Contraceptive Device Research Articles

Female’s Experience with Post-placental Intrauterine Contraceptive Device Use in a Tertiary Care Centre in Pakistan

Background: Insertion of a post-placental intrauterine contraceptive device (PPIUCD) has been recommended by the World Health Organization (WHO) as one of the safe and effective methods of temporary contraception. In the immediate post-delivery period, females are highly driven and in need of an effective method for contraception so that child-rearing can be easy without unintended pregnancy. Objective: To assess the outcome of females accepting PPIUCD in terms of insertion, complications, and discontinuation rate at 6 weeks and 6 months. Methods: Retrospective, cross-sectional study conducted at the Department of Obstetrics and Gynecology, Lahore General Hospital, Pakistan, from May 2015 to August 2019. The data were collected and analysed after approval from the hospital ethical committee and were retrieved from the maternal and neonatal child health programme. Record of clinical visit and telephonic survey for miscellaneous complaints at 6 weeks and 6 months were evaluated from the medical records department and relevant data were extracted. The data were analysed using the IBM Statistical Package for the Social Sciences (SPSS® Statistics) V21.0 software (International Business Machines Corporation [IBM], New York, USA) and the results were expressed in descriptive statistics in frequencies and percentages. Results: Total live births during the study period were 43,065. PPIUCD was inserted in 5,275 females (12.24%). Only 13% presented for clinical follow-up; 87% had a telephonic conversation. Of these, 33% were advised to have a clinical visit; 83% reported no complaints. Reassurance was needed in 11% and threads were trimmed in 2%. Problems reported were displaced intrauterine contraceptive device (IUCD; 3.3%); spontaneous expulsion (24.0%); vaginal infections (4.7%); missing strings (3.0%); cramping (25.0%); dyspareunia (6.0%); spotting (52.0%); and vaginal discharge (16.0%). Ultrasound was advised (3.0%), as were symptomatic treatment (14.0%) and antibiotics and IUCD removal (0.7%). IUCD was discontinued by 6.7% of the females for various reasons: family pressure (0.3%); wanting a further child (0.7%); and opting for another method of family planning (14.0%). IUCD was removed and reinserted in 4.9%. Conclusion: PPIUCD has a low turnover rate of follow-up but has high compliance with devices and a low complication rate; however, complications can be reduced by improving patient selection and clinical follow-up. It provides an excellent window of opportunity for providing effective long-term contraception to the patients who need it the most.

Antichlamydial Antibodies In Women With Ectopic Pregnancy

Methods: A case control study that was conducted in the Department of Obstetrics and Gynecology at Azadi Teaching Hospital / Kirkuk-Iraq during the period of 10 months from 1st of Feb till 1st of Dec 2019. It included 86 pregnant women selected from outpatient clinic and those who were admitted to the emergency department. They were divided into two groups: Case group included 43 women diagnosed with ectopic pregnancy and control group included 43 women with early normal intra uterine pregnancies (1st trimester). Women using an intrauterine contraceptive device at the time of conception or had previous history of ectopic pregnancy, infertility, tubal surgery or smoking were excluded . After obtaining verbal consent from them five ml of venous blood was collected from all women to investigate for serum anti chlamydial IgG antibody titer.Conclusion: Higher proportion of women with ectopic pregnancy had positive anti- chlamydial antibody than those with normal pregnancy. Anti-chlamydial antibody titer may play an important role to predict the risk of ectopic pregnancy as the mean of anti-chlamydial antibody titer was significantly higher in patients who diagnosed with ectopic pregnancy than that in women with normal pregnancy regardless age, gestational age or parity.

Counseling on the Selection of Contraceptive Devices for Women of Childbearing Age at Banjar Basa, Marga Village Tabanan

Indonesia as a developing country with a large population is greatly helped by the contraception method to reduce population and improve women's health. The types of saline contraception start from MKJP and Non-MKJP. Each type of contraception has advantages and disadvantages and each has an individual suitability and suitability for each woman. Providing complete information is an important factor in choosing a contraceptive device. The provision of information related to contraceptives and their types as well as health detection in women after childbearing is optimized to increase the coverage of active family planning participants and reduce high-risk groups who are not allowed to use certain contraceptive methods. From the activities carried out, it was obtained from 15 women of childbearing age who participated in this activity as many as 6 people (40%) had good knowledge regarding contraception and as many as 9 people (60%) had less knowledge about contraception. After being given education, there was a significant increase in the understanding of women of childbearing age regarding contraception, namely as many as 15 people (100%).

