Extensive Education Campaigns Research Articles

Commentary] Postpartum Depression: An Invisible Distress in the United Kingdom

This opinion piece explores the complexities of Postpartum Depression (PPD), its impact on the mother and child’s mental health, and the societal challenges it presents. PPD extends beyond the commonly experienced “baby blues” and can significantly impact a mother’s functionality due to its potential to evolve into a long-term depressive disorder if not properly addressed. The piece highlights the inadequacy of current maternal mental health support structures within the National Health Service (NHS), pointing out the lack of specialised treatment options tailored to new mothers' unique needs. It discusses the compound effects of social stigma and cultural barriers that limit access to necessary support, underscoring the urgent need for enhanced support systems and policy reforms. The piece highlights the serious long-term effects of PPD on children, such as developmental delays and emotional and behavioural challenges, advocating for early intervention and comprehensive support systems that address the needs of both mothers and their families. It calls for the adoption of thorough PPD management strategies, including the use of effective screening tools such as the Edinburgh Postnatal Depression Scale, and extensive educational campaigns to identify early PPD symptoms. The piece further urges for policy changes to provide new mothers with tailored resources and support, promoting a more inclusive and supportive healthcare environment for affected families.

Palliative and Supportive Care for Patients with End-Stage Hepatocellular Carcinoma: Perspectives of Egyptian Domestic Caregivers.

Palliative care is a holistic, patient-centered approach to improving the quality of life for those with terminal diseases and their families. The main objective of the current study was to evaluate the Egyptian domestic caregivers' knowledge, attitudes, and competencies related to palliative and supportive care. Three hundred and thirty-five family caregivers in total were recruited. A descriptive research design was used. Four tools were used to collect data; structured interview questionnaire to collect demographic questions, palliative care knowledge questionnaire, Palliative Attitude Scale, and Competence Scale. The study was conducted in oncology outpatient and pain clinics located at the Damietta Cancer Institute in Damietta Governorate, Egypt. Nearly two-thirds of the informal family caregivers are aged between 30-40 years old; 54% are female, and 83% are married. Also, sixty-seven point eight of the informal family caregivers were working (part-time). Furthermore, 65 % of them had insufficient knowledge, 68 % had a positive attitude, and 58% of the informal family caregivers had non-competency skills regarding palliative and supportive care. Approximately two-thirds of informal care providers had insufficient total knowledge scores, more than half possessed a positive attitude, and more than half reported non-competency skills regarding palliative care of hepatocellular patients. It is highly advisable to launch extensive health education programs and campaigns aimed at all of the unpaid informal family careers of patients with serious terminal illnesses, including hepatocellular carcinoma, at various governments with greater sample sizes.

Importance of pain assessment, documentation, and education among nurses caring for critically Ill patients: A cross-sectional study

<b>Objectives:</b> The present study examines the importance of pain assessment, documentation, and education among nurses caring for critically ill patients.<br /> <b>Methods:</b> This cross-sectional descriptive study was conducted on a convenience sample of 200 nurses working in acute care settings of hospitals in Irbid, Jordan. Data were gathered via self-administered questionnaires. Eight items of the pain aassessment and management for critically ill questionnaire were used in this study to measure the importance of pain assessment, documentation, and education for nurses caring for critically ill patients.<br /> <b>Results:</b> There was a significant positive correlation between the use of pain assessment tools for patients’ able self-report and the importance of assessment tools. The nurses rated pain assessment in intensive care units patients with burns as being the most extremely important. Regarding the importance of assessing the need for pre-emptive analgesia before specific procedures, the most often rated as extremely important to do was the invasive line placement procedure. Most participants used the guidelines of clinical practice recommendations of the American Society of Pain Management Nursing for the assessment and management of pain.<br /> <b>Conclusions:</b> Poor pain assessment, documentation, and education are significant problems demanding a constructive re-appraisal of the present pain practices. Improving pain assessment, documentation, and education via extensive educational programs and campaigns is essential for optimal pain practice.

