RESUMO
PIP: The development of contraception has allowed women to think about and experience motherhood not as their destiny but as an option. Humans have always been interested in controlling their fertility. Writings unearthed in the 18th century demonstrated the interest of the ancient Egyptians and Greeks in fertility control. The oral contraceptive (OC) pill, developed in the 1950s by Pincus and Rock, has allowed millions of women to avoid unwanted pregnancy. Since 1960, when the oral contraceptive Enovid was first marketed in the US, over 200 million women throughout the world have used OCs. Modern formulations have low hormone doses, which has minimized side effects. OCs now have an effectiveness of 98%. The method is controlled by the woman, permitting autonomous decisions about pregnancy. Currently, in Colombia, 12.9% of women in union use OCs, 25.7% are sterilized, 11.1% each use IUDs and traditional methods, 4.3% use condoms, 2.5% use injectables, 1.4% use vaginal tablets, 0.7% each use Norplant and vasectomy, and 1.8% use other methods. 27.8% use no method. OCs can be used as an emergency method in case of rape, an unexpected sexual encounter, or failure of another method. When used as a postcoital method, OCs must be taken within 72 hours of unprotected sexual intercourse.^ieng
Assuntos
Comportamento Contraceptivo , Anticoncepcionais Orais , Estudos de Avaliação como Assunto , Serviços de Planejamento Familiar , América , Colômbia , Anticoncepção , Países em Desenvolvimento , América Latina , América do SulRESUMO
PIP: Fertility in developing countries has declined by about 1/3, from an average of 6 children per woman in the 1960s to 4 in 1990. 38% of reproductive-age women in the developing countries excluding China use a family planning method, as do over 70% in developed countries. 81% of contraception in the developing world is provided by the IUD, male or female sterilization, and oral contraceptives (OCs). 25% of couples in the developing world who use contraception use IUDs, 12% use OCs, and 44% use voluntary sterilization. Injectables are used by approximately 12 million women in developing countries, 3% of married women currently using a method. Almost 1/2 sterilized couples are in China and 1/4 in India. Sterilized women outnumber sterilized men by 3 to 1 worldwide, and voluntary female sterilization is the world's most widely used method. Nearly 138 million women of reproductive age have been sterilized. Voluntary female sterilization is less popular in developed countries except the US, where 23% of married women of reproductive age have undergone the procedure. 42 million couples worldwide use vasectomy. Some 120 million married women in developing countries are estimated to have unsatisfied needs for family planning. Each year, over 20 million women are believed to undergo unsafe abortions, and approximately 70,000 die as a result. Each day, nearly 1 million persons are believed to be infected with sexually transmitted diseases. Approximately 19 million persons had been infected by HIV by late 1994.^ieng
Assuntos
Comportamento Contraceptivo , Anticoncepção , Anticoncepcionais Orais , Países Desenvolvidos , Países em Desenvolvimento , Dispositivos Intrauterinos , Esterilização Reprodutiva , Serviços de Planejamento FamiliarRESUMO
PIP: The Colombian National Survey of Demography and Health was conducted in 1995 within the third round of world Demographic and Health Surveys. This survey was realized with the participation of 10,112 households containing 11,140 individuals in 5 regions of the country. It showed that 99.6% of women in Columbia were familiar with family planning methods and 72% of married women or those living in consensual union used contraceptives, especially those who were more educated and lived in urban areas. 58% of uneducated women used contraceptives vs. 77% of those who had higher education. Uneducated women preferred sterilization, while better educated women preferred IUDs and the condom. The Colombian women thought that the ideal number of children was 2 or 3 vs. a real fertility rate of 3. In Colombia there has been a significant decline of fertility since the 1960s. According to the 1995 National Demographic Survey (ENDS-95) fertility had declined by 23% in the previous 5 years and by 14% in the previous 10 years. In the Pacific region of the country the total fertility rate stayed high at 5, while in the large cities like Bogota, Medellin, and Cali the average number of children was 2.5. 17% of girls 15-19 years old were either mothers or pregnant with their first child. 9% of girls 19 years old had at least 2 children. With regard to sex behavior, 1 of every 5 rural women and 6% of those in urban areas did not know how to avoid HIV infection. 82% of women did not change their sex behavior after having learned about AIDS; 5% demanded to know the sex history of their partners; and 3% decided not to have sexual relations. Regarding sexual violence, 72% of the women said that verbal abuse is also violence. 26% of adolescent girls had been sexually abused by a relative, half of them by stepfathers, in a country where second and third unions are increasingly frequent. Among women who were victims of violence, the percentage who complained to the authorities increased from 11% to 27% between 1990 and 1995.^ieng
Assuntos
Atitude , Coeficiente de Natalidade , Comportamento Contraceptivo , Anticoncepção , Demografia , Violência Doméstica , Infecções por HIV , Comportamentos Relacionados com a Saúde , Conhecimento , Gravidez na Adolescência , Delitos Sexuais , América , Comportamento , Colômbia , Crime , Países em Desenvolvimento , Doença , Serviços de Planejamento Familiar , Fertilidade , América Latina , População , Dinâmica Populacional , Psicologia , Comportamento Sexual , Problemas Sociais , América do Sul , VirosesRESUMO
