Long-term Contraception Research Articles

ANALYSIS OF EFA PERCEPTION FACTORS ON CONTRACEPTION USE IN THE WORKING AREA OF PUSKESMAS KRAMAT WATU

A preliminary survey conducted by researchers at the Kramatwatu health center who was visiting by interviewing 10 PUS about their perceptions of using contraception. From the interview results, it was found that 7 of these women did not use contraception and 3 of them used long-term contraception. From the presentation of the preliminary data above, PUS who do not use contraception that the use of contraception is considered contrary to religion because many children have a lot of sustenance. Research Objectives: To determine the factors related to the perception of PUS on contraceptive use in the Kramatwatu Community Health Center Work Area in 2019.This study used a cross sectional time approach. With a population of 15,962 PUS and a sample of 99 respondents. The sampling technique used in this research is accidental sampling, data is directly taken from respondents by distributing questionnaires.Research Results More than half of the perception of EFA was negative for the use of contraception by 50.5%, More than half of the respondents' education was elementary-junior high school at 55.6%, More than half of the respondents' understanding was negative by 56.6%, Most of the respondents' knowledge is low at 70.7%, Most respondents get information from non-medical sources of 68.7%, Most respondents have a number of children 3 or more by 69.7%, there is a relationship between education, understanding, knowledge, sources of information and number of children with PUS perception of contraceptive use.We recommend that health workers promote the delivery of IEC that is more complete and comprehensive to each PUS so that it can eliminate negative assessments by PUS on contraceptive use, and can increase the achievement of family planning targets, for Family Planning Field Instructors (PLKB / PKB) so that they can increase husband's support so that in the future the achievement of family planning targets is increasing

The Effect of Counseling using decision-making tools for family planning on interest in using the IUD

Increasing the used of long-term contraception method of Intra Uterine Device (IUD)user required a good and quality counseling between the client and the provider (medical personnel). The research amis to determine the effect of counseling using decision-making tools for family planning on the interest in using IUDs in Dr. M.M. Dunda Hospital, Limboto District. The research type is Quasi Experiment, the population of all pregnant women who are admitted to Dr. M.M. Dunda Limboto. The sample was all 22 pregnant women who came in April 2020 which were divided into two groups, the intervention group and the control group. Sampling technique used accidental sampling. Data collected using a check list sheet and using chi square analysis. The results showed that X2 count> X2 table (6.6> 3,841) then H0 was rejected and Ha was accepted, so it could be concluded that there was an effect of counseling using ABPK on the interest in using IUDs in Dr. M.M. Dunda Hospotal, Limboto District.

Communication Pattern of Family Planning Field Officers in Increasing Community Participation of Long-Term Contraception Usage

The Field Officers play a role to convey family planning information and services. Thus, the community members can receive and understand family planning information properly and giving feedback. The problem posed is on how the role of Family Planning Field Officers in increasing the long-term contraceptive usage in Parigi Moutong Regency, Central Sulawesi Province. This research was conducted with the aim of revealing new concepts about the role of the Field Officers. This research was conducted using qualitative approach. Data collection is done through interviews, observation, and document study. The results of the study illustrate that the role of the Field Officers in communicating Family Planning Programs to increase couples participation using long-term contraception has not yet materialized, because the quality of information delivered is insufficient.Local cultural factors also do not approve vasectomy because it is contrary to religious values. Based on the results of the study, the new findings raised were the capacity of the Field Officers, the social cultural and economic aspects of husband and wife, as well as the environment which greatly influenced the Field Officers’ role in increasing community participation of long-term contraceptive usage in Parigi Moutong Regency.

HUBUNGAN PENGETAHUAN TENTANG METODE KONTRASEPSI DENGAN SIKAP TERHADAP PEMILIHAN METODE KONTRASEPSI PADA AKSEPTOR KONTRASEPSI WANITA