Knowledge Attitude and Perceptions Towards Vitamin D among General Public

Vitamin D deficiency is becoming a global epidemic. Vitamin D deficiency is associated with numerous chronic diseases including cancer, heart disease and diabetes type 1 and type 2.. It is currently estimated that one billion people suffer from vitamin D deficiency worldwide. The aim of this study is to investigate the knowledge, attitude and practices (KAP) towards vitamin D deficiency, sun exposure, supplementation and fortification. Methods A cross-sectional study was performed among 200 people from all age groups for a a period of six months (January 2021-June 2021). Result About 60% of the participants are educated from college or university. Additionally, there is a negative attitude towards Vitamin D and sunlight exposure. Nearly 25.5% of the respondents were unsure to expose themselves to sunlight. About 50% of population has taken vitamin D supplement. About 78% of people accepted vitamin D is important for health. 46.5% of people are willing to undergo test for Vitamin D. About 54.9% of people preferred Vitamin D supplement in form of pills. tablets, granules. Therefore, extensive health educational campaigns for the public should be implemented by the government to raise their knowledge on the importance of Vitamin D. Governmental actions including increasing awareness of the importance of vitamin D and guidelines on how to obtain it are necessary.

EFFECT OF THE COVID-19 PANDEMIC ON THE CLINICAL EVOLUTION OF ACUTE APPENDICITIS AND ACUTE CHOLECYSTITIS

Background: The World Health Organization declared a worldwide Coronavirus (COVID-19) pandemic on March 11, 2020. In Uruguay, unlike most countries, a mandatory confinement was not declared. On the contrary, an extensive education and prevention campaign was carried out associated with measures to reduce social mobility, such as prohibiting meetings and closing bars.Objectives: The aim of the present study was to evaluate the COVID-19 pandemic in Uruguay and its repercussion on the clinical evolution of the two most common surgical pathologies: acute appendicitis (AA) and acute cholecystitis (AC).Methods: A retrospective comparative cohort study was performed at the Emergency Department of the University Hospital “Hospital de Clinicas Manuel Quintela,” the most important tertiary referral hospital in the city of Montevideo, capital of Uruguay. Two cohorts were identified: 13th of March 2019 to 13th of June 2019 [Pre-Covid period (PCP)] and the same period in 2020 [Pandemic Covid period (PCVP)]. Demographic and clinical data were analyzed.Results: A total of 118 cases were registered in 2019 and 109 in 2020. There were 43 cases (36.4%) of acute appendicitis in the pre-Covid period and 42 cases (36.5%) in Pandemic Covid period (p = 0.745). Acute cholecystitis cases differed significantly between cohorts, with a raise of cases in the Pandemic Covid period (14 vs 25) (p = 0.027). The surgical approach (Laparoscopy vs Open) did not change significantly (p = 0.207). A significant increase in complicated cases (AA + AC) was found during the pandemic (PCP 57 cases vs PCVP 67 cases) (p < 0.001). The sub-analysis of AA and AC showed a significant increase in AA’s complicated cases during PCVP (14 vs 25; p < 0.001) and no significant changes in the AC group (p = 0.99).Conclusion: An increase of complicated cases of AA was observed with maintenance of the number of consultations that might be explained by the excellent pre-hospital care system and absence of lock-down measures. The results are contradictory in some aspects, which calls for a deeper analysis, comparing different realities and longer periods of time in order to be able to draw conclusions that are representative for the Coronavirus pandemic in Uruguay.

KNOWLEDGE, ATTITUDES, AND PRACTICES (KAP) TOWARD DENGUE FEVER IN CALI, COLOMBIA

ABSTRACT Dengue fever is a vector-borne disease transmitted by the Aedes (Ae. aegypti or Ae. albopictus) mosquito, with a presence in more than 100 countries and a major cause of morbidity and mortality globally, particularly in the Americas. As an alternative to mosquito habitat control, international health organizations propose community empowerment methodologies shaped by recommendations resulting from the understanding of the knowledge, attitudes, and practices (KAP) of communities toward the disease. This study focuses on the Ladera region of the city of Cali, Colombia, a community identified as high risk for dengue fever in a dengue-endemic city. The objective is to understand KAP toward dengue fever of the people in the region after the 2010 dengue epidemic, when extensive educational campaigns were conducted to fight the disease. One hundred forty-six people were surveyed in four health facilities, each located in a different comuna (commune) of the study area. Sixty-eight percent of the respondents were female, 83 percent were between the age of 18 and 65, and almost half of the sample only completed elementary education. Indices were calculated for each dimension of the survey. Results are compared by comuna within the region and to a recent similar study conducted in Cali. The X 2 statistic was used to test for the significance of socio-demographic variables (that is sex, age, and education) on the responses to the survey questions and the indices values. A multinomial regression model was run using as a dependent variable each KAP index and as independent variables the socio-demographic variables. Results show individuals exhibit medium to high levels of knowledge, positive attitudes, and medium to low levels of practicing preventive measures. Spatial patterns on the indices and responses to questions in the sample were not identified. Socio-demographic variables do not show strong relationships with the knowledge, attitudes, and practices indexes. Results are comparable to those obtained in a more recent KAP study conducted in the city. These findings can help determine differences between communities to design and improve initiatives targeted to the needs of populations at risk and identify behavioral changes through time.

