Female Field Workers Research Articles

Preterm birth and neonatal mortality in selected slums in and around Dhaka City of Bangladesh: A cohort study.

Although under-five mortality has declined appreciably in Bangladesh over the last few decades, neonatal mortality still remains high. The objective of the study is to assess the level and determinants of preterm birth and the contribution of preterm birth to neonatal mortality. Data for this study came from selected slums in and around Dhaka city, where; since 2015, icddr,b has been maintaining the Health and Demographic Surveillance System (HDSS). The HDSS data were collected by female Field Workers by visiting each household every three months; however, during the visit, data on the Last Menstrual Period (LMP) were also collected by asking each eligible woman to ascertain the date of conception. Gestational age was estimated in complete weeks by subtracting LMP from the date of the pregnancy outcome. In this study, 6,989 livebirths were recorded by HDSS during 2016-2018, and these births were followed for neonatal survival; both bivariate and multivariate analyses were performed. Out of total births, 21.7% were born preterm (before 37 weeks of gestation), and sub-categories were: 2.19% for very preterm (28 to 31 weeks), 3.81% for moderate preterm (32 to 33 weeks), and 15.71% for late preterm (34 to 36 weeks). The study revealed that preterm babies contributed to 39.6% of neonatal deaths; however, the probability of death was very high on the 1st day of birth (0.124 for very preterm, 0.048 for moderate preterm, 0.024 for late preterm, and 0.013 for term birth), and continued until the 3rd day. In the regression analysis, compared to the term neonates, the odds of neonatal mortality were 8.66 (CI: 5.63, 13.32, p<0.01), 4.13 (CI: 2.69, 6.34, p<0.01) and 1.48 (CI: 1.05, 2.08, p<0.05) respectively for very, moderate, and late preterm birth categories. The population attributable fraction for neonatal mortality was 23%, and sub-categories were 14% for very preterm, 10% for moderate preterm, and 6% for late preterm. Although urban slums are in proximity to many health facilities, a substantial proportion of preterm births contribute to neonatal deaths. So, pregnant women should be targeted, to ensure timely care during pregnancy, delivery, and post-partum periods to improve the survival of new-borns in general and preterm birth in particular.

Accommodation Patterns in the Speech of Arabic-Speaking Children and Adolescents: A Variationist Analysis

This paper presents a variationist analysis of patterns of speech accommodation by 40 Arabic-speaking children and adolescents (aged 3–17) experiencing dialect contact in a Bedouin speech community near Damascus, Syria. It examines participants’ use of the phonological variables (θ), (ð), and (q), and the morphophonological feminine suffix (-a) in recorded sociolinguistic interviews and play sessions with two female fieldworkers, a local and an urban speaker, in order to investigate accommodation patterns across different interlocutors. Accommodation patterns were influenced by age, gender, and the linguistic variable under examination. Convergence to the urban interviewer was most evident in the realization of (q), whereas little convergence, and indeed variation, occurred in the realization of (-a), and more convergence occurred in the speech of girls and speakers younger than 15. Divergence and maintenance emerged in the speech of 15–17-year-old male speakers. These patterns are analysed in light of Accommodation Communication Theory and issues of identity and linguistic prestige in Arabic. Accommodative behaviour in the speech of participants exhibits their awareness of the social value of the phonological variables under investigation and demonstrates a high level of sociolinguistic awareness and competence.

Women Pluralists Negotiating Immigrant Children’s Health in an Era of Mass Migration (the 1960s)

The article explores immigrant children’s health in Toronto, Canada, during mass migration by analysing a 1960s women-led project involving southern Europeans launched by the International Institute of Metropolitan Toronto, the city’s leading immigrant agency and part of a long-standing North American pluralist movement. Focused on the immigrant female fieldworkers tasked with convincing parents known for their ‘reticence’ in dealing with ‘outsiders’ to access resources to ensure their children’s well-being, it assesses their role as interpreters for the public health nurses investigating the Italian and Portuguese children who increasingly dominated their referrals from Toronto’s downtown schools. Without exaggerating their success, it documents the women’s capacity for persuasion, and notes the value of community-based pluralist strategies in which women with links to those being served play active roles as front-line intermediaries. The article highlights the history of women’s grassroots multiculturalism and the need to consider pluralism’s possibilities as well as its limits.