PIP: A brief summary was provided of a report which examined the factors important in contraceptive choice and continuation. The study involved Guatemala, Trinidad and Tobago, Hong Kong, Jordan, Nepal, and Kenya between 1984 and 1987. The aim was to improve family planning services in efficiency and quality of programming. The findings indicated that continuation of use was related to women's personal motivation (desire for no more children or postponed pregnancy), obtaining the desired method, and knowing there was partner agreement on the chosen method. The implication for family planning programs was the inclusion of counseling and education for increasing motivation, provision of a variety of contraceptive methods, and inclusion of the male partner in decision making about contraceptives. On the basis of 5 questions asked of clients about perception of counseling, the results of the quantitative assessment indicated that a higher score on counseling was associated with a discontinuation. The suggestion was that counseling may be too extensive and force discussion issues with unwilling clients. Misunderstanding increasing anxiety levels of clients, rather than contributing to confidence in methods. Counseling should be reassuring and not scary regarding potential side effects. Sometimes more time is spent during counseling on nonrelevant issues to the client and less time on proper and consistent use of the chosen method. What is meant by proper and appropriate counseling needs to be further defined, and the impact on consistent and proper use of contraceptives needs to be indicated. Hypothesis testing should be conducted on the idea that it is quality of counseling, and not quantity, that is important for clients. Recommendations for family planning programs were: 1) the focus should be on essential information and discussions that help the client make an adequate choice and properly use the method chosen; 2) the available time should be a factor in the number of issues discussed; 3) the client's ability to understand and retain information should be a factor in determining the amount of information; and 4) service providers must be aware of differing needs and levels of knowledge of clients.^ieng
Assuntos
Comportamento Contraceptivo , Anticoncepção , Aconselhamento , Pesquisa , África , África Subsaariana , África Oriental , Instituições de Assistência Ambulatorial , América , Ásia , Ásia Ocidental , Região do Caribe , América Central , Países em Desenvolvimento , Serviços de Planejamento Familiar , Ásia Oriental , Guatemala , Planejamento em Saúde , Hong Kong , Jordânia , Quênia , América Latina , Oriente Médio , Nepal , América do Norte , Trinidad e TobagoRESUMO
PIP: A 1979 survey of women aged 15-45 years from Sao Paulo, Brazil, concerning their contraception use demonstrates the impact of family planning, even without an official family planning program. 23% of the women were using the pill and 16% were sterilized. Very few used diaphragms, condoms, or IUDs. Although there is now an official family planning program in Brazil, only middle and upper class women have access to sophisticated means of birth control. Poor women are limited to tubal ligation which is often disguised as a cesarean section (the rate at some hospitals for this operation is 90%). Since the Integrated Project was introduced in 2 pilot areas in 1983, 12 branches, where community representatives run monthly discussion meetings and classes are held on family planning methods, have been established in the city. Nurses coordinate volunteer efforts. The program began in slum areas by utilizing the nurses and nurseries already in place to care for children of working women. New expansion will require integrating the family planning program into other established, nongovernmental organizations and working with municipal and state governments.^ieng
Assuntos
Participação da Comunidade , Comportamento Contraceptivo , Serviços de Planejamento Familiar , Governo , Processos Grupais , Planejamento em Saúde , Acessibilidade aos Serviços de Saúde , Enfermeiras e Enfermeiros , Voluntários , América , Brasil , Comunicação , Anticoncepção , Atenção à Saúde , Países em Desenvolvimento , Saúde , Pessoal de Saúde , América Latina , Organização e Administração , Política , Avaliação de Programas e Projetos de Saúde , América do SulRESUMO
Family planning clinics for university students play a valuable role in promoting health. This research project, a pilot study among women students who sought family planning services through a Costa Rican university clinic, introduced student evaluation of the family planning clinic, documented services provided in family planning visits, and identified issues for further study. Aged 18-33 years, the 53 respondents (a convenient sample) who completed a self-administered questionnaire were mostly (64%) single; all were sexually active; and 78% wished to have children (or more children) some day. Though all were sexually active at the time of their visit, only 62% were currently using contraception, and fewer than half of these were using effective methods. Nearly all students (96%) reported they learned new information during their appointment, and many received screening tests and examinations. Respondents rated their satisfaction with aspects of clinic service as high, citing the clinic's low visibility on campus as the most important area for improvement. All of the students said they would definitely return (85%) or would consider returning (15%). The results support the continuance of such a clinic on the campus, as well as of the practice of student evaluation. This collaborative study demonstrated areas for future research and stimulated interest in the university clinic as a research setting.