Labour leaders as identity entrepreneurs: Identity formation in the Swedish trade union movement in the 1920s

This article explores how cohesive labour movements are created. Although overlooked by previous research, strategic labour leaders that act as identity entrepreneurs can play a decisive role in class formation processes. Using the Swedish trade union movement during the crucial period from 1910 through the 1930s as a case, I examine the labour leaders’ strategic actions to create cohesiveness in the movement. Being pressured by emerging left-wing organizations in the 1910s, Swedish labour leaders realized that the Trade Union Confederation needed a strong organizational identity. The threat of the fragmentation of the trade union movement into different organizations fighting over the same members made the leaders formulate and implement a strategy for cohesion. Through an extensive education campaign to teach trade union members the aim and meaning of the reformist union movement, the leaders hoped to solve the fragmentation problem. This article indicates not only that labour leaders actively managed identity formation in the Swedish case, but also that internal education served as a means for creating cohesiveness in the movement.

Progress of Local Health Department Planning Actions for Climate Change: Perspectives from California, USA.

Public health departments are on the frontlines of protecting vulnerable groups and working to eliminate health disparities through prevention interventions, disease surveillance and community education. Exploration of the roles national, state and local health departments (LHDs) play in advancing climate change planning and actions to protect public health is a developing arena of research. This paper presents insights from local public health departments in California, USA on how they addressed the barriers to climate adaptation planning with support from the California Department of Public Health’s Office of Health Equity Climate Change and Health Equity Section (OHE), which administers the California Building Resilience Against Climate Effects Project (CalBRACE). With support from the U.S. Centers for Disease Control and Prevention (CDC) Climate-Ready States and Cities Initiative (CRSCI), CalBRACE initiated an adaptation project to seed climate planning and actions in county health departments. In this study, we compared the barriers and strategies of twenty-two urban and rural LHDs and explored potential options for climate change adaptation in the public health framework. Using key informant interviews and document reviews, the results showed how engagement with CalBRACE’s Local Health Department Partnership on Climate Change influenced the county departments’ ability to overcome barriers to adaptation through the diversification of funding sources, the leveraging strategic collaborations, extensive public education and communication campaigns, and the development of political capital and champions. The lessons learned and recommendations from this research may provide pathways and practices for national, state and local level health departments to collaborate in developing protocols and integrating systems to respond to health-related climate change impacts, adaptation and implementation.

Sociodemographic factors influencing knowledge, attitude, and practices regarding the prevention of common cancers among adults in urban slum, Kolkata

Context: Cancer is a serious global public health problem. Public awareness plays a big role in the prevention of cancer. Aims: This study aims to evaluate influence of sociodemographic characteristics and related factors on knowledge, attitude, and practice (KAP) regarding the prevention of common cancers. Settings and Design: This community-based observational, cross-sectional study was conducted in the slum area of urban field practice area of a tertiary care hospital, Kolkata. Materials and Methods: The survey was conducted with a sample of 415 using a semistructured questionnaire related to KAP regarding the prevention of cancers. Mann–Whitney U-test and Kruskal–Wallis test were conducted to determine group differences for sociodemographic variables. Linear correlational analysis was performed to identify associated factors and measure the strength and direction of relationships Results: Median scores for knowledge, attitude, and practice differed by sociodemographic characteristics. Positive correlations were observed between knowledge–attitude (r = 0.395, P < 0.01), attitude–practice (r = 0.391, P < 0.01), and knowledge–practice (r = 0.460, P < 0.01). Age, gender, educational status, and socioeconomic class were significantly associated with KAP score of participants. Conclusions: Knowledge about primary preventive measure was found to be less. The study found varying degrees of positive correlation between KAP. Knowledge and level of education had positive associations with attitude and adherence to preventive measures. The findings suggest a need for targeted community awareness interventions for the elderly populations, among men and those with no school education. The positive linear correlations reaffirm that better knowledge can lead to positive attitude and subsequently in good practices. Extensive health educational campaigns should be provided to the general population.