Let's Talk about Sex, Maybe: Interviewers, Respondents, and Sexual Behavior Reporting in Rural South Africa.

Researchers are often skeptical of sexual behavior surveys: respondents may lie or forget details of their intimate lives, and interviewers may exercise authority in how they capture responses. We use data from a 2010-2011 cross-sectional sexual behavior survey in rural South Africa to explore who says what to whom about their sexual lives. Results show an effect of fieldworker age across outcomes -- respondents report "safer", more "responsible" sexual behavior to older fieldworkers; and an effect of fieldworker sex -- men report more sexual partners to female fieldworkers. Understanding fieldworker effects on the production of sexual behavior survey data serves methodological and analytical goals.

What's Rapport Got To Do With It? The Practical Accomplishment of Fieldwork Relations Between Young Female Researchers and Socially Marginalised Older Men

Drawing on field notes, interview transcripts and personal reflections, this paper describes an ethnographic research project as a practical accomplishment. The project has employed two young female fieldworkers in negotiating and documenting the social worlds of socially disadvantaged and marginalised older men in inner city Sydney, Australia. We provide a rich description of the various processes involved in this kind of research such as gaining entry, recruiting participants, obtaining consent and conducting interviews. Our analytical and interpretive focus is on the social relationships of fieldwork and the problematic role of rapport as the ideal (or only) basis for such relationships. We show how these relationships and the information they generate have been variably and situationally accomplished in our project. Our findings suggest that communicative relationships in field research can take a variety of forms that produce useful data but that these are not necessarily illustrative of rapport between researcher and researched. We conclude by arguing the need for the methodological literature of ethnography to develop a new analytical vocabulary for describing research practice and a conceptual framework that moves beyond neo-positivist and normative prescriptions for doing 'good' fieldwork.

Factors associated with non-use of antenatal iron and folic acid supplements among Pakistani women: a cross sectional household survey.

BackgroundWorld Health Organization recommends a standard daily oral dose of iron and folic acid (IFA) supplements throughout pregnancy to begin as early as possible. The aim of the present study was to determine the prevalence of use of antenatal IFA supplements, and the socio-demographic factors associated with the non-use of antenatal IFA supplements from 14 selected districts in Pakistan.MethodsData was derived from a cross sectional household survey conducted in 14 project districts across Pakistan. Trained female field workers conducted interviews with married women of reproductive age from December 2011 to March 2012. Women with the most recent live births in the preceding five years of the survey were selected for this study. Data was analysed by using STATA 13 and adjusted for the cluster sampling design. Multivariate logistic regression models were constructed to identify the independent factors associated with the non-use of antenatal IFA supplements.ResultsOf 6,266 women interviewed, 2,400 (38.3%, 95% CI, 36.6%, 40.1%) reported taking IFA supplements during their last pregnancy. Among IFA users, the most common source of supplements was doctors (49.4%) followed by community health workers (40.3%). The mean (±SE) number of supplements used was 76.9 (±51.6), and the mean (±SE) month of pregnancy at initiation of supplementation was 5.3 (±1.7) months. Socio-demographic factors significantly associated with the non-use of antenatal IFA supplements were living in Dera Ghazi Khan district (AdjOR: 1.72), maternal age 45 years and above (AdjOR: 1.97), no maternal education (AdjOR: 2.36), no paternal education (AdjOR: 1.58), belonging to the lowest household wealth index quartile (AdjOR: 1.47), and no use of antenatal care (ANC) services (AdjOR: 13.39).ConclusionsThe coverage of antenatal IFA supplements is very low in the surveyed districts of Pakistan, and the lack of parental education, older aged women, belonging to poorest households, residence in Dera Ghazi Khan district and no use of ANC services were all significantly associated with non-use of these supplements. These findings highlight the urgent need to develop interventions targeting all pregnant women by improving ANC coverage to increase the use of antenatal IFA supplements in Pakistan.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2393-14-305) contains supplementary material, which is available to authorized users.

"There is iron and iron…" Burkinabè women's perceptions of iron supplementation: a qualitative study.