PIP: In Costa Rica, a nurse researcher or a nurse clinician interviewed 53 female students aged 18-33 at the family planning clinic at the Universidad Nacional Heredia. This 6-month, descriptive pilot study aimed to learn what services are covered during family planning visits, the students' evaluation of the clinic, and their demographic characteristics. 36% of the students were either married or in a consensual union. Just 25% of the women had children. 78% of the students wanted to be mothers (mean ideal family size = 1.8). All the women were sexually active, yet only 26% had previously sought family planning advice. 62% currently used birth control. 62% of family planning users used natural family planning methods or barrier methods. Referral by a health provider was more common than referral by a friend (17% vs. 7.3%). 34% of all students had used other services in the student health department. The most common services covered during family planning visits were pelvic exam (59%) and contraceptive information (51%). Other relatively common services were sexuality counseling (26%), breast exam (24%), and blood pressure check (23%). 96% of the students received new information mainly on contraceptive methods (65%), breast self-examination (39%), and sexuality education (35%). The students were satisfied with all clinic services (3.9-4.9, with 5 equaling very satisfied), especially, with the opportunity to ask questions, counseling provided, and advice given by clinicians. 22% of the students wanted greater clinic outreach, especially about family planning. 85% said that they would definitely return to the university clinic. 91% would recommend it to a friend wanting family planning advice. The field of family planning needs of and services to university students is an open field for nurse researchers.
Assuntos
Comportamento do Consumidor , Serviços de Planejamento Familiar , Serviços de Saúde para Estudantes , Estudantes , Adolescente , Adulto , Comportamento do Consumidor/estatística & dados numéricos , Costa Rica , Serviços de Planejamento Familiar/estatística & dados numéricos , Feminino , Humanos , Projetos Piloto , Fatores Socioeconômicos , Serviços de Saúde para Estudantes/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Inquéritos e QuestionáriosRESUMO
"This paper reviews survey-based data regarding contraceptive prevalence and methods employed in Latin America and the Caribbean, with an emphasis on changes in the mix of methods over time. The most striking recent trend is the rise in use of female sterilization.... By contrast, use of male sterilization remains negligible in most countries. The oral contraceptive pill is by far the most popular of the temporary methods, though its prevalence has more often declined than increased in recent years. Together female sterilization and the pill make up around [two-thirds] of contraceptive practice in Latin America and the Caribbean." (SUMMARY IN ENG)
Assuntos
Comportamento Contraceptivo , Anticoncepção , Anticoncepcionais Orais , Esterilização Reprodutiva , Fatores de Tempo , América , Região do Caribe , Demografia , Países em Desenvolvimento , Serviços de Planejamento Familiar , América Latina , América do Norte , População , Dinâmica PopulacionalRESUMO
PIP: Men, as well as women, were interviewed in the Haiti National Contraceptive Prevalence Survey (NCPS) in 1989. THe inclusion of males allowed the survey to: 1) attain information on fertility, contraceptive use and supply sources, method mix, and unplanned pregnancies; 2) explain the difference between the number used; 3) examine the role of men in family planning; and investigate barriers to contraceptive usage. The preliminary report of the survey found that the use of family planning among women in union (WIU) has gone up to 10%; use of traditional contraceptive methods is less than 1%. The pill is the most frequently used method (4% of all WIU); followed by female sterilization (2.5%), and the "injection" (16%). Less than 1% of WIU use condoms. Among men in union (MIU), 11% use family planning. Condoms are the most commonly used method (3.4% of MIU). Women may underreport condom use. MIU may report use of condoms with partners outside of their current union. Among all men, 8.5% use family planning; 6% of single men, mostly in urban areas, report using condoms. Most men say that they use condoms to prevent pregnancy; 13% use them for protection against sexually transmitted diseases, including the acquired immunodeficiency syndrome. Another 20% give both reasons. Among women and men in union who are using family planning, 2.3 gave reasons of infertility, sexual activity, or pregnancy. 37% of the nonusers are breastfeeding or pregnant; another 10% would like a pregnancy (18%); 16% of men believe their partner is menopausal. Among women who gave birth in the 5 years previous tot he survey, more than 2/3 has at least 1 antenatal care visit; 22% had more than 6 visits. 3 in 10 of these birth were not planned.^ieng
Assuntos
Preservativos , Comportamento Contraceptivo , Coleta de Dados , Serviços de Planejamento Familiar , Fertilidade , Motivação , Gravidez , Estatística como Assunto , América , Comportamento , Região do Caribe , Anticoncepção , Demografia , Países em Desenvolvimento , Haiti , América Latina , América do Norte , População , Dinâmica Populacional , Psicologia , Pesquisa , Comportamento Sexual , Comportamento SocialRESUMO
PIP: The Mexican Institute of Social Security (IMSS) provides a postpartum family planning program offering information and available contraceptive options. 356,000 postpartum women received contraception through this program in 1989. It is estimated that 136,000 of these women would not have received any contraception without the assistance of this postpartum program. 40% of the family planning services in Mexico are currently being provided by IMSS. Contraception is recommended for postpartum women with and without reproductive risk factors. Staff training, prenatal contraceptive counseling, and selection of contraceptive methods are essential in implementing a successful program. IMSS consists of 311,000 employees, 900 outpatient clinics, and 200 hospitals offering obstetrical and gynecological services. Counseling is provided in prenatal care regarding available contraceptive methods and their side-effects. Available methods offered through IMSS postpartum services include IUDs, female sterilization, and progestin-only oral contraceptives. In 1989, 79% of urban contraceptor acceptors chose IUDs, 30% chose sterilization, and 1% chose the mini- pill. IMSS hopes to expand this selection to include injectables, implants, and male sterilization. Future expansion of these new methods is dependent upon physicians accepting and encouraging their use.^ieng
Assuntos
Comportamento Contraceptivo , Aconselhamento , Organização e Administração , Aceitação pelo Paciente de Cuidados de Saúde , Filosofia , Período Pós-Parto , Instituições de Assistência Ambulatorial , América , Anticoncepção , Países em Desenvolvimento , Serviços de Planejamento Familiar , Planejamento em Saúde , América Latina , México , América do Norte , ReproduçãoRESUMO
Operations research is the study of factors that can be controlled by program administrators. Among such factors is the frequency of performing program activities. The present experiment, conducted in Lima, Peru during 1985-86, tested the impact of holding family planning post sessions once per month, twice per month, and weekly. Frequency was shown to have a major impact on program outputs, costs, and cost-effectiveness. Depending on the indicator, sessions held twice per month produced between 1.5 and 2.1 times the output of those conducted once per month. Weekly sessions produced between 1.3 and 1.6 times the output of those held twice per month. At an output level of nearly 11,200 visits per year, twice-per-month sessions were estimated to be 7-38 percent more cost-effective, depending on the indicator, than once-per-month sessions, and 6-28 percent more cost-effective than weekly sessions.