Family planning is the first program established by the Indonesian government as one of the methods to suppress population growth in Indonesia since 1970. Badan Kependudukan dan Keluarga Berencana Nasional (BKKBN) established a sustainable development program namely Kependudukan, Keluarga Berencana dan Pembangunan Keluarga (KKBPK) which is equivalent to the international level program Sustainable Development Goals (SDGs). Participants of Riau province are using active contraception from 2017-2018 always ranks 8th lowest out of 34 provinces in Indonesia with the most methods in the form of non- long-term contraception methods (non-MKJP). One of the reason is low of society knowledge related to contraceptive methods. Knowledge and attitude are foundation in forming a behavior that is suitable with conditions for contraceptive acceptor.The purpose of this research was to know the relationship of knowledge about contraceptive methods with attitudes about the selection of contraceptive methods in women’s contraceptive acceptors in primary health center region of Pekanbaru city.The method of this research used analytic observational study design, with a cross sectional study design. This research was conducted at 12 primary health centers region of Pekanbaru city. The sampling technique is done by stratified random sampling with a sample size of 400 people and statistically tested using the Spearman correlation test. The result of spearman 's rho correlation analysis indicate there is a significant relationship between knowledge and attitude (pvalue = 0.027) with a correlation coefficient value of 0.097.

528 Use of highly effective postpartum contraception by women with opioid use disorder

Rates of inpatient provision (IPP) of long acting and permanent methods (LAPM) in women with opioid use disorder (OUD) remain largely unknown. Thus, we sought to determine the rates and associated clinical and demographic factors of IPP LAPM in women with OUD. This was a retrospective cross-sectional study using the National Inpatient Sample of women with OUD who had a delivery related hospitalization between 2012 and 2016 identified using the relevant Diagnosis Related Group and ICD-9 and ICD-10 codes. Women with OUD who underwent tubal sterilization (PPTL) or received a long acting reversible contraceptive (LARC) during the delivery admission were identified using relevant ICD-9 and ICD-10 codes. Those who underwent a hysterectomy were excluded. Patients were stratified into IPP LARC, PPTL, and no long-term contraception groups. Univariate and multivariable regression analyses were performed to evaluate the relationships between collected variables and LAPM utilization. Of 22,340 eligible deliveries in women with OUD, 2,291 (10.2%) women received LAPM (Table 1).The most common form of LAPM was PPTL (86.8%). In multivariable analysis of known clinical and demographic factors associated with contraceptive decision-making, cesarean section (aOR 5.21, 95% CI 4.64-5.83) was the strongest predictor of LAPM use while stillbirth (aOR 0.23, 95% CI: 0.08-0.65) was strongly associated with not utilizing LAPM (Table 2). Region of delivery and hospital location were also associated with a higher utilization of LAPM. The rate of LAPM utilization in women with OUD appears to be dependent on delivery location and route, specifically in urban academic centers and larger facilities. Efforts should be made to expand access to LAPM equitably across the country.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Determinant Factors for Selecting the Contraceptive Acceptor Method in the Banjardowo Family Planning Village Semarang

Objective: Indonesia’s population is ranked fourth in the world, while central Java is ranked third nationally. Governments are making efforts to control the population through familyplanning programs. The family planning program to increase the amount of coverage of longterm contraception methods (MKJP) is still low. The purpose of this study is to know the determinant factor associated with the selection of acceptor contraceptive methods.
 Materials and Methods: This method uses a cross-sectional approach conducted in a banjardowo semarang village with 103 samples. The inclusion criteria of a sample of women of childbearing age, having a husband, using contraception. The sampling technique used is simple random sampling. Data were analyzed with Chi Square and Fisher Exact Test.
 Results and Discussion: The results of data analysis have a significant relationship between the determinant factors with the choice of contraceptive methods, age (p = 0,000; PR = 2,273; CI = 1,184-4,364), the purpose of using contraception (p = 0.04; PR = 1.515; CI = 1.065-2.157 ), Current number of children (p = 0.02; PR = 1.767; CI = 1.075-2.904), people suggesting (p = 0.011; PR = 1.359; CI = 1.359 (1.083-1.705) and previous experience using contraception (p = 0,000; PR = 2, 067; CI = 1,416-3,018) There was no significant relationship on the Education factor (p = 0.754; PR = 0.895; CI = 0.673-1.190), employment (p = 0.274; PR = 1.148 ; CI = 0.885- 1.490), First pregnancy age (p =0.753; PR = 0.953; CI = 0.695-1.305), expected number of children (p = 0.667; PR = 1.054; CI = 0.833-1.333).
 Conclusions: determinant factors which shows a significant relationship in determining MKJP or non MKJP contraceptive methods are age, the purpose of using contraception, the number of children desired, the person suggesting and experience using previous contraceptives. mother’s education, mother’s occupation, age of first pregnancy and the number of children expected to be unrelated to the contraceptive method chosen by the acceptor.
 Bangladesh Journal of Medical Science Vol.20(2) 2021 p.313-317