Background parenchymal enhancement in contrast-enhanced MR imaging suggests systemic effects of intrauterine contraceptive devices

ObjectivesLevonorgestrel-releasing intrauterine contraceptive devices (LNG-IUDs) are designed to exhibit only local hormonal effects. There is an ongoing debate on whether LNG-IUDs can have side effects similar to systemic hormonal medication. Benign background parenchymal enhancement (BPE) in dynamic contrast–enhanced (DCE) MRI has been established as a sensitive marker of hormonal stimulation of the breast. We investigated the association between LNG-IUD use and BPE in breast MRI to further explore possible systemic effects of LNG-IUDs.MethodsOur hospital database was searched to identify premenopausal women without personal history of breast cancer, oophorectomy, and hormone replacement or antihormone therapy, who had undergone standardized DCE breast MRI at least twice, once with and without an LNG-IUD in place. To avoid confounding aging-related effects on BPE, half of included women had their first MRI without, the other half with, LNG-IUD in place. Degree of BPE was analyzed according to the ACR categories. Wilcoxon-matched-pairs signed-rank test was used to compare the distribution of ACR categories with vs. without LNG-IUD.ResultsForty-eight women (mean age, 46 years) were included. In 24/48 women (50% [95% CI: 35.9–64.1%]), ACR categories did not change with vs. without LNG-IUDs. In 23/48 women (48% [33.9–62.1%]), the ACR category was higher with vs. without LNG-IUDs; in 1/48 (2% [0–6%]), the ACR category was lower with vs. without LNG-IUDs. The change of ACR category depending on the presence or absence of an LNG-IUD proved highly significant (p < 0.001).ConclusionThe use of an LNG-IUD can be associated with increased BPE in breast MRI, providing further evidence that LNG-IUDs do have systemic effects.Key Points• The use of levonorgestrel-releasing intrauterine contraceptive devices is associated with increased background parenchymal enhancement in breast MRI.• This suggests that hormonal effects of these devices are not only confined to the uterine cavity, but may be systemic.• Potential systemic effects of levonorgestrel-releasing intrauterine contraceptive devices should therefore be considered.

Safety profile of immediate post-partum intrauterine device insertion during caesarean delivery – a clinical trial with three years of follow up

Background: Many countries recommend the use of long-acting reversible contraceptive intrauterine device immediately after cesarean delivery. The cesarean delivery rate in Iraqi public hospitals is 32.2% and may reach 85.8% in private hospitals. Immediate post-partum intrauterine device insertion at cesarean is rarely done in Iraq. Objectives: To assess the safety and practicality of immediate post-partum intrauterine device insertion during cesarean delivery for family planning and pregnancy spacing in Iraqi women. Subjects and Methods: A single arm clinical trial included 150 eligible women who attended Al-‎Elwiyah Maternity Teaching Hospital or Al Hayat Rahibat Hospital for term delivery. A copper intrauterine device was placed in the uterine cavity immediately after delivery of the placenta during cesarean delivery. The intrauterine device was fixed in place at the fundus using an absorbable suture. Patients were followed up at six weeks, then annually for three years. Results: Expulsion of the intrauterine device was not reported by any of the participants. The most-reported complaints in the first twelve months of intrauterine device placement were abdominal pain, abnormal vaginal discharge, and ‎heavy menstrual blood loss, however, none were statically significant (P= 0.256). After the first year, there was a significant reduction in the ‎frequency of complaints (P= 0.002). Only 7.33% (95% CI: 6.92–7.75%) of the patient requested intrauterine device removal within the three years. The main reason was to plan a new pregnancy followed by recurrent infection associated with uncontrolled diabetes ‎mellitus. Diabetes was ‎a significant predictor for immediate post-partum intrauterine device removal, P= 0.049. Conclusion: The intrauterine device placement during cesarean delivery with suture fixation is a safe procedure with a zero-expulsion rate and is an effective reversible long-term contraceptive method.

