Practice Of Family Planning Research Articles

English

Family planning is an important practice for women as it can help to improve financial and social status. Unwanted pregnancy has negative effects for husband and financial. However, couples married at a late age may not practice family planning because they want to have kids. The aims of this study were to determine the prevalence, factors associated with husband’s socio demography and decision making in family planning practices among women in reproductive age who attended a polyclinic in Serdang, Malaysia. A cross sectional study was conducted on 245 women with a systematic random sampling. Descriptive analysis, Fisher exact and Chi-square tests were conducted to identify the influence of husband’s socio demographic factors and decision making in family planning practices. The prevalence of family planning practices among married women was moderate (53.9%). Family planning practices among women showed significant relationship with the husband’s socio demography which were husband’s race (p = 0.018), religion (p = 0.008) and making decision in family planning (p = 0.002). The husband’s socio demography showed a significant relationship with the prevalence of the wife practicing family planning. This clearly indicates that the husband is the individual that influence the wife to use contraceptive method. Decision making in family planning by both the husband and wife is important in choosing to use contraceptive method. Health promotion in the concept of health education for male contraceptive method such as pamphlet and booklet is important to promote husband involvement in family planning. DOI : http://dx.doi.org/10.17576/JSKM-2015-1302-05

Evaluation of Transtheoretical Model-Based Family Education Among Females of Zahedan (Southeast of Iran).

Background:It cannot be denied that many improvements in female and child health have been achieved worldwide through international family planning programs. More than half of the females (57%) with unintended pregnancy admitted that they had not used birth control the month before conception.Objectives:The aim of this study was to promote family planning practice among females of Zahedan (southeast of Iran) through the transtheoretical model (TTM).Patients and Methods:The current quasi-experimental study was conducted on 96 eligible females, who were allocated either to the case or the control group and were selected from homes in the border of Zahedan city (southeast of Iran) during 2010. Convenience sampling by door-to-door visits was used for finding eligible cases. A TTM-based self-administrated family planning questionnaire was used for data collection. Participants in the intervention group received education in two groups, based on their stage of change: precontemplation, contemplation, preparation, action, maintenance, and all groups were followed for three months.Results:The result of the chi-square test did not show any significant difference in the stage of change: precontemplation, contemplation, preparation, action, maintenance before education between the control and intervention groups (P = 0.55). After education, subjects in the intervention group moved forward through stage of change and got at least one step closer to the family planning behavior., with this change being significant (P < 0.001), while the movement of participants through stage of change not being significant in control group (P = 1). The results of statistical tests illustrated that the mean knowledge of the intervention group was 7.5 ± 7.1 versus 0.5 ± 4 for the control group (P < 0.001), mean of attitude of the intervention group was 5.5 ± 5.41 versus 0.09 ± 2.04 for the control group (P < 0.001), and practicing family planning methods (P < 0.007) in the intervention group was higher than the control group after education based on TTM.Conclusions:According to this study, the educational plan based on TTM was effective in changing knowledge, attitude, and practice and directing females towards taking action. Moreover, self-efficacy, perceived barriers and benefits are factors that affect the use of family planning methods.

Assessing the knowledge, attitude and practice of family planning among women living in the Mbouda health district, Cameroon.

Background and objectivePromotion of family planning has been shown to reduce poverty, hunger, maternal and infant mortality, and contribute to women’s empowerment. But many resource-limited countries still have very low rates of contraceptive use. The present study aimed to assess the knowledge, attitude and practice of family planning among women living in a resource-poor rural setting.MethodsWe conducted a cross-sectional study in January 2010 in the Mbouda Health District, Cameroon. After a multistage random selection, 120 households were selected. Participants were women aged at least 15 years old, sexually active, and who volunteered to participate in the study. Data were collected during an anonymous interview using a structured pre-tested questionnaire.ResultsA total of 101 women were enrolled, their ages ranging from 18–58 years with a mean of 31.7 ± 8.8 years. Ninety-six percent of these women had already heard about family planning. Almost all respondents (98 %) were aware of at least one contraceptive method, the most cited being the male condom (96 %), the safe period (86.1 %), injectables (76.2 %) and oral pills (75.2 %), Sixty-six women (65.3 %) were currently practicing at least one contraceptive method, and the three prevailing methods used were: the safe period (50 %), the male condom (34.8 %), and injectables (12.1 %). The main reasons precluding women from practicing contraception were lack of knowledge (31.4 %), uselessness (31.4 %) and unbearable side effects (8.6 %). Fourteen of these women (42.4 %) expressed the willingness to start practicing contraception if they received more information about the subject. Decision on the number of children to have was made by both the man and the woman in 59.5 % of cases. The practice of contraception had been decided by the couple in 39.6 % of cases, and 9.4 % of men were not aware that their wives were currently practicing contraception.ConclusionAlthough the level of awareness about family planning and contraceptive methods is quite satisfactory, the level of contraceptive use is not optimal in our setting. Consequently, more adapted educational and counseling interventions should be undertaken among women, and family planning messages directed to men need to be included too.

