RESUMO
The objective of this study was to evaluate possible factors associated with discontinuing use of TCu 380A IUDs due to personal reasons among 2748 users. Overall, a total of 88 subjects discontinued using the TCu 380A IUD within 12 months postinsertion for personal reasons. The most common reasons were planned pregnancy (32%) and husband or family opinion against IUD use (26%). The gross cumulative 12-month life table discontinuation rate for all personal reasons was 4.0 per 100 women. Having no education and/or living in a rural area were the sociodemographic characteristics associated with an increased risk of discontinuation for personal reasons. Effective and regular counseling about IUD use, especially among illiterate women, may help prevent IUD discontinuations related to personal reasons.
PIP: The objectives were to examine the rates and timing of IUD discontinuation for personal reasons, and to analyze the users' discontinuation characteristics. Data were used from randomized clinical trials with a total of 2748 TCu 380A users, healthy and sexually active women, between 18 and 40 years of age; and comparing the performance of the TCu 380A3 with that of various other IUDs conducted by Family Health International, from 1985 to 1989, in family planning clinics located in Cameroon, Chile, Egypt, El Salvador, Malaysia, Mexico (2 centers), Nigeria, Pakistan, Peru, Philippines (3 centers), Sri Lanka (2 centers), Thailand, Turkey, and Venezuela. The last pregnancy ended at least 40 days before IUD insertion. Participants were asked to return for follow-up visits at 1, 3, 6, and 12 months after insertion. Subjects discontinuing IUD use for personal reasons were more likely to be married or in a consensual union and to have fewer years of education; to reside in rural areas; to have had fewer children and to want additional children; and less likely to have been previous IUD users than were women who discontinued IUD use for medical reasons or who were lost to follow-up or continued IUD use after the 12-month follow-up visit. At 12 months of use, the discontinuation rate for personal reasons was 4.0/100 women, compared to 5.8/100 women for medical reasons, and 3.7/100 women for pregnancy and expulsion. 31.8% of the 88 cases discontinuing for personal reasons had a planned pregnancy; and the husband's objection or family influence against IUD use contributed to 26.1% of the IUD removals for personal reasons. 18.2% no longer needed contraception and 13.6% wished to switch methods. Dissatisfaction with the method, moving to another country, and unspecified reasons together were responsible for 10.3% of the discontinuations for personal reasons. Other variables which were not statistically significant constituted: age, parity, additional children wanted, previous contraceptive method used, and months after last pregnancy.
Assuntos
Comportamento do Consumidor , Dispositivos Intrauterinos de Cobre , Atitude , Comportamento do Consumidor/estatística & dados numéricos , Escolaridade , Família , Feminino , Humanos , População RuralRESUMO
PIP: Data from the 1987 National Health and Fertility Survey were used to explore trends and differentials in unwanted fertility in Mexico. Women were classified in three educational categories: illiterate or incomplete primary, complete primary or some secondary, and complete secondary or more. The four urbanization categories were: under 2500; 2500 to 19,999; 20,000 and more; and metropolitan areas. The place of primary socialization was the place of residence until age 12. Two categories of employment of household head were included, agricultural or nonagricultural. The categories for mother's employment considered employment until the union and employment between the time of union and the birth of the first child. The proportion of births that were unwanted was estimated by calculating the total fertility rate for the year before the survey and comparing it to desired family size. The "total desired family size" was 2.4 for the entire sample. In other words, nearly 37% of the total fertility rate was undesired. The greatest differentials in percentages of undesired fertility were found in educational categories. 40.7% of the total fertility rate in the least educated groups vs. 13.6% in the most educated groups was undesired. Differentials in the other categories ranged from 1.9 for a history of employment before the birth of the first child to 8.8 for agricultural or nonagricultural employment of the household head. When effects of education were controlled, the percentage of undesired fertility declined as educational level increased for all rural or urban residence categories, places of socialization, and employment groups except women who worked before the first child was born. Women with more education, urban residence, and with histories of employment had the lowest levels of undesired fertility.^ieng
Assuntos
Coeficiente de Natalidade , Criança não Desejada , Escolaridade , Emprego , Fertilidade , População Rural , População Urbana , América , Demografia , Países em Desenvolvimento , Economia , América Latina , México , América do Norte , População , Características da População , Dinâmica Populacional , Pesquisa , Classe Social , Fatores SocioeconômicosRESUMO
PIP: Family Health International's (FHI) research and development activities in improving and developing contraceptives and making them available to the public are presented. While FHI, along with other agencies, has been actively promoting and contributing to ongoing international family planning efforts since its creation in 1971, the period 1971-91 has, nonetheless, witness more births, maternal deaths, induced abortions, and infant deaths than over any 20-year span in history. While family sizes have decreased over the period due to greater contraceptive awareness and use, politicians, civil servants, and theologians are indicted as partly responsible for retarding further positive change. The number of women of reproductive ages in developing countries will increase by almost 30% in the 1990s, and the world's population will at least double over the next century. 95% of new births will stem from developing countries. Concerted efforts and global commitments of policymakers must be forthcoming in the battle against both high fertility and AIDS prevention. Specifically, at least 130 million new contraceptive users must be recruited in the 1990s. Surveys and field experiences indicate a large degree of unmet need for contraceptive services, with 50-80% of married women in developing countries expressing their desire to limit or space future births. Demand for contraception only increases once a program is in place; rapid reductions of total fertility are exemplified in the cases of Thailand, Colombia, South Korea, Sri Lanka, and Indonesia. Given the resources and commitment, the number of users could be doubled within 10 years.^ieng