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN PEMAKAIAN KONTRASEPSI IMPLANT DI PUSKESMAS SIMPANG RAMBUTAN

Contraception is an attempt to space pregnancies or plan the number and spacing of pregnancies using contraceptive methods. Implant is a contraceptive device in the form of a small capsule containing the hormone lovonorgestril which is placed under the skin of the inner upper arm. The formulation of the problem in this study was to determine the relationship between Fear of Side Effects, Access to Service Facilities, and Husband's Support with the use of Implant Contraception at the Simpang Rambutan Health Center, Banyuasin Regency in 2021. The research design that will be used in this study is descriptive analytic with a cross sectional approach. The research was carried out in the work area of ​​the Simpang Rambutan Health Center in July-August 2021 with a sample of 32 respondents. The analysis used is the che square test. Univariate analysis results show that of the 33 respondents most of the respondents did not use implant contraceptives, which amounted to 19 respondents (59.4%) and 13 respondents (40.6%). The results of the chi-square statistical test obtained value = 0.011 for the variable fear of side effects, p value = 0.000 for access to health services, p value = 0.002 for husband's support. shows that there is a significant relationship between fear of side effects, husband's support and access to health services with the use of implant contraceptives at the Simpang Rambutan Health Center, Banyuasin Regency in 2021. The suggestions in this study are that it can be used as study material for the puskesmas in order to increase the coverage of implant contraceptive participants. especially in the work area of ​​the Simpang Rambutan Health Center, Banyuasin Regency.  Keywords        : Implant Contraception, Access to Health Services, Husband's Support.

Awareness and Acceptance of PPIUCD among Pregnant Females Attending Tertiary Care Hospital in Pakistan

Introduction: The postpartum intrauterine contraceptive devices (PPIUCD) is the only family planning strategy for couples asking highly viable, reliable, reasonable, non-hormonal, instantly reversible, and long-acting contraceptive that can be started during the immediate postpartum period and it has no a negative impact on lactation. In spite of this advantage, the acknowledgment and utilization of prompt PPIUCD were exceptionally low and the reasons for dismissing quick PPIUCD utilization have not been characterized in Pakistan. Subsequently, this study determined the level of adequacy and factors related with quick PPIUCD utilize among ladies who gave birth. Methods: A cross-sectional study was conducted from July 2020 to June 2021 at Lahore General Hospital, Lahore. Two hundred females patients were effectively met utilizing structured and pre-tested survey. Health facilities were chosen. Study participants were chosen systematically. Information entered and data was analyzed using SPSS version 23. Calculated relapse examinations were done. A significant association was pronounced at a p-value less than 0.05. Results: Out of these 200 females, 80 females patients (40%) had information of PPIUCD, as it were 30 % of ladies had past information almost PPIUCD however only 8 % of ladies practiced it within the past. After counseling 22% of ladies concurred for addition of PPIUCD after this delivery. Conclusion: The study concludes that the antenatal ladies had poor information with respect to PPIUCD. Practices were indeed more awful. This might be credited to low education, refusal by family particularly male partner, and religious convictions. But once suitable information and data is given, state of mind gradually changes. Keywords: PPIUCD, Awareness, Pregnancy, Hospital

Acceptability of Intrauterine Contraceptive Device Insertion in immediate Postpartum Period

Background: Mostly, females seek birth space after a delivery. But usually are unaware about contraceptive method and their usage, especially during postpartum period. Controversial results have been noticed from literature regarding the acceptability of PPIUCD among females of reproductive age groups. So we conducted this study to find the acceptability in local population. Aim: To determine the frequency of acceptability of immediate post-partum intra-uterine contraceptive device insertion in females presenting for delivery. Methods: This cross sectional study was conducted in Gynae Unit-II, Shalamar Hospital, Lahore for a period of six months after approval of synopsis i.e. from 4th October 2016 to 4th April, 2017. 90 patients enrolled in this study. Informed consent was taken from all the patients. After delivery, IUCD implanted after taking approval from female and her husband and acceptability noted. All the collected data was entered and analyzed on SPSS version 20. Results: The mean age of the patients was 29.52±7.38 years. The low SES patients were 41(45.6%), middle SES patients were 40(44.4%) and high SES patients were 9(10%). In this study 54(60%) patients accepted the use of IUCD. Conclusion: In our study, the acceptability of immediate PPIUCD insertion in females presenting for delivery was 60%. Keywords: Acceptability, Post-partum, Intra-uterine Contraceptive Device, Delivery

Size‐Dependent Inhibition of Sperm Motility by Copper Particles as a Path toward Male Contraception