Knowledge and Practice of Family Planning and Factors Associated with Use of Contraception in a Rural Area of Bangladesh.

Knowledge and Practice of Family Planning and Factors Associated with Use of Contraception in a Rural Area of Bangladesh.

Implementation and Operational Research: Integration of Family Planning Services in a Peer-Managed HIV Care Clinic Serving Most-at-Risk Populations in Phnom Penh, Cambodia.

To assess contraceptive uptake and method choice among women living with HIV (WLHIV) attending an HIV care clinic serving most-at-risk women in Phnom Penh, Cambodia, before and after the implementation of family planning (FP) services. Semistructured questionnaires were administered to clients before (July, 2011) and after (July, 2012) FP service implementation with provision of contraceptive methods (pills, injectables, implants, and intrauterine device [IUD]). Among 250 and 249 clients interviewed before and after implementation respectively, 24.5% of women reported selling sex for money during the last 6 months before and 35.3% after implementation. Awareness about contraceptive methods significantly increased among clients postimplementation. Among sexually active women, male condom remained the contraceptive method of choice with an overall condom use during the last 6 months at 91% postimplementation vs. 95.6% preimplementation (P = 0.11). Although the use of noncondom FP methods increased but not significantly (16.4% after vs. 12.6% before implementation, P = 0.8), the use of dual method (condom plus another method) remained low and did not significantly increase after implementation (14.8% after vs. 11.0% before, P = 0.28). Our results show that FP practices of WLHIV attending an HIV care clinic for most-at-risk populations did not significantly change after integration on-site provision of a wide range of FP methods. Innovative strategies and further research are needed to better understand how to promote the use of noncondom FP methods and prevent unwanted pregnancies and abortions among most-at-risk women and WLHIV.

Anemia among Muslim Bedouin and Jewish women of childbearing age in Southern Israel.

There are inequalities in health indicators among different ethnic groups living in the same region and receiving the same medical services. Anemia is a global problem. Although the prevalence of anemia is not high in Israel, differences among ethnic groups have not been studied. Our objective was to assess anemia among Bedouin and Jewish women of childbearing age in southern Israel. A retrospective observational study was conducted based on data from computerized medical records. Seven thousand eight hundred seventy-one women in the study clinics underwent complete blood counts and had blood hemoglobin levels of 11g/dl or below. The Jewish patients were older (31.7 vs. 29.7years, P < 0.001), practiced birth control more (24.2 vs. 9.9%, P < 0.001), and adhered to it more (81.1 vs. 61.9%, P < 0.001). Bedouin women had more children (3.7 vs. 1.9, P < 0.001), and more Bedouin women were pregnant during the study period (49.3 vs. 35.0%, P < 0.001). The most prevalent types of anemia were iron deficiency and anemia of chronic disease. Two types of anemia were proportionally higher among Jewish women, anemia of chronic disease (18.1 vs. 9.7%, P < 0.001) and folic acid deficiency (3.3 vs. 2.2%, P > 0.001). The adherence rates for treatment were very low. Three factors associated with severe anemia (hemoglobin below 8g/dl) were being Bedouin (odds ratio (OR) = 1.295, P < 0.001), use of birth control (OR = 0.419, P < 0.001), and pregnancy (OR = 0.447, P < 0.001). Being a Bedouin woman is a risk factor for severe anemia, and adherence to treatment for anemia is very low in both groups. These findings should be addressed in a national program to reduce health inequalities.