Most pregnant women in Burkina Faso are iron deficient and many are anemic. This study assessed women's understanding of anemia and the role of iron in preventing and treating this condition. A qualitative study was conducted within a randomized controlled trial of weekly iron supplementation in a rural malaria endemic area. Focus groups with women of similar age, parity, and marital status took place in 12 of 24 study villages. Two additional focus groups were conducted with female field workers. Tape-recorded transcripts were translated into French and analyzed using Framework analysis. Anemia, for which no Mooré term or traditional treatment for anemia was evident, was described in terms of blood volume. Moderate blood loss (diminished blood) could be easily replaced by eating well and was not considered serious. Massive blood loss (finished blood) was a rare, life-threatening illness. Iron tablets could increase blood volume and help women withstand massive blood loss at delivery, but for the latter, transfusion was indicated. Women had no knowledge of iron's role and did not readily concede that iron supplements contained elemental iron. Neither adolescents nor field workers were convinced of the benefits of supplementing non-pregnant adolescents, who were incorrectly considered to be at low risk of anemia. Young women's knowledge of anemia did not provide an adequate explanatory framework to motivate anemia prevention. Improving information on the role of iron is especially important for adolescent girls who may be incorrectly considered at low risk of anemia as they have not yet experienced pregnancy.

Development and pilot testing of 24-hour multiple-pass recall to assess dietary intake of toddlers of Somali- and Iraqi-born mothers living in Norway.

The aim of this study was to develop, test, and evaluate a 24-h recall procedure to assess the dietary intake of toddlers of Somali- and Iraqi-born mothers living in Norway. A protocol for a 24-h multiple-pass recall procedure, registration forms, and visual tools (a picture library for food identification and portion size estimation) was developed and tested in 12 mothers from Somalia and Iraq with children aged 10–21 months. Five female field workers were recruited and trained to conduct the interviews. Evaluation data for the 24-h recall procedure were collected from both the mothers and the field workers. Nutrient intake was calculated using a Norwegian dietary calculation system. Each child’s estimated energy intake was compared with its estimated energy requirement. Both the mothers and the field workers found the method feasible and the visual tools useful. The estimated energy intake corresponded well with the estimated energy requirement for most of the children (within mean ± 2 SD, except for three). The pilot study identified the need for additional foods in the picture library and some crucial aspects in training and supervising the field workers to reduce sources of error in the data collection.

Behind the silence of harmony: risk factors for physical and sexual violence among women in rural Indonesia

BackgroundIndonesia has the fourth largest population in the world. Few studies have identified the risk factors of Indonesian women for domestic violence. Such research will be useful for the development of prevention programs aiming at reducing domestic violence. Our study examines associations between physical and sexual violence among rural Javanese Indonesian women and sociodemographic factors, husband's psychosocial and behavioral characteristics and attitudes toward violence and gender roles.MethodsA cohort of pregnant women within the Demographic Surveillance Site (DSS) in Purworejo district, Central Java, Indonesia, was enrolled in a longitudinal study between 1996 and 1998. In the following year (1999), a cross-sectional domestic violence household survey was conducted with 765 consenting women from that cohort. Female field workers, trained using the WHO Multi-Country study instrument on domestic violence, conducted interviews. Crude and adjusted odds ratios at 95% CI were applied for analysis.ResultsLifetime exposure to sexual and physical violence was 22% and 11%. Sexual violence was associated with husbands' demographic characteristics (less than 35 years and educated less than 9 years) and women's economic independence. Exposure to physical violence among a small group of women (2-6%) was strongly associated with husbands' personal characteristics; being unfaithful, using alcohol, fighting with other men and having witnessed domestic violence as a child. The attitudes and norms expressed by the women confirm that unequal gender relationships are more common among women living in the highlands and being married to poorly educated men. Slightly more than half of the women (59%) considered it justifiable to refuse coercive sex. This attitude was also more common among financially independent women (71%), who also had a higher risk of exposure to sexual violence.ConclusionsWomen who did not support the right of women to refuse sex were more likely to experience physical violence, while those who justified hitting for some reasons were more likely to experience sexual violence. Our study suggests that Javanese women live in a high degree of gender-based subordination within marriage relationships, maintained and reinforced through physical and sexual violence. Our findings indicate that women's risk of physical and sexual violence is related to traditional gender norms.