Levonorgestrel vs. Copper Intrauterine Devices for Emergency Contraception

BackgroundIn the United States, more intrauterine device (IUD) users select levonorgestrel IUDs than copper IUDs for long-term contraception. Currently, clinicians offer only copper IUDs for emergency contraception because data are lacking on the efficacy of the levonorgestrel IUD for this purpose.MethodsThis randomized noninferiority trial, in which participants were unaware of the group assignments, was conducted at six clinics in Utah and included women who sought emergency contraception after at least one episode of unprotected intercourse within 5 days before presentation and agreed to placement of an IUD. We randomly assigned participants in a 1:1 ratio to receive a levonorgestrel 52-mg IUD or a copper T380A IUD. The primary outcome was a positive urine pregnancy test 1 month after IUD insertion. When a 1-month urine pregnancy test was unavailable, we used survey and health record data to determine pregnancy status. The prespecified noninferiority margin was 2.5 percentage points.ResultsAmong the 355 participants randomly assigned to receive levonorgestrel IUDs and 356 assigned to receive copper IUDs, 317 and 321, respectively, received the interventions and provided 1-month outcome data. Of these, 290 in the levonorgestrel group and 300 in the copper IUD group had a 1-month urine pregnancy test. In the modified intention-to-treat and per-protocol analyses, pregnancy rates were 1 in 317 (0.3%; 95% confidence interval [CI], 0.01 to 1.7) in the levonorgestrel group and 0 in 321 (0%; 95% CI, 0 to 1.1) in the copper IUD group; the between-group absolute difference in both analyses was 0.3 percentage points (95% CI, −0.9 to 1.8), consistent with the noninferiority of the levonorgestrel IUD to the copper IUD. Adverse events resulting in participants seeking medical care in the first month after IUD placement occurred in 5.2% of participants in the levonorgestrel IUD group and 4.9% of those in the copper IUD group.ConclusionsThe levonorgestrel IUD was noninferior to the copper IUD for emergency contraception. (Supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and others; ClinicalTrials.gov number, NCT02175030.)

Expanding Options for Intrauterine Contraception

In the U.S., levonorgestrel IUDs are preferred over copper IUDs for long-term contraception because they reduce menstrual bleeding and cramping. How do

Influential Factors of Fertile Age Couples (PUS) in the Selection of Long-Term Contraception Methods (MKJP) in the Work Area of the Medan Community Health Center

Efforts to reduce population growth are carried out by controlling births through family planning. The contraceptive method recommended by the government is the Long Term Contraception Method (MKJP) because it is more efficient, safe, and effective. Data at the state, provincial, district / city level, as well as data from the Community Health Center, the use of non-MKJP (73.4%) is more desirable than the Long-Term Contraception Method (MKJP) (26.6%). Many factors cause someone to choose to use MKJP based on Green's theory. The purpose of this study was to analyze the factors that influence EFA in the selection of the Long-Term Contraception Method (MKJP). This type of research is an analytic survey with a cross sectional design. The research was conducted in the working area of ​​the Medan Teladan Community Health Center. The population of PUS mothers was 2,897 people, and the sample was obtained 110 people. Data analysis was univariate, bivariate using chi-square and multivariate using multiple logistic regression at the 95% confidence level ( = 0.05). The results showed that the variables that had an effect on the selection of MKJP in the Medan Teladan Community Health Center were knowledge (p = 0.002), family / husband support (p = 0.038), and the role of cadres (p = 0.001). The variables that had no effect were attitude (p = 0.153), accessibility (p = 0.061), and peer support (p = 0.098). The most dominant factor was the role of the cadre variable with a value of Exp (B) / OR = 8.819, which means that respondents who stated that the role of cadres was supportive had the opportunity to choose MKJP by 8.8 times higher than stating that the role of cadres was not supportive. The conclusion of this study is that the selection of MKJP by Fertile Age Couples (PUS) is influenced by knowledge, family / husband support, and the role of cadres. It is recommended that KB cadres increase counseling to husbands and wives about MKJP by offline (face to face, leaflets, brochures, etc.) and online (internet) during the Covid-19 period.