Evaluation of family planning services in a rural area in Al-Shohdaa district, Menoufiya governorate

Objectives The aim of our study was to examine improvement in women's health through assessment of knowledge, attitudes, and practices of family planning in our locality, which may help identify health problems associated with contraceptive methods to face them properly. Background The rewards of family medicine come from knowing patients well over time and developing a mutual trust, respect, and friendship, and from the variety of problems encountered in practice that keep the family physician professionally stimulated and challenged. The postpartum period is a convenient time to address family planning; women are particularly motivated to prevent conception just after birth, and so the family physician is in a good position to provide the necessary counseling in terms of contraception for the new mother. Patients and methods This study included 200 women who were selected randomly from Kafer El-Sawlmia village, a rural area in Egypt. An interview in the Arabic language was completed through a precoded questionnaire by each one of the women, ranged in age from 18 to 49 years. Results Sociodemographic factors played a minor role in the usage of contraceptive methods; women's level of education and socioeconomic status were not significant determinants of the likelihood of contraceptive use. Contraceptive methods were not used in this study by 7.5% of women. Most of the women in the study were not aware of physiological, surgical, and emergency contraceptive methods; hormonal methods were the most common contraceptive method used in the area of the study. Conclusion Improvement in the use of contraceptives methods and women health can be achieved by conducting awareness-raising seminars for husbands, mass media contraceptive methods awareness, proper counseling both before and at during the method selection and regular contact between the family doctor and the client.

Family planning use among women living with HIV: knowing HIV positive status helps - results from a national survey.

BackgroundWomen living with HIV continues to encounter unintended pregnancies with a concomitant risk of mother-to-child transmission of HIV infection. Preventing unintended pregnancy among HIV-infected women is one of the strategies in the prevention of new HIV infections among children. The aim of this analysis was to assess the practice of family planning (FP) among HIV-infected women and the influence of women’s awareness of HIV positive status in the practice of FP.MethodsThe analysis was made in the Malawi Demographic and Health Survey (DHS) data among 489 non-pregnant, sexually active, fecund women living with HIV. Multiple logistic regression analysis was performed using SPSS software to identify the factors associated with FP use. Adjusted odds ratios (AOR) with 95 % confidence intervals were computed to assess the association of different factors with the practice of family planning.ResultOf the 489 confirmed HIV positive women, 184 (37.6 %) reported that they knew that they were HIV positive. The number of women who reported that they were currently using FP method(s) were 251 (51.2 %). The number of women who reported unmet need for FP method(s) were 107 (21.9 %). In the multiple logistic regression analysis, women’s knowledge of HIV positive status [AOR: 2.32(1.54, 3.50)], secondary and above education [AOR: 2.36(1.16, 4.78)], presence of 3–4 alive children [AOR: 2.60(1.08, 6.28)] and more than 4 alive children [AOR: 3.03(1.18, 7.82)] were significantly associated with current use of FP.ConclusionWomen’s knowledge of their HIV-positive status was found to be a significant predictor of their FP practice. Health managers and clinicians need to improve HIV counselling and testing coverage among women of child-bearing age and address the FP needs of HIV-infected women.

An assessment of antenatal care among Syrian refugees in Lebanon.