Effective inhibition of sperm motility using a spermicide can be a promising approach in developing non‐invasive male contraceptive agents. Copper is known to have contraceptive properties and has been used clinically for decades as intrauterine contraceptive devices (IUDs) for contraception in females. Beyond that, the spermicidal use of copper is not explored much further, even though its use can also subdue the harmful effects caused by the hormonal female contraceptive agents on the environment. Herein, the size, concentration, and time‐dependent in vitro inhibition of bovine spermatozoa by copper microparticles are studied. The effectivity in inhibiting sperm motility is correlated with the amount of Cu2+ ions released by the particles during incubation. The copper particles cause direct suppression of sperm motility and viability upon incubation and thereby show potential as sperm‐inhibiting, hormone‐free candidate for male contraception. In addition, biocompatibility tests using a cervical cell line help optimizing the size and concentration of the copper particles for the best spermicidal action while avoiding toxicity to the surrounding tissue.

Continuation of post-coital intrauterine contraceptive devices beyond index cycle at Sexual Health Sheffield

We aimed to observe the continuation of Emergency IUD beyond the index cycle and reasons for removal. We analysed data from the patients’ electronic records of fifty consecutive women who had an IUD fitted at Sexual Health Sheffield for emergency contraception. 48 (96%) women continued with the IUD beyond the index cycle and 31 (62%) women for more than 1 year. Heavy menstrual bleeding, dysmenorrhoea and pain were the most frequent reasons cited for removal.

Pattern of contraceptive choice among clients attending a tertiary health institution in Ogbomoso, Southwestern Nigeria

Background: There is no ideal contraceptive method; therefore, likelihood of method choice shifts among clients from time to time. Aim: The aim of this study is to determine the most chosen modern contraceptive method, and the factors influencing that choice among clients attending a relatively new tertiary health institution in Southwestern Nigerian. Methods: A retrospective review of the case records of clients attending the family planning clinic of Ladoke Akintola University of Technology Teaching Hospital Ogbomoso, southwestern Nigeria, from January 2012 to December 2017. Results: Six hundred and twenty-nine clients accessed modern contraceptive methods during the study period. Their age ranged between 15 and 50 years with a mean of 33.0 ± 12.93. Most of the clients were married 616 (97.9%), had postsecondary education 405 (64.4%), and were of Christian faith 460 (73.1%). Progestogen-only injectable was the mostly chosen by the clients 228 (36.2%), and this is followed by intrauterine contraceptive device 186 (29.6%). Child spacing was the most common reason for contraception by the clients 357 (56.8%). Parity, postpartum contraception, previous contraceptive use, outcome of last delivery, mode of delivery of antecedent pregnancy, and educational status were all significantly associated with the mostly chosen method. Conclusion: Progestogen-only injectable contraceptive is the mostly chosen method among the clients, and this is a shift from what is obtained in southwestern Nigeria where intrauterine contraceptive device used to be the modern contraception method of choice.

Determinants of Intrauterine Contraceptive Device Discontinuation Among Women Using Family Planning, in Southwest Ethiopia: Unmatched Case-Control Study.

BackgroundAlthough the intrauterine contraceptive device is an effective, reliable, safe, and recommended contraceptive method, it is still underutilized and has a high discontinuation rate in Ethiopia. The study aims to assess determinants of the discontinuation of IUCDs among women using family planning in Ilu Aba Bor Zone.MethodsA facility-based unmatched case–control study was conducted from September to October, 2021 among 168 (56 cases and 112 controls) IUCD-user women in public health facilities in south-west Ethiopia. Pretested, structured and interviewer administered questionnaires were used for data collection. The data were coded, cleaned and entered to Epi-data version 3.1 and exported to SPSS version 23 for advanced analysis. A binary logistic regression was used to estimate the degree of association between the outcome variable and independent variables. Finally, variables with a p-value less than 0.05 at 95% confidence interval were declared as statistically significant with outcome variable.ResultsA total of 168 (163) respondents participated in the study, with a response rate of 97%. The mean (+SD) age of the respondents was 31.36 ± 5.916. Regarding the educational status of respondents about 36 (64.3%) of cases and 90 (84.1%) of controls have formal education, and about 42 (75%) of cases’ husbands and 97 (90.65%) of controls’ husbands have formal education, respectively. Experiencing side effects (AOR = 2.36; 95% CI: 1.01, 5.55), lack of follow up (AOR = 4.069; 95% CI: l.30, 12.69), and planning for next pregnancy (AOR 4.14; 95% CI: 1.58, 10.88) were found to be the main determinants of intrauterine device discontinuation.ConclusionThe findings of the study showed that lack of follow-up after insertion of the IUCD, experiencing side effects, and having a plan for the next pregnancy were found to be the main determinants of intrauterine device discontinuation. Hence, arranging recommended regular follow-up and treating side effects are very important to sustain intrauterine device utilization.