Family Approach Model in Affecting Cognitive and Psychomotor of Women of Reproductive Age to Use Long-term Contraceptive Method

Background: Family planning and birtth con­trol is a program launched by the government to overcome population problems. Based on the Indonesian health profile in 2016, the new and active family planning participants mostly pre­ferred injections and tablets (short-term con­traception). The use of short-term contracep­tion tends to decrease the continuity of contra­ceptive use. It may affect the fertility rate. The family approach model was expected to be able to contribute in overcoming population pro­blems, especially in making decisions for the use of the Long-term Contraceptive Method. This study aimed to determine the family approach model in affecting cognitive and psy­chomotor of women of reproductive age to use long-term contraceptive method. Subjects and Method: This was a quasi experimental study with pre and post designs. This study was conducted at the Ngampel village, Mojoroto District, Kediri City, East Java, from June to July 2019. This study popu­lation was all women of reproductive age. A sample of 30 women of reproductive age was selected by purposive sampling. The dependent variable were the cognitive and psychomotor aspects. The independent variable was the family approach. The data was collected by questionnaire. The data were analyzed with Mann Whitney. Results: The cognitive and psychomotor aspects after giving a family approach model to the treatment group (Mean= 6.60) were higher than the control group (Mean= 6.00). The result was statistically significant (p<0.001). Conclusion: Family approach model can be used as an alternative solution to population problems. The family approach model can affect cognitive and psychomotor aspects. It can contribute to the decision making for the use of the Long-term Contraceptive Method. Keywords: family approach model, long-term contraceptive method Journal of Maternal and Child Health (2020), 5(4): 346-351 https://doi.org/10.26911/thejmch.2020.05.04.01

The Contextual Effect of Posyandu on the Decision to Use Long Term Contraceptive in Tulungagung, East Java

Background: Family planning will help reduce population growth, fertility, improvement quality of life, women's health status, unwanted pregnancy, and abortion. The selection of the use of con­traceptives needed leads to a contraceptive that has higher effectiveness, namely the long-term contraceptive method. This study aimed to analyze contextual effect of posyandu on the decision to use long term contraceptive in Tulungagung, East Java Subjects and Method: This was a cross-sectional study conducted at 25 integrated health posts (posyandu) in Kauman health service, Tulungagung, East Java, in January 2019. A sample of 200 women of childbearing age was selected by stratified random sampling. The dependent variable was the use of long-term contraceptive method. The independent variables were age, education, knowledge, occupation, husband and family supports, women's perception, local culture, and posyandu. The data were collected by questionnaire and analyzed by a multilevel multiple logistic regression run on Stata 13. Results: The use of long-term contraceptive method increased with age ≥35 years (b= 1.68; 95% CI= 0.51 to 2.85; p= 0.005), education ≥Senior high school (b= 2.22; 95% CI= 0.97 to 3.46; p <0.001), high knowledge (b= 2.05; 95% CI= 0.75 to 3.35; p= 0.002), working outside the house (b= 1.66; 95% CI= 0.54 to 2.78; p= 0.004), strong husband and family support (b= 2.11; 95% CI= 0.87 to 3.34; p= 0.001), positive perception of long-term contraceptive method (b= 1.92; 95% CI= 0.75 to 3.08; p= 0.001), and supportive local culture (b= 1.10; CI 95%= -0.04 to 2.25; p= 0.009). Posyandu had strong contextual effect on the use of long-term contraceptive method with ICC= 26.70%. Conclusion: The use of long-term contraceptive method increases with age ≥35 years, education ≥Senior high school, high knowledge, working outside the house, strong husband and family support, positive perception of long-term contraceptive method, and supportive local culture. Posyandu has a strong contextual effect on the use of long-term contraceptive method. Keywords: long-term contraceptive, multilevel analysis. Correspondence: Dika Yanuar Frafitasari. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: dikayanuar@gmail.com. Mobile: +6282145642707. Journal of Maternal and Child Health (2020), 5(1): 58-67 https://doi.org/10.26911/thejmch.2020.05.01.07