BackgroundAfter more than three years of violence in Syria, Lebanon hosts over one million Syrian refugees creating significant public health concerns. Antenatal care delivery to tens of thousands of pregnant Syrian refugee women is critical to preventing maternal and fetal mortality but is not well characterized given the multiple factors obtaining health data in a displaced population. This study describes antenatal care access, the scope of existing antenatal care, and antenatal and family planning behaviors and practice among pregnant Syrian refugees in various living conditions and multiple geographic areas of Lebanon.MethodsA field-based survey was conducted between July and October 2013 in 14 main geographic sites of refugee concentration. The assessment evaluated antenatal services among a non-randomized sample of 420 self-identified pregnant Syrian refugee women that included demographics, gestational age, living accommodation, antenatal care coverage, antenatal care content, antenatal health behaviors, antenatal health literacy, and family planning perception and practices.ResultsIn total, 420 pregnant Syrian refugees living in Lebanon completed the survey. Of these, 82.9% (348) received some antenatal care. Of those with at least one antenatal visit, 222 (63.8%) received care attended by a skilled professional three or more times, 111 (31.9%) 1–2 times, and 15 (4.3%) had never received skilled antenatal care. We assessed antenatal care content defined by blood pressure measurement, and urine and blood sample analyses. Of those who had received any antenatal care, only 31.2% received all three interventions, 18.2% received two out of three, 32.1% received one out of three, and 18.5% received no interventions. Only (41.2%) had an adequate diet of vitamins, minerals, and folic acid. Access, content and health behaviors varied by gestational age, type of accommodation and location in Lebanon.ConclusionsStandards of antenatal care are not being met for pregnant Syrian refugee women in Lebanon. This descriptive analysis of relative frequencies suggests reproductive health providers should focus attention on increasing antenatal care visits, particularly to third trimester and late gestational age patients and to those in less secure sheltering arrangements. With this approach they can improve care content by providing early testing and interventions per accepted guidelines designed to improve pregnancy outcomes.

INTERACTIVE WORKSHOPS TO PROMOTE GENDER EQUITY AND FAMILY PLANNING IN RURAL COMMUNITIES OF GUATEMALA: RESULTS OF A COMMUNITY RANDOMIZED STUDY

In Guatemala, especially in rural areas, gender norms contribute to high fertility and closely spaced births by discouraging contraceptive use and constraining women from making decisions regarding the timing of their pregnancies and the size of their families. Community workshops for men, women and couples were conducted in 30 rural communities in Guatemala to test the hypothesis that the promotion of gender equity in the context of reproductive health will contribute to gender-equitable attitudes and strengthen the practice of family planning. Communities were randomly assigned to intervention and control groups. Pre/post surveys were conducted. Odds ratios estimated with mixed effect models to account for community-level randomization and repeated measures per participant were compared. The analyses showed statistically significant effects of the intervention on two of the three outcomes examined: gender attitudes and contraceptive knowledge. Findings regarding contraceptive use were suggestive but not significant. The results suggest that it is possible to influence both inequitable gender norms and reproductive health knowledge and, potentially, behaviours in a short span of time using appropriately designed communications interventions that engage communities in re-thinking the inequitable gender norms that act as barriers to health.

Knowledge and Practice of Family Planning among Female Basic School Teachers in the City of Accra, Ghana

Family planning has been practiced in Ghana since time immemorial but modern practices were adopted in 1969 when the Ghana government launched the program. Since then efforts had been made to publicize and establish family planning clinics across the country aimed at assisting couples to space births, prevent unwanted pregnancies, promote and highlight the acceptability and adoption of contraceptives as well as help infertile families. However, studies on them in relation to the working class have been limited. This study tended to find out the gap between knowledge and practice among female basic school teachers in a selected community in an urban setting in Accra. The study found out that knowledge and awareness about family planning is associated with the practice of family planning (r = 0.747: p < 0.05). It further showed that 77.6% were aware of family planning of which 71.3% are practicing one method or the other. Knowledge also correlates with the likeness of family planning among the female teachers (r=0.712; p < 0.05). It concluded that the level of knowledge and practice of family planning was high among the teachers and that the gap between knowledge and practice was insignificant. However, some respondents still mistake family planning for contraception. It recommended that education on family planning must not be limited to only women and female teachers but to their spouses as well.