PIP: Operations research is the study of factors that can be controlled by program administrators. One of these factors is the frequency of performing program activities. The operational variable is the frequency of having clinical sessions in medical back-up posts in a community-based distribution (CBD) program in Lima, Peru. The study covered 42 posts in urban marginal areas of Lima. 3 performing frequencies were compared: 1) once a month; 2) twice a month; and 3) weekly. A randomized block design was used. The study lasted 12 months--from August, 1985-July, 1986. 3 output indicators were chosen: 1) effectiveness; 2) efficiency; and 3) cost-effectiveness. Outputs include program acceptors, total visits, IUD insertions, sessions and family planning (FP) visits. The once-per-month posts finished 98% of scheduled sessions while the twice-a-month and weekly sessions finished 97% and 96%, respectively. Mean duration of the clinic sessions held by the monthly and twice-monthly posts was 2.9 hours (s.d.=.84 and .73, respectively). Mean duration for the weekly group was 2.8 hours (s.d.=.67). About 73% of the FP talks scheduled for the monthly post were really accomplished compared to 66% for the twice-monthly and weekly groups. The 42 posts held 1136 clinic sessions during the year and had 11,196 visits, including 5371 FP visits. 1705 women accepted a FP method at the posts. 77% were IUD takers; 15% chose pills; and 8% accepted barrier methods. There were 4768 IUD visits. There were 414 pill visits and 18% barrier method visits. About 89% of all FP visits were IUD-related. 87% of all IUD insertions were referred by CBD workers and 5% by supervisors. There were 2954 total visits in monthly posts; 3501 in twice-monthly; and 5641 in weekly posts. Output went up linearly with session frequency, but in lesser proportion than the rise in the number of sessions held. Differences are statistically significant for all outputs. Twice-a-month posts had 1.5-2.1 times the output of once-a-month posts; weekly posts had about 1.3-1.6 times the output as twice-a-month posts, depending on the variable chosen. With output level of nearly 11,200 visits per year, twice-a-month sessions were estimated to be 7-38% more cost-effective than once-a-month sessions; 6-28% more cost-effective than weekly sessions.
Assuntos
Atenção à Saúde/métodos , Serviços de Planejamento Familiar/organização & administração , Serviços de Saúde Comunitária/economia , Serviços de Saúde Comunitária/organização & administração , Análise Custo-Benefício , Atenção à Saúde/economia , Feminino , Humanos , Pesquisa Operacional , Peru , Saúde da População UrbanaRESUMO
PIP: The authors identify some variables associated with the adoption and continuation of contraception in Mexico. The focus is on determinants of choice of different methods, as well as the impact of selected socioeconomic and demographic factors and the influence of institutions providing family planning services on choice of method.^ieng
Assuntos
Comportamento Contraceptivo , Anticoncepção , Demografia , Planejamento em Saúde , Avaliação de Programas e Projetos de Saúde , Fatores Socioeconômicos , América , Países em Desenvolvimento , Economia , Serviços de Planejamento Familiar , América Latina , México , América do Norte , Organização e Administração , PopulaçãoRESUMO
PIP: This article is a summary of the Jamaican Contraceptive Prevalence Survey (JCPS). As a brief survey report on Jamaica, it states the past fertility rates of Jamaica, the pertinent present fertility rates in correlation with family planning prevalence, and the health education levels of Jamaican women. JCPS found that the total fertility rate between 1983 and 1989 fell from 3.5 to 2.9 children per woman. More than 90% of women interviewed knew of modern contraceptive methods and 55% of all women in union are using contraception. Most mothers giving birth within the past 5 years received antenatal care and more than 90% were attended by health personnel. Nearly all women breastfeed offspring and the average duration is 13 months. About 2/3 received a tetanus injection. JCPS analyzed Jamaican women's knowledge of AIDS and 14% of these women self-assessed themselves as high risk individuals. Although most women correctly understood possible routes of AIDS transmission, misconceptions were common (e.g. 58% believe giving a blood donation is an AIDS risk, 35% thought insect bites could transmit the virus, 16% feared sharing personal items, and 8% said being in a room with an AIDS victim was a risk behavior).^ieng
Assuntos
Síndrome da Imunodeficiência Adquirida , Coeficiente de Natalidade , Aleitamento Materno , Comunicação , Comportamento Contraceptivo , Coleta de Dados , Infecções por HIV , Conhecimento , Cuidado Pré-Natal , Pesquisa , Tétano , América , Região do Caribe , Anticoncepção , Atenção à Saúde , Demografia , Países em Desenvolvimento , Doença , Serviços de Planejamento Familiar , Fertilidade , Saúde , Serviços de Saúde , Fenômenos Fisiológicos da Nutrição do Lactente , Infecções , Jamaica , Serviços de Saúde Materna , Centros de Saúde Materno-Infantil , América do Norte , Fenômenos Fisiológicos da Nutrição , População , Dinâmica Populacional , Atenção Primária à Saúde , VirosesRESUMO
We studied the frequency of venereal disease in 329 prostitutes working at massage parlours in Santiago. The mean age was 24 years and half of them had high school or university studies. In spite of frequent sexual contacts averaging 2.8 per day, the prevalence of significant venereal disease was not high in this group. Notably, AIDS infection was not detected. Vaginitis due to Trichomonas or Candida infection was the commonest problem and this was half as frequent among gum preservative users. Marital condition, age, obstetrical history and other variables were not related to genital infection.