Effects of Copper-Containing Intrauterine Devices on the Endometrium

Abstract The use of copper-containing intrauterine devices (Cu-IUDs) is a safe, effective, and long-term contraceptive method. Here, we review the effects of Cu-IUDs on subsequent pregnancy and the morphology, local coagulation function, sensitivity to estrogen and progesterone, cell proliferation, and immune response of the endometrium. Studies on the morphology of endometrium indicate that the use of Cu-IUDs can affect the number and binding capacity of estrogen and progesterone receptors in the endometrium and reduce the response of the endometrium to estrogen and progesterone. The use of Cu-IUDs can also affect the proliferation of endometrial cells, suggesting that the aseptic inflammation caused by Cu-IUDs may differ from chronic infectious or noninfectious inflammation; this highlights that the use of Cu-IUDs provides protection against endometrial proliferative diseases. The use of Cu-IUDs increases local endometrial angiogenesis, bleeding tendency, and fibrinolytic activity, which can result in prolonged menstruation or abnormal uterine bleeding. Additionally, the use of Cu-IUDs can cause the infiltration of numerous lymphocytes, monocytes, macrophages, and other inflammatory cells around the endometrial gland and changes in endometrial immune function, immune cell function, and the number and type of immune molecules. Cu-IUD-induced decidual injury significantly increases the invasiveness of trophoblasts, further affecting the aberrant expression of their growth-, angiogenesis-, and invasion-related factors and improving the formation of the placenta. Moreover, the endometrial damage caused by Cu-IUD placement before embryo transfer can improve both clinical pregnancy and live birth rates; however, specific changes in the immune system after Cu-IUD use as well as its effects on future pregnancies require further investigation.

Pregnant again? Perspectives of adolescent and young mothers who and do not experience a repeat pregnancy in adolescence

ABSTRACT Introduction: Teen pregnancy remains a major social and public health issue in developing countries. Each additional child compromises the development of both the mother and children. Scarce studies have been performed in Latin America. Purpose: This study explores and analyzes individual and family factors associated with repeat pregnancies during adolescence to better elucidate the phenomenon. Methods: Qualitative-descriptive study. Thirty semi-structured interviews were conducted with mothers 20 years of age or younger from urban areas of Santiago, Chile. Participants were divided into Repeat Pregnancy (RP) and No Repeat Pregnancy (NRP) groups. Qualitative data analysis was based on elements of grounded theory. Results: The RP group generally related life stories reflecting greater psychosocial vulnerability. Most of the RP group dropped out of school after their first pregnancy to focus on parenting and had a passive attitude towards contraception. In contrast, members of the NRP group actively sought long-term contraceptive methods, motivated largely by the desire to continue their education to improve their living conditions and achieve greater personal fulfilment. They tended to have family support networks that facilitated school retention. Conclusion: Key differences between groups included use of contraception, focus on life projects, and motivation to finish school. Prevention strategies should promote long-term contraceptive methods, offer strategies to help young mothers continue their education, facilitate achievement of personal projects, and provide support for parenting.

1006. Contraception, Pregnancy and ART in Women of Child-Bearing Years

BackgroundSimpler anti-retroviral (ART) regimens with less pill burden and fewer side effects can improve adherence and clinical outcomes. Warnings about dolutegravir possibly causing neural tube defects (NTD) are alarming and have the potential to limit ART options for women of child-bearing years. A recent preliminary analysis from an observational study group in Botswana prompted a warning from the US Department of Health and Human Services (DHHS), released in May 2018, about the use of dolutegravir during conception.MethodsAt a large urban HIV clinic in New Orleans, a retrospective chart review was performed on adult women up to age 40 who were seen in clinic in 2018 to assess for dolutegravir use, as well as discussion of NTD and pregnancy.Results132 woman in the age range were seen in 2018, the mean age was 33 years (range 19 to 40). Average age of HIV diagnosis was 26. Most were African-American (83%) and 81% had Medicaid or no insurance. Eleven percent were diagnosed with HIV due to testing during pregnancy and 17% during routine screening. Sexual exposure was the main reported risk factor for HIV (69%) and 48% had another STD. Only 61% had a documented discussion of contraception and pregnancy plans. Over their treatment at the clinic, 47 pregnancies occurred. Most of the women were on integrase regimens (65%), although 14% were on protease inhibitor regimens and 20% were on other regimens or combination regimens. Forty two percent of the women were ever on dolutegravir and 12 had NTD discussed, resulting in 3 regimen changes. The main reason it was not discussed was permanent sterilization, change to a different ART regimen prior to the warning, long-term contraception, or no sexual activity. Seven pregnancies occurred while on dolutegravir, three were prior to the warning, one after the first trimester, and one ended in abortion. None had an NTD reported.ConclusionDolutegravir is very commonly used due to its tolerability and simplicity. While recent reports show the risk of NTD to be lower than previously thought, it is still elevated compared to other ART and a more open discussion of pregnancy plans, contraception, and NTD if applicable, needs to occur in women living with HIV.Disclosures All Authors: No reported disclosures