Risk factors associated with hepatitis B virus infection among pregnant women attending the antenatal care unit of the Bamenda Regional Hospital

ObjectivesApproximately 257 million people are infected with hepatitis B virus (HBV) especially in the middle and low-income countries, despite the Global Health Sector Strategy on viral hepatitis 2016–2021 which aims to eliminate viral hepatitis as a public health threat by 2030. Hepatitis B virus (HBV) remains a common public health problem in Cameroon with a high prevalence among pregnant women. Therefore, this study was designed to assess risk factors associated with hepatitis B virus infection among pregnant women attending the antenatal care unit of the Bamenda Regional Hospital. Study designThe study was a health facility-based cross-sectional study carried out from March to May 2020. The inclusion criteria were all pregnant women who came for their first visit. MethodsA well-structured questionnaire and laboratory test methods were used to collect data from 221 pregnant women who were consecutively enrolled in the study. The OnSite HBsAg Rapid Test (source: CTK Biotech, Inc. REF: R0040), was used to detect HBsAg in serum. Both descriptive statistics and Chi-square (and Fisher's exact) test were used for data analysis. ResultsThe prevalence of HBV infection among pregnant women was 4.98% (11/221). Although knowledge, attitude and practice towards HBV by pregnant women were not significantly associated with the risk of infection, there were higher odds of poor practice (P = 0.0152) and attitudes (P = 0.0016) among those without knowledge on HBV infection. ConclusionsFree of charge vaccination for those with negative HBsAg test results and extensive health education campaigns against HBV is recommended among pregnant women attending the antenatal care unit of the Bamenda Regional Hospital.

Knowledge and Beliefs of Tanta University Employees Regarding Emerging Respiratory Tract Infections and Its Preventive Measures Based on Health Belief Model

Background: The emerging respiratory tract infections (ERTIs) may imply future possible pandemics that present a persistent threat to public health and a huge burden on healthcare services. There is a greater chance for getting ERTIs related to several factors including traditional beliefs and lack of knowledge. Aim: toassess knowledge and beliefs of Tanta university employees regarding ERTIs and its preventive measures based on health belief model (HBM). Design:A descriptive study design was utilized. Settings: five faculties of medical campus that affiliated to Tanta University. Subjects: A Convenience sample of 300 employees working at the previous mentioned settings. Tools: Two tools were used:Tool (I): A Structured interview sheet which included data about bio-socio-demographic characteristics of the studied employees and their knowledge related to the ERTIs and its preventive measures. Tool (II):Beliefs of the studied employees regarding ERTIs based on HBM. Results: More than two fifths of the studied employees had lower level of knowledge regarding the ERTIs and more than half of them had negative beliefs toward ERTIs and its preventive measures. Significant statistical difference was observed between knowledge and beliefs of the studied employees. Conclusion & Recommendations: The study participants had inadequate knowledge and negative beliefs toward ERTIs and its preventive measures. An extensive educational health campaign should be provided to the public to create awareness and positive attitude and beliefs regarding the ERTIs and its preventive measures.

The interplay between COVID-19 restrictions and vaccination

Lancet Infectious Diseases, The - Sous presse. Epreuves corrigees par l'auteur. Disponible en ligne depuis le jeudi 1 avril 2021

Demography factors influencing Indonesian general knowledge on COVID-19

Pandemic COVID-19 is a health problem that is spread all over the world including Indonesia. As 4 June 2020, Indonesia has reached 28,818 persons confirmed COVID-19, 1,721 deaths related to COVID-19 and 8.892 patients have recovered from the disease. The amount of response and attention of the public regarding the COVID-19 case in Indonesia and the circulation of information in the community became the basis of interest in identifying and analyzing demography factors with general knowledge on COVID-19. Participants were 1,254 collected through online questionnaire distributed on social media platform, from February 5, 2020 to June 6, 2020. Data analyzed used Chi square test with significant &amp;lt;0.05. The result showed that majority of respondents have good general knowledge about COVID-19 and the personal prevention towards the disease (&amp;gt;75%). Nonetheless, most misinformation was that COVID-19 killed everyone contracted to it, came from a biological weapon laboratory, and that covering mouth and nose with bare hand is considered as correct coughing ethic. Characteristics that showed statistical significances were education, occupation, and educational/occupational background. Although Indonesian governments already give the best effort to educate the public to stop the transmission, an extensive educational health campaign should be done to raise awareness in public about preventive knowledge and behavior of COVID-19.