Assuntos
Aborto Induzido , Síndrome da Imunodeficiência Adquirida , Pessoal Administrativo , Intervalo entre Nascimentos , Criança não Desejada , Anticoncepção , Países em Desenvolvimento , Características da Família , Infecções por HIV , Planejamento em Saúde , Recursos em Saúde , Necessidades e Demandas de Serviços de Saúde , Mortalidade Infantil , Cooperação Internacional , Mortalidade Materna , Organizações , Filosofia , Dinâmica Populacional , Crescimento Demográfico , Desenvolvimento de Programas , Religião , Pesquisa , América , Ásia , Sudeste Asiático , Coeficiente de Natalidade , China , Colômbia , Conservação dos Recursos Naturais , Demografia , Doença , Economia , Meio Ambiente , Serviços de Planejamento Familiar , Ásia Oriental , Fertilidade , Indonésia , Coreia (Geográfico) , América Latina , Mortalidade , Organização e Administração , População , América do Sul , Sri Lanka , Tecnologia , Tailândia , VirosesRESUMO
PIP: Results on adolescent's knowledge, attitude, and practice in sexuality and reproductive health are presented from 2 surveys of 1199 middle-class youths aged 13-18 years in main cities of Colombia. Survey populations were selected from high schools and users of Family Compensation Fund. While traditional values and customs prevail among these youths, they nonetheless tend to begin sex between ages 15-18, and have little concern over the consequences of their sexual behavior. They are, moreover, quite ignorant about reproductive health. Sexuality is not thought of as part of marriage, women are expected to be virgins at marriage, and a resounding 87% of the study population rejected abortion legislation. 90% of the young men had their 1st sexual encounter with either a prostitute or domestic servant, while 90% of the young women had their 1st encounters with friends from within their social groups. Sexual relations from adolescence on were supported by 35% of the girls and 60% of the boys, 72% of the girls and 38% of the boys supported virginity, yet less than 10% were in favor of the notion of open relationships. 20% of the girls and 25% of the boys had active sex lives, with homosexuality representing 1.6% and 3.1% of the two sex groupings, respectively. Sex education is practically non-existent. Most young women know little of contraception, and fail to use it out of misconceptions regarding method safety, and fear of one's parents finding out. The young men, on the other hand, cite forgetfulness and inability to obtain contraception as reasons for use failure. Accordingly, 5% of the girls fell pregnant between ages 15-17, with 66% ending in abortion, and 18.6% of the girls and 12.3% of the boys admitted to having had a sexually transmitted disease. 55% indicated that they would not use contraceptives.^ieng
Assuntos
Aborto Induzido , Síndrome da Imunodeficiência Adquirida , Adolescente , Atitude , Criança não Desejada , Coito , Comunicação , Comportamento Contraceptivo , Anticoncepção , Cultura , Infecções por HIV , Conhecimentos, Atitudes e Prática em Saúde , Homossexualidade , Conhecimento , Legislação como Assunto , Casamento , Gravidez na Adolescência , Instituições Acadêmicas , Educação Sexual , Comportamento Sexual , População Urbana , Fatores Etários , América , Comportamento , Coeficiente de Natalidade , Colômbia , Coleta de Dados , Demografia , Países em Desenvolvimento , Doença , Educação , Serviços de Planejamento Familiar , Fertilidade , América Latina , População , Características da População , Dinâmica Populacional , Psicologia , Pesquisa , Estudos de Amostragem , Comportamento Social , América do Sul , VirosesRESUMO
PIP: This paper analyzes a data set on women of Mexican origin delivering in Los Angeles hospitals, in order to examine whether Mexican women's attitudes toward their 1st-born infants are influenced by the sex of the child, either alone or in combination with other factors, such as the difficulty of labor and delivery or the woman's social support system. The authors' hypothesize that the mother's attitude toward the 1st child will be determined primarily by factors other than the child's sex, since there is evidence to suggest equal sex preference among women in Latin culture. They predict that the most negative attitudes would be expressed in the case of an unplanned pregnancy, of a child being born into an unstable family or with physical abnormalities. The women described in this paper are all from the Mestizo, or Hispanicized peoples from Mexico. The analyses are based on interviews with a sample of 518 low risk women. Data on the medical course of their labor and delivery was also collected from their medical charts. The operationalization and measurement of each predictive variable are explained. Sex differences in women's evaluations of their children were examined with Chi-Square analyses. As expected, almost no differences on any attitude measure were found. In general the mothers were very pleased with their infants, whether male or female, although there is a suggestion that if they were disappointed, they were more likely to be displeased with a female infant than with a male. Regression analyses, more sensitive for picking up sex differences than the simple Chi-Square, were performed to determine which of the predictive variables were most related to the mother's attitude. Results show that sex was not a predictive variable. Contrary to what was predicted, whether or not the baby was planned, appeared to be relatively unimportant in the mother's attitude toward her child. A 2nd surprising finding was that the woman's experience of birth was unrelated to her evaluation of her child. The social support system had a significant impact on the mother's evaluation of her child. For both boys and girls, social support from the baby's father was associated with a positive attitude toward infants. Women were significantly more negative toward their infants if they had a poor relationship with the baby's father. Finally, the more acculturated women expressed less positive attitudes toward their newborns; this relationship was slightly stronger for girls than boys.^ieng