Pattern of spousal support and communication among family planning clients in a tertiary care centre in north western Nigeria

Background: Globally, there has been the recognition of the importance of male involvement in family planning and providers sees their support as an effective way of reducing barrier to accessing Family Planning services. Aim: Assess the pattern of spousal support and communication for family planning. Methodology: This was a mixed study design. A structured questionnaire was used to collect information from Family Planning client, attending Ahmadu Bello University Teaching Hospital’s Reproductive Health clinic and Ahmadu Bello University Medical Centre. An in-dept. interview (with FP providers) and FGDs (with clients) were also conducted. Result: A total of 280 clients that were served with questionnaire across the two facilities within three months. Of the 280 respondents only 65% had tertiary level of education. Prior discussion of family planning with spouse was found in 82.5% of respondents and in 80.3% of the respondents said their spouses were aware of the chosen method. However, it was only in 39.5% of clients that, the chosen method was influenced by their spouses. Financial support by spouse was found in 69% of respondents. In 90% of respondents, there was the influence of the spouse on the intended duration of the chosen method. However, it was only in 33.5% of the respondents that the spouse influenced the discontinuation of previous method. Conclusion: Couple communication and spousal support were present in over two-third of family planning clients in Zaria, Northern Nigeria. Targeting men in behavioral change communication will improve the uptake of family planning services and improve the continuation of use of long-term contraceptives.

Description of Fertile Age Couples with Long Term Contraception

The use of LTCM has many advantages and more recommended by the government than non-LTCM because it is more efficient, safer and more effective. However, the facts on the ground are that women with FA prefer non-LTCM. Data from the Pasar Merah Village were LTCM acceptors (34.42%), while non-LTCM acceptors (65.57%). This study was to analyze the descriptions of long-term contraceptive users (EFA). This research was an analytic survey with a Cross-Sectional design. The research was conducted in Pasar Merah Village. The populations were 610 women with a sample of 86 people. Data analysis was univariate, bivariate using chi-square and multivariate using multiple logistic regression with 95% confidence (α=.05). The results showed that variables associated with long-term contraceptive method users by women of FA in East Pasar Merah Village were knowledge (p=.001) and husband's support (p=.012). Unrelated variables were age (p=.118), parity (p=.019), education (p=.122), income (p=.375), health worker support (p=.128). The most dominant factor, namely the knowledge variable, had a value of Exp (B)/OR = 5.938, meaning that the respondent had good knowledge, the opportunity to use LTCM was 5.9 times higher than respondent with less knowledge. The conclusion of this research is that the husband's knowledge and support are related to the use of LTCM. It is suggested that PKB and PLKB increase counseling for women with FA and husbands so that the knowledge of women with FA increases, husbands can provide positive support. Counseling can be done individually or in groups online during the Covid-19 pandemic.

PIH7 Cost-Effectiveness Analysis of Etonogestrel Contraceptive Implant Compared to SIX Other Contraceptive Methods Based on Real Life DATA in France