Efficacy of Immediate Post-Partum Intrauterine Contraceptive Device in a Tertiary Care Hospital

Objective: To determine efficacy of post-partum intrauterine contraceptive device (IUCD) in women presenting to a tertiary hospital.To compare efficacy of post-partum Intrauterine device between vaginal Insertion and Intra-Cesarean Insertion. Material and Method: A Prospective, cross sectional study was conducted at Department of Gynecology and Obstetrics Unit III, Abbasi Shaheed Hospital, Karachi from Jan2020 to June, 2020. Total 234 patients were included in this study. Patients fulfilling the inclusion criteria were enrolled in the study after taking Informed consent. Copper containing IUCD was inserted. Follow up was done at 6weeks and six months of delivery. All women were counseled to report missing threads, heavy vaginal bleeding, and vaginal discharge with pain in abdomen on each visit during follow-up. Abdominal, speculum and vaginal examinations was done. Efficacy was determined by the expulsion rate. Statistical analysis was done by SPSS Version 20. Results: Out of total insertions 103(44.01%) were intra caesarean and 131 (55.98%) IUCDs were placed after vaginal delivery. Symptoms of unusual vaginal discharge were reported by 28(11.9%) women, missing thread were reported by 67(28.5%), abdominal pain was reported by 92(39.2%) and heavy bleeding was reported by 44(18.8%) patients at follow-up. efficacy of vaginal insertion was 79(60.30%) and intra-cesarean insertion of PPIUCD was 65(63.10%). Conclusion: It can be concluded that PPIUCD in the field of postpartum family planning is a promising approach. Whatever may be the mode of delivery, PPIUCD is safe and effective. Keywords: Efficacy, Vaginal Insertion, Post-Partum Intrauterine Contraceptive Device, missing threads

Role of Postpartum IUCD Insertion after C-Section

Objective: To evaluate the outcome of C-section with and without postpartum IUCD insertion in terms of wound infection and bleeding. Methodology: In this Randomized Control Trial, at Department of Obstetrics/Gynaecology, Allied Hospital, Faisalabad during the years 209-20, we included 302 cases (151 in each group) who fulfilled the inclusion/exclusion criteria. Two groups were formed, Group A with inserted IUCD and Group B without IUCD insertion. Bleeding and wound infection was compared in both groups within seven days of caesarean section. Results: Both groups were insignificant regarding bleeding and wound infection. 6.6%(n=10) in Group-A and 5.3%(n=8) in B Group had wound infected (p=0.627), 2.6%(n=4) group A cases and 1.3%(n=2) cases of B group were recorded with bleeding (0.410). Conclusion: Insertion of postpartum IUCD is not significantly different when compared without IUCD insertion regarding heavy bleeding and wound infection. Keywords: C-section - caesarean section, IUCD - intrauterine contraceptive device.

