(s)
Intoxicación Alcohólica/psicología , Desempeño Psicomotor/efectos de los fármacos , Asunción de Riesgos , Adulto , Atención/efectos de los fármacos , Método Doble Ciego , Humanos , MasculinoRESUMEN
PIP: Data drom the Indonesian Contraceptive Prevalence Survey in 1987 was used to examine the extent to which socioeconomic factors affect the direct association between proximate determinants and fertility. The Bongaarts framework was applied to individual level data on married women who had at least on birth between 1982 and 1987. The fertility measure was the probability of having a birth in the last 12 months before the survey. Proximate determinants were breast feeding, fertile period (non-amenorrhea), sexual exposure, and contraceptive use. Socioeconomic variables were husband's education, wife's education, husband's occupation, religion, urban/rural status, and region of residence. The logit regression analysis is controlled by the age of the respondent and number of children ever born at the time of the survey. There is a possibility that socioeconomic variables may have a direct impact on fertility and the logit framework does not model perfectly the true stochastic model. Thus, a regression is specified in which the probability of experiencing a birth is regressed on both proximate determinants and socioeconomic determinants and on socioeconomic determinants alone. Results show that fertility is lower when the duration of breast feeding and level of contraceptive use is higher. Fertility is higher when the length of the fertile period and sexual exposure is higher. Education showed no significant impact on duration of breast feeding, but when both parents' education is considered, women's lack of education is related to having longer fertile periods (an average of 64 months). When the wife's education is considered alone, women with no schooling and less education have 56-44 more months of sexual exposure. The husband's education considered alone followed the same pattern. As level of parents' education rose, the probability of contraception increased. Women have shorter fertile periods when husbands are farmers. Religion explains duration of breast feeding and contraception. Urban/rural status explains variations in breast feeding duration and fertile period length. Women on Bali and Java were shown to have shorter fertile periods, less sexual exposure, and higher probability of contraceptive use. All 4 proximate determinants had an effect on fertility; most socioeconomic factors had no net effect on current fertility. Contraceptive use had the strongest effect on limiting fertility.^ieng