Prevalence of Family Planning Practices among Women Influenced by Husband’s Socio Demography and Decision Making

Family planning is an important practice for women as it can help to improve financial and social status. Unwanted pregnancy has negative effects for husband and financial. However, couples married at a late age may not practice family planning because they want to have kids. The aims of this study were to determine the prevalence, factors associated with husband’s socio demography and decision making in family planning practices among women in reproductive age who attended a polyclinic in Serdang, Malaysia. A cross sectional study was conducted on 245 women with a systematic random sampling. Descriptive analysis, Fisher exact and Chi-square tests were conducted to identify the influence of husband’s socio demographic factors and decision making in family planning practices. The prevalence of family planning practices among married women was moderate (53.9%). Family planning practices among women showed significant relationship with the husband’s socio demography which were husband’s race (p = 0.018), religion (p = 0.008) and making decision in family planning (p = 0.002). The husband’s socio demography showed a significant relationship with the prevalence of the wife practicing family planning. This clearly indicates that the husband is the individual that influence the wife to use contraceptive method. Decision making in family planning by both the husband and wife is important in choosing to use contraceptive method. Health promotion in the concept of health education for male contraceptive method such as pamphlet and booklet is important to promote husband involvement in family planning. DOI : http://dx.doi.org/10.17576/JSKM-2015-1302-05

Awareness, Prevalence and Determinants of Birth Control Methods Use among Women in Saudi Arabia

Objectives: The aim of this study was to characterize Saudi women’s current contraceptive choices and adherence to contraceptive regimens and to determine the knowledge, attitude and practice of contraception and the associated socio-demographic factors among a representative sample of Saudi married women in Al Qassim region, KSA. Methodology: Cross-sectional survey of women in Saudi Arabia aged 18-49 years (n= 300) was conducted. Questions include knowledge and attitude towards contraception, history of pregnancy, cause for use and reasons for avoiding contraception . Results: Of the 287 survey participants, 40 (13.9%) women were not used contraception. Among the 247 women who used contraception, the most frequently used current methods were oral contraceptive (49.1%) condom (17.1%) and intrauterine device (16%). There was a significant increase in contraceptive used among working women, 30 years and older, with high level of education, and those having a large number of children. Conclusion: there is deficient in the awareness of contraceptive methods in Al- Qassim region, Saudi Arabia as well as the knowledge, attitude, and practice of family planning.

Married Men's Involvement in Family Planning - A Study from Coastal Southern India.

Over the years, India has emerged as one of the most populous countries in the world, next only to China. Unregulated fertility can compromise the economic development and political stability of a country. Family planning was always thought to be a woman's prerogative, especially in a male dominant society like India. Consequently, most of the studies on family planning focused on women as the subject of interest. To assess the knowledge, attitude and practices of family planning amongst men who have been married for at least five years. A cross-sectional study was carried out in the teaching hospitals of Kasturba Medical College (Manipal University), Mangalore; India among 156 men who had been married for at least five years. They were selected using non-random sampling method and were interviewed using a pretested semi structured validated questionnaire. Chi-square test was used for statistical analyses. Overall, 75.6% were aged between 26 and 34 years, 41.7% had one child, 92.3% subjects from upper and 86.9% from lower socio-economic status were aware about the male family planning services available in the market. Most husbands preferred that their spouse should be sterilized (53.8%). Family planning methods were actively practiced by 71.2 %. Most of the studies on family planning have focused mainly on females. This study throws light on the male perspective of family planning. Our study subjects were well aware about various family planning services and their attitude towards family planning was favorable, but the number of men practicing family planning was not high.

Perceptions of Couples Who Use Jadelle Implant in Blantyre District, Malawi

Malawi has a high total fertility rate of 5.7 per woman and Jadelle implant may be an ideal option for couples who want to practice family planning. Jadelle is a long term contraceptive which is inserted just under the skin of a woman’s upper, inner arm by a nurse or midwife and prevents a woman from getting pregnant for a period of five years. But the use of Jadelle for family planning depends on perceptions of couples. The purpose of this study was to explore the perceptions of couples who choose Jadelle as their family planning method at a Central Hospital in Blantyre district. This study used a descriptive qualitative design. A purposive sample of 5 couples was used. Ethical clearance was granted by relevant authorities. Data was analysed through content analysis. The findings showed that the following nine themes emerged from the qualitative data: 1) men and women perspectives about mode of action of Jadelle; 2) knowledge about effectiveness and efficacy of Jadelle among men and women; 3) sources of information about Jadelle; 4) information given to Jadelle users by providers; 5) benefits of Jadelle; 6) challenges associated with Jadelle; 7) myths associated with Jadelle; 8) attitudes of providers of Jadelle and 9) role played by men regarding use of Jadelle. In conclusion, this study found that both men and women generally lacked knowledge of Jadelle. Men play a vital role when couples are choosing contraceptives. Every opportunity should be utilised at antenatal, postnatal and family planning clinics to teach individuals about family planning. This may allow women and men to make informed choices about the use of Jadelle.