Circumcision of HIV-infected men and transmission of human papillomavirus to female partners: analyses of data from a randomised trial in Rakai, Uganda

Male circumcision reduces the transmission of high-risk human papillomavirus (HPV) in HIV-uninfected men and their female partners. We assessed whether circumcision of HIV-infected men would reduce the transmission of high-risk HPV to their female partners. Female partners of HIV-infected men (aged 15-49 years) in Rakai, Uganda, with CD4 counts of greater than 350 cells per mL who were randomly assigned to undergo circumcision immediately (intervention group) and after 24 months (control group) were assessed for infection with high-risk HPV. Randomisation was done in blocks of 20, stratified by community, with computer-generated random numbers. Laboratory technicians and female fieldworkers were masked to the circumcision status of male participants. The main outcome assessed in this study was the effects of circumcision of HIV-infected men on transmission of HPV to their female partners. Analysis was by intention to treat. The trial is registered with ClinicalTrials.gov, number NCT00124878. 474 men were assigned to the intervention group, 448 to the control group. 211 women were in consensual relationships with 193 men in the intervention group, and 171 women were in consensual unions with 155 men in the control group. High-risk HPV at the 2-year follow-up was prevalent in 88 female partners (55%) of 159 men in the intervention group and 68 (52%) of 131 female partners of men in the control group (prevalence risk ratio 1·07, 95% CI 0·86-1·32, p=0·64). Incidence of high-risk HPV over 2 years was 32·0 per 100 person-years in the female partners of men in the intervention group and 30·6 per 100 person-years in the female partners of men in the control group (incidence rate ratio 1·05, 0·77-1·43, p=0·78). No difference was noted in the clearance of genotype-specific high-risk HPV between the intervention group (196 [46%] of 424) and control group (167 [48%] of 347; rate ratio 0·96, 0·83-1·12; p=0·61). Because circumcision of HIV-infected men did not affect transmission of high-risk HPV to their female partners, promotion of consistent safe sexual practices for HIV-infected men remains important. Bill & Melinda Gates Foundation and National Institutes of Health.

Zinc Treatment for 5 or 10 Days Is Equally Efficacious in Preventing Diarrhea in the Subsequent 3 Months among Bangladeshi Children1–4

We conducted a randomized, double-blind placebo controlled, community trial in rural Bangladesh in children 4–59 mo of age to compare the efficacy of a 5- and 10-d course of zinc therapy on the incidence and duration of diarrhea over the subsequent 90-d follow-up after initial treatment for an acute childhood diarrheal (ACD) episode. Children (n= 1622) with ACD were randomly allocated to either 5 or 10 d of zinc treatment. Female field workers visited each child daily, supervised the administration of zinc, recorded the duration of current episode, and the occurrence and duration of diarrhea over the subsequent 3 mo. The incidence of diarrhea over the 90 d of follow-up did not differ between the 5-d (1.08 ± 1.38 episodes) and 10-d (1.02 ± 1.35 episodes) groups (P= 0.35). Children in both groups experienced a comparable duration of diarrheal episodes (3.1 ± 5.6 d vs. 2.9 ± 5.6 d, 5-d vs. 10-d, respectively;P= 0.64) with a mean difference between groups within the defined range of equivalence. Time to onset of the first episode and the proportion children experiencing diarrhea during the 90-d follow-up also did not differ between groups. These findings suggest that among Bangladeshi children, a 5-d zinc treatment for ACD is as efficacious as 10 d in preventing diarrhea in the subsequent 3 mo.

“What Indiana Can Do”: The Influence of Female Field Workers on the Indiana Committee on Mental Defectives, 1915-1924

“What Indiana Can Do”: The Influence of Female Field Workers on the Indiana Committee on Mental Defectives, 1915-1924

The Nicaraguan Health and Demographic Surveillance Site, HDSS-León: A platform for public health research

To describe the Health and Demographic Surveillance System (HDSS) in León, Nicaragua and to present results from the 2002-2003 baseline. A 22% sample of the total population in León, both urban and rural, was selected in 1993. This sample was updated in 2002 and will be followed up on a biannual basis with regard to births, deaths, in-migration, and out-migration. A group of 18 female fieldworkers perform 10 household interviews per day, 20 days per month. They use a map that is produced by a Geographical Information System. It shows all the households, and is the main means of the interviewers finding the households. An extensive data quality control system is used. In total, 54,647 persons lived in the area of the surveillance system, and they resided in 10,994 households. The mean age was 26 years; the sex ratio was 0.93. The infant and neonatal mortality rates were 25.4 and 20.5 per 1,000 live births, respectively. In total, 2,034 people out-migrated from the study area and 3,377 in-migrated. Of the households, 53% were classified as non-poor, 41% as poor, and 6% as extremely poor. Six per cent of the population did not have a toilet or a latrine, and only 16% in the rural area had indoor running water. The surveillance system revealed that 10% were illiterate. The HDSS in León has shown that it can serve as a platform for further intervention studies as well as for research training.