Attitude, Knowledge and Practice of Contraceptive Methods in Rural Areas

Introduction: Promotion of family planning has been shown to reduce maternal and neonatal mortality and promotes women empowerment. Contraception is regarded as an important preventive measure against unintended pregnancies. Although contraceptive methods are freely available in Family Planning centers, the utilization is low. Aims And Objectives: To assess the attitude, knowledge and practice of contraceptive methods in rural areas Material and Method: The study was carried in Pak Rd Crescent Medical and Dental College, Dinanath. Duration was 6 months from 1 July 2021 till 31 December 2021. It was a descriptive study. Sample size was 1200. Postoperative patients including caesarean section and spontaneous vaginal delivery and patients coming in outpatient department including antenatal and patients with gynecological problems were included. The women were interviewed regarding knowledge of contraceptive methods and choice to decide these methods. Most of them had knowledge but less number of women agreed to decide family planning method. Results: Usually women who gave interview were between age 31 to 40 years 37.6% and21 to 30 years 33.1%. Maximum parity 2 -4 were 47.1% and P 5 and above were 44.7%. 69.3% of them were illiterate. 86.4% women had knowledge of IUCD, 91.8% regarding COCP and 91.1% about injectable contraceptives.95.6% knew about male condoms. For the practice of contraceptive methods, maximum demand was of male condoms 13.8%, COCP 9.5%, IUCD 4% and injectables 4.6%. The reasons for not practicing family methods were husband and family pressure 30.1%, different myths about contraception 27.2%, family not complete 17.6%, cultural reasons 14.6%, lack of knowledge 8.8% and need for male gender 4.5% Conclusion: Although most of the ladies had knowledge of contraceptive methods but they were reluctant to practice them. Motivation of husband and mother in law is important factor to achieve positive attitude towards contraception. Counselling against myths and false belief is essential. Keywords: IUCD intra uterine contraceptive device, COCP combined oral contraceptive device

Magnitude of intrauterine contraceptive use and its associated factor among women attending family planning service, Cross sectional study

Background: From the different Family planning methods available an intrauterine contraceptive device, IUCD is widely available and is highly effective in terms of safety and effectiveness. Despite this fact, there is low utilization of IUCD in Ethiopia. Objectives: The aim of this study was to determine the magnitude of intrauterine contraceptive device use and associated factors among women attending family planning services in selected public health centers in Kolfe Keraniyo Sub-City, Addis Ababa, Ethiopia 2021. Method: This facility based cross- sectional study was conducted among 399 women attending the FP clinics of randomly selected health centers in Kolfe Keraniyo Sub City, from June 15 to July 20, 2021.The data were collected with pretested questionnaire and entered to Epi-info version 7.2 and analyzed by using SPSS statistical software version 25. Descriptive analysis was done to describe the variables in frequencies, percentages, and mean with the standard deviation. Logistic regression analysis was also used to identify the presence of association between dependent and independent variables. 95% CI and P-value &lt;0.05 were used to indicate the significance level. Result: A total of 399 women were included in the study (with response rate of 100%). The mean age of the participants was 29.8(SD±8.2). This study determined IUCD utilization among participants to be 14.8%. Factors associated with IUCD utilization among women attending family planning service were: Maternal age (AOR=3.1; 95%CI(2.07-7.36), Educational status of no formal education (AOR=0.35; 95%CI (0.01-0.40), future plan of fertility to limit birth (AOR=5.87, 95% CI :2.33-14.87), monthly income ≤600ETB (AOR=0.06; 95%CI(0.01-0.25), number of children alive (AOR=0.13; 95%CI(0.03-0.52) and wanting any more children (AOR=0.10; 95%CI(0.01-0.70) were significantly associated with IUCD utilization. Conclusion and recommendation: Age of the women, income and educational status were identified as factors increasing the likelihood of IUCD utilization. Therefore, to scale up the utilization of IUCD, empowering women, FP counseling and expanding female education should be undertaken.

Effect of the COVID-19 pandemic on contraceptive prescribing in general practice: a retrospective analysis of English prescribing data between 2019 and 2020

ObjectivesThis paper looks at how contraceptive prescribing by General Practices in England was affected by the COVID-19pandemic and lockdown. It compares English prescribing data in April – June 2019, the year before COVID19, and April–June 2020, the first three months of ‘lockdown’.Design & SettingThis paper is based on retrospective analysis of the English Prescribing Dataset which reports monthly on prescribed items from English General Practices. Data on all forms of prescribed contraceptive methods were extracted using BNF codes, and total quantities tabulated by method. To reach the total number of months of contraception provided, total quantities were divided or multiplied according the frequency with which the method is taken per month or the numbers of months of contraception provided.ResultsPrescription of the combined oral contraceptive pill reduced by 22% during the period of lockdown compared to the same three months in 2019. Prescriptions of Progestogen-Only pills remained stable. Prescription of long-acting methods reduced, with the greatest reductions in implants (76% reduction from pre-lockdown levels), intra-uterine systems (79% reduction from pre-lockdown levels) and intrauterine devices (76% reduction from pre-lockdown levels).ConclusionsThe disruption of face-to-face contraceptive consultations in General Practice during a COVID-19 ‘lockdown’ has resulted in a reduction in oestrogen –containing methods compared to progestogen-only methods, which require less face-to-face monitoring.Implant and intrauterine contraceptive device prescription reduced by three quarters over the first three months of lockdown, which has the potential to result in a rise in unintended pregnancies.