PIP: A sample of 329 prostitutes from the eastern area of Santiago, Chile, who attended the Dermatology Service of the Salvador Hospital in January-February 1988 were studied to determine the current incidence of sexually transmitted disease among prostitutes. Approximately 600 prostitutes attend the service for required monthly health examinations. The 329 women worked in established locales such as saunas, massage parlors, and nightclubs. None were uncontrolled street prostitutes. The average age was 24.3 years. 68% were single, 17% were separated, and 15% were married. Only 14% had no more than primary education, and half had high school or college educations. The average parity was 1.52. 83% used contraception. 31% used oral contraceptives (OCs), 21% used injectables, 24% used IUDs, and 7% used other methods. The average number of sexual contacts per day was 2.87. 54% always used condoms, 36% occasionally did so, and 10% never did so. The estimated number of monthly sexual contracts/woman was 65. 22% of the women had some sort of genital pathology. No cases of HIV infection were seen. 9.7% were diagnosed with trichomonas, 4.6% with unspecified vulvovaginitis, 3.3% with candidiasis, 1.8% with syphilis, 1.5% with gonorrhea, .9% with condyloma acuminata, and .3% with active herpes. The frequency of vaginitis did no appear to be associated with the number of sexual contacts, but other pathologies were more common in women with more partners. Women who always used condoms were only half as likely to have genital pathologies or vaginitis as women who never used condoms.
Assuntos
Trabalho Sexual , Infecções Sexualmente Transmissíveis/epidemiologia , Adulto , Chile/epidemiologia , Dispositivos Anticoncepcionais Masculinos , Estudos Transversais , Escolaridade , Feminino , Humanos , Infecções Sexualmente Transmissíveis/prevenção & controle , Vaginite/epidemiologiaRESUMO
PIP: The results of the Dominican Republic's 1986 Demographic and Health Survey suggest increased reliance on effective means of contraception but a continued preference for large family size. The survey covered 7649 women 15-49 years of age. Although only half of the women surveyed were currently using a contraceptive method, over 93% of these women were relying on an effective method, largely female sterilization. A desire to become pregnant was the main reason given for nonuse of contraception. However, 29% of women who were not using a method of contraception at the time of the survey indicated they did not want to become pregnant within the next 2 years. Many of these women expressed unfounded fears about the side-effects of contraceptive methods such as the pill. The 1986 survey recorded a total fertility rate of 3.7 lifetime births/woman for the 1983-85 period--the 1st time this rate has dropped below 4. However, survey respondents indicated a desired fertility rate of only 2.8 births, suggesting an unmet need for family planning services in the Dominican Republic. Another survey finding--that 68 infants/1000 die before their 1st birthday--suggests a need for greater access to maternal-child health services, especially in the country's rural areas.^ieng
Assuntos
Coeficiente de Natalidade , Comportamento Contraceptivo , Coleta de Dados , Demografia , Características da Família , Fertilidade , Necessidades e Demandas de Serviços de Saúde , Mortalidade Infantil , Mortalidade , Dinâmica Populacional , População , Projetos de Pesquisa , Comportamento Sexual , América , Região do Caribe , Anticoncepção , Países Desenvolvidos , Países em Desenvolvimento , República Dominicana , Economia , Serviços de Planejamento Familiar , América Latina , América do Norte , Pesquisa , Estudos de AmostragemRESUMO
PIP: The 1987 National Survey of Maternal and Infant Health of Guatemala indicated that only 23% of eligible women use contraception. The total fertility rate averaged 5.6 lifetime births between 1982-87, although the survey suggested that many women would prefer a smaller family size. Oral contraceptives and female sterilization are the most widely used methods of fertility control; 18% of married women have used the pill at least once and 10% are sterilized. 34% of the 5122 women surveyed reported ever-use of contraception. Women over 30 years of age were almost twice as likely to be contraceptive acceptors than younger women, and 41% of urban women compared with only 15% of rural women were contracepting. The private sector (predominantly the Association for Family Welfare) supplies 2/3 of the contraceptives used by Guatemalan women, while providers in the public sector include public sector include public hospitals, health centers, and the Guatemalan Institute of Social Security. The large unmet need for family planning in Guatemala is indicated by the survey finding that 2/3 of the married women who did not want more children were not practicing contraception. In urban areas, 47% of women who did not want more children were not using a family planning method; in rural areas, this statistic was 79%. The greatest unmet need exists among the indigenous Indian population: 91% of women in this group who do not desire more children are not contraceptive users. Education plays a major role in influencing contraceptive acceptance. 84% of those with no education compared with 24% of those with a high school education were not contracepting.^ieng