Policy responses to reduce single-use plastic marine pollution in the Caribbean

Caribbean economies depend heavily on a healthy marine ecosystem, but the region includes ten of the top global marine polluters per capita. Regional marine pollution is driven by illegal plastic waste dumping due to poor waste management systems with limited recycling, and weak enforcement. Governments recognize the impacts of marine debris on their social and economic well-being and have responded with policies to curb plastic pollution. Most focus on bans of single-use plastic and polystyrene, which comprises ~80% of Caribbean marine litter. However, there is little comparative analysis of policy responses to determine their efficacy. This paper reviews current policies in 13 English-speaking Caribbean countries, exploring tools used and process of implementation. Eleven have introduced legislative policies, with seven including fines and penalties for non-compliance. All successful policies involve multiple tools, including primary stakeholder engagement, sufficient lead time between policy announcement and implementation, and extensive public education campaigns.

Practice and Barriers toward Breast Self-Examination among Palestinian Women in Gaza City, Palestine.

Breast self-examination (BSE) is one of many first-line screening practices aimed at early detection and prevention of fatal outcomes of breast cancer. The present study aimed to identify Palestinian women's practices, awareness, and barriers to BSE. Using descriptive-analytical methods, a previously validated questionnaire was administered to a conveniently selected sample of women. The study was conducted among women who visited primary health clinics (PHCs) in Gaza City. A total of 390 participants who met the selection criteria answered the self-administered questionnaires. We used SPSS version 24.0 to analyze the data. The findings suggest that the practice of BSE among women in Gaza is low, with only 40% of the study participants reporting that they never practiced BSE before, even though 76.7% reported that they were aware of BSE. In general, the main barriers to BSE practices were that participants had wrong perceptions and lacked knowledge about BSE. Others also reported fear of detecting breast cancer as a barrier. The practice of BSE among Palestinian women in the Gaza Strip is low and marred with trivial issues as barriers that could be eliminated with dedicated and extensive educational campaigns in the area.

Assessment of Awareness, Knowledge, Attitude, and the Practice of Vitamin D among the General Public in Malaysia

Background: Vitamin D deficiency is becoming a global epidemic, which is still undertreated despite increased treatment availability and increase in therapeutic options. This study aimed to explore the awareness, knowledge, attitude and practices regarding Vitamin D among the general public in Malaysia.&#x0D; Methods: A cross-sectional survey was carried out in a public area using a convenience samplingtechnique to recruit participants around Selangor and Kuala Lumpur shopping malls area. An anonymous self-administeredquestionnaire was used for data collection and it was circulated to 603 Malaysian. A total of 400 participants were completed and returned to the researchers. &#x0D; Result: Although 90.5% of the participants have heard/learnt about Vitamin D. About 78.0% of them showed limited knowledge about some aspects of Vitamin D with (mean ± SD = 1.78 ± 0.894). Additionally, there was a negative attitude towards Vitamin D and sunlight exposure. For instance, nearly 70.0% of the respondents did not like to expose themselves to sunlight. Only 30.0% of the participants had taken Vitamin D supplement before.There is a small, positive correlation between the knowledge score and education level, rho = 0.124, n = 400, P = 0.013, with a higher score associated with higher education level.&#x0D; Conclusion: The findings provided a piece of contemporary real-world evidenceon the lack of knowledge and practices about Vitamin D among the general public. Therefore, extensive health educational campaigns for the public should be implemented by the government to raise their knowledge on the importance of Vitamin D.

Assessment of Knowledge, Attitude and Practice towards Prevention of Respiratory Tract Infections among Hajj and Umrah Pilgrims from Malaysia in 2018.