가나 볼타지역 가임여성의 가족계획 실천에 영향을 미치는 요인

Background: Family planning is widely practiced today to resolve the over-growing population and overcome obstacles that thwart socio-economic growth. While Ghana was the first country in Africa to implement family planning program, its birthrate is still twice as much as world average due to weak infrastructure and strategic plans to enforce the policy. Thus, there is a need to objectively verify the factors that affect family planning of fertile women of Ghana.Methods: Total of 630 self-administered questionnaires were distributed from April 8 to 17 of 2013 to collect data. Six-hundred eigh -teen questionnaires were analyzed, excluding the 12 incomplete questionnaires. Collected data were analyzed using PASW SPSS ver. 18, and logistic regression analysis was performed to verify the factors that affect practice of family planning.Results: Satisfaction with health and medical facilities, experience with family planning education and awareness of birth control methods significantly affected practice of family planning. Based on analysis using odds ratio, enforcement rate of family planning increased by 4.574 times when the subjects were satisfied with health and medical facilities, by 3.920 times when received family planning education, and by 3.284 times when they were aware of birth control methods.Conclusion: By adopting family planning education program, government should be able to change fertile women’s perception of family planning. A strategic plan is necessary in order to increase access to medical facilities, improve service satisfaction, and induce women to enforce family planning voluntarily.Keywords: Family planning services; Satisfaction with health and medical facilities; Experience with family planning education; Awareness of birth control method

Family Planning Behavior and Small Family Concept Acceptance in Two Different Geographical Characteristics Municipality of South Klaten, Klaten, Central Java

The research aim to know the family planning behaviour, the acceptance small family norm and the influential factors in two villages that have different geographical aspect. The behaviour involve the knowledge, the attitude and the practice where as the influential factors involve education, accupation, values of children, income, children still born and family size desired. The research areas are chosen purposive in two villages that have different geographical aspect, social aspect and cultural aspect. The aspect are: 1) location and topography, 2) socialy structure, and 3) the achievement of effective acceptor. Based on the three aspects, Ngalas village (developing) and Sumberejo (developed) are chosen as research areas. The recorded as ative acceptor (recordedin RI/PUS/1991 form). The respondents are chosen by cencus at two neighborhoord association at every village. There are six variables in this research are assumed influence the periode of the contraceptives use, such as education, occupation status, values of children, family income, children still born, and family size desired. There are three variables are assumed influence the small family norm, such as education, occupation status, and values of children. The data was analyzed by frequency table, crosee table, and statistical analysis (Q square and Regresion). The data was always compared between the two villages. The analysis use computer by Microsoft Program. The research result showed that Sumberejo was better than Ngalas in the knowledge, the attitude, and the practice of family planning. Most of the people who live in Sumberejo understood the contraception device well (52,4%), where as in Ngalas (26,8%). Both of them agreed on using contraception device (more than 70%). The respondent who live in Sumberejo used IUD (40%) and MOW/MOP (23,23%). They had used of the contraception device for 4.8 years on an average. Mean while the respondents in Ngalas use IUD (23,68%) and MOW/MOP (2,63%). They had used the contraception device for 3,8 years on an average. With respect to decision making of family planning. Sumberejo was better than Ngalas (Sumberejo: 83,4% and Ngalas 63,64%). The purpose of family planning has achieved birth stop. Sumberejo achieved 73,33% and Ngalas achieved 54,55%. The research result showed that the both Sumberejo and Ngalas accepted small family norm. Values of children were heigh (Sumberejo 97,57% and Ngalas 93,31%). It indicates that the parent still hope the children role for their family. Not only did the parent hope from economics aspect but they hoped from non economic aspect as well. Both the average of live birth and the children who still alive in Sumberejo was lower than Ngalas. Mean while the number of the children who were desired was 2,9 child in Sumberejo and 2,8 in Ngalas. Based on seven statement that was used to identify the small family, there was tendency that the respondent in Sumberejo had better attitude than Ngalas about small family. The factor that influence the period of the contraception device was the number of the children who still children, income, and family planning norm did not influence the period of using of contraception device. The influential factors in acceptance of small family was education. The higher education the better aception of small family norm. Values of children also influenced the acceptance of small family norm, but there was difference of the direction between Sumberejo and Ngalas. In Sumberejo the higher occupation the better aceptance of small family norm, but in Ngalas, the higher percentance occupation the lower acceptance of small family norm.