A comparison of efficacy of a 5‐day versus 10‐day zinc therapy for acute childhood diarrhoea (ACD) on the incidence of diarrhoea in subsequent three months

Design Randomised, double‐blind, placebo controlled community trial.Seeting Rural BangladeshSubjects and Methods: Children (n=1622) aged 4 – 59 months with acute diarrhea, detected by daily community surveillance, were randomly allocated either to 5‐ or 10‐days of zinc treatment. Those allocated to the 5‐day course received an indistinguishable placebo for the remaining 5 days. Female field workers visited each individual child daily and supervised the administration of zinc.Result: The two groups were comparable in terms of age, sex, nutritional status and selected SES variables. Adherence to the treatment was 99% for the 1st five days and 97% for 2nd five days. The mean (±SD) incidence of diarrhoea over 90 days did not differ significantly between 5‐d vs 10‐d groups (1.08±1.38 vs 1.02±1.35; p=0.35; respectively). Children in both groups spent a comparable days with diarrhoea (3.1±5.6 d vs 2.9±5.6 d; p=0.64; 5‐d vs 10‐d respectively). Time to onset of the first episode during 90 d period did not differ significantly between groups. The proportion of children suffering from diarrhoea over the 90‐day period did not differ significantly between groups. The diarrhea incidence and prevalence in the two groups were also comparable.Conclusions: These findings suggest that a 5‐day zinc treatment for ACD is as efficacious as 10 days of therapy in preventing diarrhoea in the subsequent three months.

Reproductive and Child Health Inequities in Chandigarh Union Territory of India

Health inequity is an emerging issue all over the world. Some populations living in specific geographic areas may have less access to basic health facilities. Therefore, a sample survey of households was carried out to study access of different population groups to reproductive and child health. Cluster sampling technique was used to select 30 clusters (18 urban, 9 slum, and 3 rural) from Chandigarh Union Territory in India. From each of these clusters, 40 households were selected randomly. Data were collected using a standard questionnaire developed by UNICEF from April to June 2006 by graduate male and female field workers who were specially recruited and trained for this purpose. A total of 5383 individuals were studied in 1200 sample households with proportionate representation from urban (56%), slum (33%), and rural (11%) areas. Literacy rate was higher (94.3%) in urban than the rural (80.6%) and slum (65.3%) areas. About 68% of the deliveries were at home and not assisted by a skilled birth attendant (nurse, midwife, or doctor) in the slums, compared to 21% and 7% in rural and urban areas (p < 0.001), respectively. Fully immunized children at the age of 2 years were 30% in slums as compared to 74% and 62.5% in urban and rural areas (p < 0.001), respectively. Hib vaccination, which is to be bought at a considerable cost, was nil in slum areas compared to 79% in urban and 45% in rural area. Contraceptive prevalence was significantly more in urban (73%) and rural areas (75%) compared to the slum areas (53.4%) (p < 0.05). It was concluded that reproductive and child health service coverage has large differences in various population groups. Special interventions should be undertaken on a priority basis to bridge the gaps so as to achieve millennium development goals in all population groups.

Women's Reproductive Rights in the Amazon Basin of Ecuador: Challenges for Transforming Policy into Practice

Despite advances made by Ecuador in developing policies on reproductive and sexual rights, implementation, and oversight remain a challenge, affecting in particular those living in the Amazon basin. This paper reports on an evaluation of sexual and reproductive health and rights (SRHR) in Orellana, Ecuador, the basis of which was the Health Rights of Women Assessment Instrument, which was altered to focus on government obligations, the reality of access and utilization of services, and the inequities and implementation challenges between the two. A community-based cross-sectional survey conducted in 2006 served to document the current status of SRHR Local female field workers interviewed 2025 women on three areas of womens reproductive health: delivery care, family planning, and pregnancy among adolescent girls age 10-19. The results suggest a reality more dismal than that of the official information for the area. Skilled delivery care, modern contraceptive use, and wanted pregnancies were conspicuously lower among indigenous women living in rural areas. Access to reproductive health services varied between rural and urban women. These significant differences in care--amongst others documented--raise concerns over the utility of national-level data for addressing inequities. The gaps evident in the validity of available information for monitoring policies and programs, and between national policy and action reveal that much still needs to be done to realize SRHR for women in the Amazon basin, and that current accountability mechanisms are inadequate.