Hubungan Pengetahuan Ibu, Dukungan Suami dan Peran Tenaga Kesehatan dengan Akseptor KB Suntik Di Poskesdes Surau Kecamatan Muara Jaya Kab. Ogan Komering Ulutahun 2021

Injectable contraception is a contraceptive device in the form of a liquid that is injected into a woman's body periodically and contains hormones. BKKBN supports being a reliable and trusted institution in realizing a balanced growing population and quality family. Factors that affect Mother's Knowledge, Husband's Support and Simultaneous Role of Health Workers with Injectable Family Planning Acceptors at Poskesdes Surau, Muara Jaya District, OKU Regency in 2021. Research This study uses a quantitative method of analytical survey with a Cross Sectional approach, using primary data with a population of 60 people and the number of samples taken using an accedental sampling technique. using injection family planning acceptors (63.3%), good maternal knowledge (70%) and supportive husband support (63.3%). Role of Health Workers value=0.012 with injectable family planning acceptors. Conclusion There is a relationship between mother's knowledge, husband's support and the role of health workers simultaneously with injecting family planning acceptors at Poskesdes Surau, Muara Jaya District, OKU Regency in 2021

Clinical skills of general practitioners in Nairobi, Kenya: a cross-sectional study.

Quality service delivery in primary care requires motivated and competent health professionals. In the Kenyan private sector, GPs with no postgraduate training in family medicine offer primary care. There is a paucity of evidence on the ability of primary care providers to deliver comprehensive care and no such evidence is available for GPs practising in the private sector in Kenya. To evaluate GPs' training and experience in the skills required for comprehensive primary care. A cross-sectional descriptive survey in 13 primary care clinics in the private sector of Nairobi, Kenya. A questionnaire, originally designed for a national survey of primary care doctors in South Africa, was adapted. The study collected self-reported data on performance of clinical skills by 25 GPs. Data were analysed using the Statistical Package for Social Sciences (SPSS, version 25). GPs were mostly aged <40 years, with ≤10 years of experience, and there was an equal sex distribution. GPs reported moderate performance with adult health, communication and consultation, and clinical administration; and weak performance with emergencies, child health, surgery, ear, nose, and throat (ENT) and eyes, women's health, and orthopaedics. The GPs lacked training in specific skills such as proctoscopies, contraceptive devices, skin procedures, intra-articular injections, red reflex tests, and use of genograms. GPs lacked training and performed poorly in some of the essential skills required in primary care. Continuing professional development, training in family medicine, broadening the model of care, and deployment of family physicians to the clinics could improve care comprehensiveness.

Effect of the Covid pandemic on progestogen-only and oestrogen-containing contraceptive prescribing in general practice: a retrospective analysis of English prescribing data

Objectives This paper looks at how trends in contraceptive prescribing by General Practices in England were affected by the Covid pandemic and lockdown. It compares English prescribing data from May 2014 to May 2021, including the period of ‘lockdown’, from April 20-June 20. Design & Setting A retrospective analysis of the English Prescribing Dataset which reports monthly on prescribed items from English General Practices was carried out. Data on all forms of prescribed contraceptive methods were extracted using British National Formulary (BNF) codes, and total quantities tabulated by method, then transformed into ‘months of contraception provided’ by each method. Results Prescription of the combined oral contraceptive pill reduced by 22% during the period of lockdown compared to the same three months in 2019. Prescriptions of Progestogen-Only pills remained stable. This continued a trend in oral contraceptive prescribing evident from May14. Prescription of long-acting methods reduced during the period of lockdown, with the greatest reductions in implants (76% reduction from pre-lockdown levels), intra-uterine systems (79% reduction from pre-lockdown levels) and intrauterine devices (76% reduction from pre-lockdown levels). These rates of contraceptive provision recovered quickly after the period of lockdown ended. Conclusions The disruption of face-to-face contraceptive consultations in General Practice during a Covid-19 ‘lockdown’ has resulted in a reduction in oestrogen –containing methods compared to progestogen-only methods, which require less face-to-face monitoring. Implant and intrauterine contraceptive device prescription reduced by three quarters over the first three months of lockdown, but rebounded in the next year.