Reproductive behavior and contraceptive practices in comparative perspective, Switzerland (1955–1970)

This paper focuses on marital birth control practices c. 1955–1970, i.e. before the era of widespread uniform adoption of modern contraceptives, in two nearby Swiss cities characterized by different religious cultures. It asks how responsibility for contraceptive practices was shared within the marital couple, whether it was the object of discussion between spouses, how the choice of a method of contraception was made and how religious culture affected these elements. This paper uses written sources reflecting medical authorities' views about birth control and 48 semi-structured interviews with elderly persons from the lower middle and working classes. The results point to three key conclusions. Firstly, the findings show a joint responsibility of both spouses for contraceptive practices. Secondly, the paper shows that religious culture plays a key role in the access to means of birth control. Specifically, Fribourg gynecologists were reluctant to prescribe modern methods. Thirdly, the results underline that a combination of methods are used throughout reproductive life, depending on the spouses' desire to have additional children and on men and women's individual attitudes toward birth control methods.

Cultural beliefs and understandings of cervical cancer among Mexican immigrant women in Southeast Georgia.

Rural Mexican immigrant women in the U.S. are infrequently screened and experience health disparities from cervical cancer. We explored cancer-related cultural beliefs in this population. We administered a cross-sectional survey to 39 Mexican immigrant women due for screening. We conducted univariate and bivariate analyses of participants' characteristics, Pap test history, cancer-related knowledge and beliefs, and cultural consensus analysis about causes of cervical cancer and barriers to screening. For all the cultural consensus tasks, there was consensus (Eigenratios >3:1) among survey participants. Comparing the rankings of risk factor clusters, clusters related to sexual behaviors were ranked more severely than clusters related to genetic or other behavioral factors. There was agreement on ideas of cervical cancer causation and barriers to screening among these women. Hence, improved methods of disseminating important health information and greater access to care are needed, particularly in relationship to stigma about sex and birth control practices.

Use of withdrawal (coitus interruptus) for both pregnancy and HIV prevention among young adults in Rakai, Uganda.

Although understudied in the context of AIDS, use of withdrawal (coitus interruptus) with or in place of other prevention methods affects exposure to both pregnancy and human immunodeficiency virus (HIV). We used mixed methods to assess use of withdrawal among 15-24-year-olds in a rural Ugandan setting with considerable HIV prevalence. We measured withdrawal reporting among (i) sexually active 15-24-year-olds enrolled in a quantitative community survey (n = 6,722) and (ii) in-depth qualitative interview participants systematically selected from the latest round of the community survey (N = 60). Respondents were asked about family planning and HIV prevention practices, including a direct question about withdrawal in the in-depth interviews. The main outcome measures were reports of current use of withdrawal on the quantitative survey (general question about family planning methods) and reports of current or recent use withdrawal in qualitative interviews (specific question about withdrawal). Qualitative interviews also probed for factors associated with withdrawal use. Although less than 1% of quantitative survey participants spontaneously named withdrawal as their current family planning method, 48% of qualitative interview respondents reported current or lifetime use of withdrawal. Withdrawal was often used as a pleasurable alternative to condoms, when condoms were not available, and/or as a "placeholder" method before obtaining injectable contraception. A few respondents described using withdrawal to reduce HIV risk. Qualitative findings revealed widespread withdrawal use among young adults in Rakai, mainly as a condom alternative. Thus, withdrawal may shape exposure to both pregnancy and HIV. Future behavioral surveys should assess withdrawal practices directly--and separately from other contraceptives and HIV prevention methods. Further clinical research should further document withdrawal's association with HIV risk.