Assuntos
Fatores Etários , Comportamento Contraceptivo , Coleta de Dados , Escolaridade , Serviços de Planejamento Familiar , Necessidades e Demandas de Serviços de Saúde , Indígenas Sul-Americanos , População Rural , Comportamento Sexual , População Urbana , América , América Central , Anticoncepção , Cultura , Demografia , Países Desenvolvidos , Países em Desenvolvimento , Economia , Etnicidade , Fertilidade , Guatemala , América Latina , América do Norte , População , Características da População , Dinâmica Populacional , Pesquisa , Estudos de Amostragem , Classe Social , Fatores SocioeconômicosRESUMO
Records of the occurrence of vaginal bleeding were obtained from women using either a natural method of contraception or one of four types of hormonal contraceptive. The relationships between their bleeding patterns and a number of demographic variables were examined, with the aim of identifying subgroups of women who, if they used a particular hormonal method of contraception, would be likely to suffer more or less disruption to their bleeding pattern than the 'norm'. Within contraceptive method, bleeding patterns were more closely related to the women's geographical region of residence than to any other factor. Some of the differences between regions were consistent across contraceptive methods. European women tended to have more bleeding/spotting days than women in other regions; Latin American women had relatively short episodes and long bleeding-free intervals, whether they were using the ovulation method, combined pills or a vaginal ring. Other differences were method-specific. Women using combined pills in India or Pakistan had fewer spotting episodes than women using the same method elsewhere; those using progestogen-only pills had more. Regional variations in bleeding patterns were particularly marked among women using DMPA, and increased over time: by their fourth injection interval, 25% of European women had amenorrhea, as compared with 72% of subjects in North Africa. These findings need to be confirmed by carefully controlled studies of menstrual bleeding patterns and their acceptability in various ethnic groups. The results would be valuable in counselling new contraceptive acceptors, and could eventually guide the choice of methods for introduction into national family planning programmes.
Assuntos
Anticoncepção/métodos , Menstruação , Administração Intravaginal , África , Ásia , China , Ensaios Clínicos como Assunto , Anticoncepcionais Orais Combinados/farmacologia , Anticoncepcionais Orais Hormonais/farmacologia , Europa (Continente) , Feminino , Humanos , América Latina , Levanogestrel , Medroxiprogesterona/análogos & derivados , Medroxiprogesterona/farmacologia , Acetato de Medroxiprogesterona , Menstruação/efeitos dos fármacos , Estudos Multicêntricos como Assunto , Norgestrel/farmacologia , Índias OcidentaisRESUMO
PIP: The total fertility rate of women in El Salvador has declined from an average of 6 children per woman in the 1970s to 4.4 in 1985, according to the Demographic and Health Survey report by Westinghouse's Institute for Resource Development. 5200 women aged 15-49, from areas covering 75-80% of the country, were surveyed. Contraceptive usage has risen from 34 to 47%. The usual method chosen is sterilization, by 70% of women. Only 7% of married women use the pill, 3% the IUD, 3% rhythm or withdrawal. Rural women, making up the majority of the population, accounted for a decline in total fertility from 8.4 to 5.9 children. In the capital San Salvador, fertility has risen from 2.6 to 3.3 children, reflecting migration of rural people into the city. The instability in El Salvador is probably responsible for a lowered life expectancy from 60 to 57 years, and for heavy out migration in the 1980s. Vaccination rates have improved recently to 47% of children under 5 years.^ieng
Assuntos
Coeficiente de Natalidade , Comportamento Contraceptivo , Anticoncepcionais Orais , Demografia , Serviços de Planejamento Familiar , Fertilidade , Inquéritos Epidemiológicos , Dispositivos Intrauterinos , Dinâmica Populacional , Pesquisa , Comportamento Sexual , Esterilização Reprodutiva , América , América Central , Anticoncepção , Países Desenvolvidos , Países em Desenvolvimento , El Salvador , Saúde , América Latina , América do Norte , PopulaçãoRESUMO