Respiratory tract infection (RTI) is a major public health challenge during the Muslim pilgrimage to Makkah. This study aims to evaluate the knowledge, attitude, and practice of Malaysian Hajj and Umrah pilgrims towards the prevention of RTIs in 2018 and determine correlations among three domains. A cross-sectional study was conducted among 225 Umrah and Hajj pilgrims. Knowledge, attitude, and practice (KAP) towards RTI prevention was assessed by using a validated self-administered questionnaire among pilgrims attending a weekly orientation course organized by private Hajj/Umrah companies. Out of 225 participants, 65.9% of respondents were female with the mean (SD) age of 46.74 (13.38) years. The interquartile range (IQR) score for knowledge is 18.0 (6.0), the mean scores of attitude and practice are 32.65 (4.72) and 25.30 (4.9). respectively. Significant and negative linear correlations between knowledge and practice (r = −0.232, p < 0.001), and attitude and practice (r = 0.134, p = 0.045) were observed. Results from the current study showed good knowledge of RTIs among Malaysian pilgrims. However, a poor attitude was reflected in their preventive practice behaviors. This will further help in the prevention and management of RTIs during Hajj and Umrah. Therefore, an extensive educational health campaign should be provided to pilgrims to create awareness.

Spread of health-related fake news in Tamil social media - A pilot study

Introduction: Fake news is a type of propaganda that consists of deliberate misinformation or hoaxes spread through traditional print and broadcast news media or online social media. Fake news concerning health subject is not a new phenomenon - its roots are probably as old as healthcare itself. Aim: This study aims to measure the volume of shares concerning health-related fake news in Tamil language social media. Materials and Methods: Analysis was performed employing the BuzzFeed Enterprise Application available through its website. BuzzFeed is a social media analytics and curation tool for content marketers. The data were obtained for 15 most commonly shared pages concerning four keywords, namely vaccinations, oral cancer, gum disease, and dental caries from May 1, 2018, to May 15, 2018, in Tamil language, the local vernacular. Results: The topic most contaminated with fake news was vaccinations (80%) followed by oral cancer and gum disease (both in 60%). Altogether, links containing fake news were shared 272 times in 15 days and accounted for 40% of the studied material. Conclusion: Action could be taken to scientifically evaluate sources of the most frequently shared medical myths. As shown above, some topics were generally free of fake news, whereas others were extremely biased and filled with fallacies. Thus, an extensive educational campaign (not only in social media) for the latter should be implemented.

A cross sectional study to assess knowledge, attitude and practices related to swine flu in school students of Kallur, Kurnool

Background: Swine flu is an acute highly contagious respiratory disease caused by influenza A (H1N1) virus. After 2009 pandemic, seasonal epidemics occurred in 2015 and 2017 usually in rainy season in India. Educational institutes are the centres of high transmission and creating awareness only can arrest the spread. Hence this study was carried out to assess the knowledge, attitude and practices regarding Swine flu and improve their knowledge.Methods: A health educational interventional study done on 202 eighth and ninth standard school students of Zilla Parishad High School, Kallur, Kurnool district during October and November, 2018 on obtaining informed consent, using a self administered questionnaire. Data entered in Microsoft excel version 2007, analysed and presented in proportions and chi square test of significance using SPSS version 23.Results: 66.8 percent and 68.8 percent of the students heard and knew about viral swine flu respectively. Good knowledge of mode of spread, symptoms and availability of treatment, vaccination and preventive measures regarding swine flu was seen. The gaps in their knowledge levels were successfully filled by health educational intervention. More than 70 percent of students were using hand kerchief and masks in crowded places, willing to approach government facilities for treatment.Conclusions: Extensive mass educational campaigns should be conducted as containment of the spread of the disease can solely be done by making people knowledgeable. Government authorities should train health workers, assistants and teachers and utilise mass and social media to create awareness, thus declining the incidence of the seasonal epidemics.

Rejecting Humanae Vitae: The Social Costs of Denying the Obvious.

Removing the idea of pregnancy from the sexual act as the result of readily available contraception has effectively limited choices about sexual behavior to the satisfaction of momentary desires. As Humanae vitae predicted, fewer marriages were contracted, divorce increased and now 40% of children are born out of wedlock despite extensive public education campaigns to promote contraception. Side effects of the hormonal pill have reduced their use so health care professionals have doubled down, providing long acting contraceptives which do not require the user to exercise choice before each act of intercourse, or of taking a pill. There is a much better way to regulate births-to learn to read the book of nature. Fertility is not a disease to be removed from the body. All that is needed is to understand the natural signs of fertility-natural family planning, now called FABM-Fertility Awareness-Based Methods. These have no side effects, enhance couple communication and offer effective choice for child spacing and demonstrably support premarital chastity for teens.