Knowing your Place: Gender and Reflexivity in two Ethnographies

Female ethnographers often appear to be more aware of their sexual status and its impact on fieldwork and relationships than their male colleagues (Okely 1992: 19, Coffey 1999: 79). Similarly, the behaviour of female fieldworkers is often more closely scrutinised than that of male fieldworkers (Mascarenhas-Keyes 1987: 187), and many female ethnographers’ accounts detail gender-specific issues and challenges that arose during their research (e.g. Moreno 1995: 220, Whitehead 1976, Middleton 1986). This paper draws on the authors’ experiences in two different rural British communities, conducting research using a combination of methods including participant observation and tape-recorded interviews. Catherine Maclean's research examined migration and social change in ‘Beulach’, a remote rural parish in the north of Scotland, while Fiona Gill's research focused on issues of identity in ‘Bordertown’, a small town near the border between Scotland and England. In both cases, while gender was not initially a focus of the research, it became increasingly salient during the fieldwork period. The paper discusses the similarities and differences between the authors’ research experiences, and the factors that account for these. The authors’ research is set in the wider context of ethnographic community studies. The paper explores the emotional impact of the fieldwork on the authors, and the consequences of this for the research. It concludes that although female researchers have to consider and deal with gender-related research problems not faced by their male colleagues, this also has positive consequences as the experiences of female ethnographers encourage a reflexive and self-aware approach.

The quality of care provided at union health and family welfare centres in Bangladesh: Clients’ perspectives

The Government of Bangladesh attempts to provide reproductive health services that emphasize maternal and child health (MCH) and family planning at different service delivery tiers through a variety of service providers. For this purpose, it has established an extensive network of reproductive health services that reaches almost every village in the country. Female field workers, known as family welfare assistants (FWAs), work at the grassroots level and provide information and counselling on various aspects of reproductive health and refer clients when necessary to clinics. They also distribute oral contraceptives and condoms at the homes of married women of reproductive age, identify pregnant women and refer them to static points of service delivery, i.e. health and family welfare centres, for ante-natal care and for obtaining clinical contraceptives.

Experiences and voices of eugenics field-workers: 'women's work' in biology.

Experiences and ideas of eugenic 'field-workers' offer a new historical perspective on American eugenics, while highlighting terms of women's early twentieth-century scientific education and research employment. To advance knowledge of heredity, the US Eugenics Record Office (ERO), between 1910 and 1924, trained 258 students (85% of them women) to collect information about individuals, families and communities. Though some historians have dismissed eugenic field-workers as careless or uncritical, many had scientific or medical backgrounds, and took research seriously. While gendered expectations and other obstacles limited women's hopes for professional advance, the female field-workers created a strong community and culture of their own. Comparing notes, some recognized that their results did not support eugenic assumptions, and cautioned against letting enthusiasm overwhelm scientific integrity. These women field-workers raised serious questions about methodology and ethics, but the situation of eugenics work at the time undermined chances for such criticism to be acknowledged. After World War I, military-related research and political manoeuvring dominated eugenics, further marginalizing field-workers. Ironically, while ERO head Charles Davenport had wanted students to promote eugenics, some demonstrated more fundamental commitment to scientific ideals--but to little avail.

Low-Dose Pill Has Better Continuation than High-Dose Pill in Bangladesh

Since 1977 the Family Planning and Health Services Project has operated in Matlab Bangladesh. It offers a variety of contraceptive and maternal and child health services through female fieldworkers. This study compared the continuation and failure rates of low-dose and high-dose oral contraceptives. A total of 456 women using the low-dose pill and 1512 women using the high-dose pill were enrolled in the study. Overall it is indicated that the women in the rural area who adopted the low-dose pill were significantly more likely to continue pill use than were those who had a chosen the high-dose pill formulation. High-dose pill users were noted to be 25% more likely to discontinue usage than those using the low-dose pill after controlling for all variables. However no variation between the two groups in the proportion who continued to practice some form of contraception was recorded among women who switched from the pill to another method. Failure rates of the two pill formulations did not differ significantly.