PIP: This article examines the Duhaney Park Youth Project, which was established in 1985 in urban Kingston, Jamaica. Since then the project has provided extensive staff training, utilized supportive community participation, and expanded its range of activities to include peer counseling, female sports, skills training, and a weekly evening youth clinic. This article describes the basic precepts and features of the project, together with relevant characteristics of the young people attending the evening clinic. Over half of these young patients were seeking assistance for family planning or sexually transmitted diseases. During the 1st 9 months of clinic operations, there were an average of 22 patient visits per month; during the last quarter, this figure had tripled to 73 visits per month. 30% of all the patients made 2 or more visits. Many of the patients said that it was the 1st time they had visited a health center. 48% of acceptors selected oral contraceptives. Experience over the years has shown that vertical programming to reach adolescents and postadolescent young people has not been very successful. This project, 1 of the 1st such comprehensive youth programs in the Caribbean region and similar in orientation to "The Door" in New York City, is more comprehensive and offers a variety of services for youth. The program could prove to be a useful model, serving as a source of experience and fresh ideas for similar efforts in other countries.^ieng
Assuntos
Serviços de Saúde Comunitária/organização & administração , Serviços de Planejamento Familiar , Adolescente , Adulto , Participação da Comunidade , Anticoncepção/métodos , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Jamaica , Masculino , Serviços de Saúde Materna , Gravidez , Gravidez na Adolescência , Infecções Sexualmente Transmissíveis/prevenção & controle , População UrbanaRESUMO
PIP: As a result of the General Population Law, the use of contraceptives has increased greatly in Mexico. In 1972, 900,000 women used contraception, representing 12% of women of reproductive age. In 1987, 7 million women, 53% of those of reproductive age were using contraception. In 1973, 70% of users purchased contraceptives commercially, whereas in 1987, 61.8% obtained them from the government. Until 1982, oral hormonal contraceptives were most widely used, but since than female sterilization has become the most common form of contraception, accounting for 35.5% of users. Sterilization is followed in prevalence by intrauterine devices (19.8%) and oral hormonal contraceptives (18.3%). Female sterilization increases in prevalence with increasing age and parity. 30% of women with 3 or more children are sterilized, versus 7.8% of those with 1 or 2 children. While contraception is more prevalent among women who have completed at least 1 year of secondary education than those with no schooling (70% vs. 23.5%), sterilization is more common among those with lower educational level (46.4% vs. 23.9%). Contraception is more prevalent in urban areas (59%) than rural areas (37.6%). While the prevalence of contraception is expected to continue increasing, it will probably be at a much slower rate.^ieng
Assuntos
Fatores Etários , Comportamento Contraceptivo , Escolaridade , Aceitação pelo Paciente de Cuidados de Saúde , América , América Central , Anticoncepção , Demografia , Países Desenvolvidos , Países em Desenvolvimento , Economia , Serviços de Planejamento Familiar , Planejamento em Saúde , América Latina , México , América do Norte , População , Características da População , Pesquisa , Classe Social , Fatores SocioeconômicosRESUMO
PIP: From 1976 to 1984 important demographic changes occurred in Panama. The total fertility rate declined from 4.5 to 3.7, and contraceptive use among married women 20-44 years of age increased from 55% to 63%. However, using data from 3 national level reproductive health surveys which were conducted in Panama in 1976, 1979, and 1984, we found that most of the changes took place between 1976 and 1979. Since 1979, overall contraceptive use and fertility have remained virtually unchanged, although there has been an important method-mix shift toward an increase in the use of contraceptive sterilization and IUD's, with an accompanying decline in the use of oral contraceptives. Although the singulate mean age at marriage remained relatively constant, the average duration of breastfeeding rose 23% during the period. Further gains in contraceptive prevalence and reduction in unplanned fertility in Panama will largely depend on enhanced program efforts 1st begun in the early 1970's by the Panama Ministry of Health. Future program efforts especially should be directed toward encouraging young couples to space their children more effectively by using temporary methods of contraception. The surveys used for this analysis were the 1976 Panama National Fertility Survey of the World Fertility Survey program, the 1979 Panama Contraceptive Prevalence Survey (Westinghouse), and the 1984 Panama Maternal-Child Health/Family Planning Survey.^ieng