To estimate the cost-effectiveness (CE) of etonogestrel (ENG) implant compared to other long-term and short-term reversible contraceptive methods delivered in France A 6-year CE Markov model assessed the cost and health outcomes of the implant versus other contraceptive methods (combined oral contraceptive pill [COC], progestogen-only pill, copper and hormonal intrauterine devices [IUD]) from a payer perspective. The target population was sexually active, not-pregnancy-seeking French females of reproductive age. Contraception efficacy, switch rates and outcomes following contraceptive failure (birth, extra-uterine pregnancy, miscarriage and abortion), were based on the French current medical practice data (FACET study). Costs included devices, drugs, exams and medical management (physician visits, procedures and hospitalizations). Incremental CE ratio were calculated as additional cost per pregnancy avoided. Efficiency frontier was plotted to identify cost-effective methods. Uncertainty was explored through sensitivity analyses. The ENG implant avoids 18.6‰ unplanned pregnancy per person-year (UPPY) over COC, 7.5 ‰ UPPY over copper IUD and 1.7‰ and 3.1‰ UPPY over 5 years and 3 years hormonal IUD respectively. The implant was on the efficiency frontier along with second generation (2G) COC and copper IUD. The ICER of the implant versus copper IUD was 2,221€ per pregnancy avoided (or 10,933€ per abortion avoided). Sensitivity analyses confirmed the cost-efficiency of the contraceptive implant, with an ICER varying from +8.5% to -55.7% of the base case value. At a WTPT of 10,000€ per pregnancy avoided, ENG implant had a 79.5% probability to be the most cost-effective method. For the 240,000 French women currently using the implant, the latter could prevent from 419 (versus 5y hormonal IUD) to 8,475 (versus 2G COC) unplanned pregnancies and, respectively, from 99 to 1,992 abortion per year. The ENG implant remains a cost-effective strategy compared to long-term and short-term reversible contraceptive methods.

Implementation of Family Planning Services for the Long Term Contraception Method (KB MKJP) in Palu City

This study aims to analyze the implementation of the Long Term Contraception Method (KB MKJP) in the City of Palu. The type of research used is descriptive with a qualitative approach by utilizing the post-positivism paradigm to see social phenomena that occur. Researchers determined the criteria for informants, namely program administrators, medical officers, and fertile age couples, including: 2 program administrators (BKKBN), 4 medical officers (Tadulako Hospital), 4 Fertile Age Couples (PUS). The results showed reliability with the aspect of timeliness, where the presence of medical personnel and program administrators was not according to what had been agreed or scheduled. Physical evidence with aspects of the facility, where the operating room is not yet available and does not meet the specified minimum requirements. Empathy with the information aspect, where the delivery of information related to KB MKJP in the form of risks and side effects is not conveyed to the PUS, while information in the form of Long-Term Contraceptive Method (MKJP) type of contraceptive methods, benefits, and benefits have been conveyed completely, clearly and easy to understand Fertile Age Couples (PUS). Empathy is seen from the information aspect that the information related to KB MKJP by program administrators and medical officers has been delivered completely and clearly. Responsiveness is not only seen by service providers, but can also be assessed through service recipients because in the selection of contraceptives there are still PUS who are not able to make appropriate decisions so that they require counseling or information delivery by program administrators.

Diseminasi Informasi Terkait Metode Kontrasepsi Jangka Panjang pada Masyarakat Desa Bunut Baok, Lombok Tengah

Indonesia is the fourth most populous country in the world. In 2015, the population growth rate in West Nusa Tenggara is equal with national population growth rate, which is about 1.39%. The long-term contraceptive methods is one of the most effective family planning programs to succeed in controlling the population growth rate. The participation rate for the use of this contraceptive methods by fertile age couples in Bunut Baok village, Middle Lombok, is only about 10%. This was dissemination of information event aimed to disseminate the information regarding long-term contraceptive methods to Bunut Baok villagers, Middle of Lombok. This social event is part of the thematic Kuliah Kerja Nyata (KKN) programs of students of Universitas Mataram in the period of 2020 in Bunut Baok villagers attended by 59 Bunut Baok villagers as participants. In this event, pre-test and post-test were also conducted to evaluate the increase of their knowledge about long-term contraceptive methods. The participants had mean age of 36 years old, mostly female and had senior high school educational level. The mean of posttest scores was higher than the mean of pretest scores (88.54vs77.03; p = 0.000). These results indicated that this dissemination of information event increase the level of knowledge of Bunut Baok villagers related to the long-term contraceptive methods.

Factors that affect the discontinuation of family planning methods in Myanmar: analysis of the 2015\u201316 Myanmar Demographic and Health Survey

BackgroundAccess to family planning contributes up to a 44% reduction in maternal deaths. Since the majority of unplanned pregnancies and abortions occur in women who were either not using contraception or not using it consistently, greater access to contraception and more consistent use of contraception are crucial in the reduction of unplanned pregnancies and abortions. This study aims to determine which types of contraceptives are most often discontinued, the reasons for discontinuation, and the factors that influence contraceptive discontinuation for women in Myanmar.MethodsThis study is a secondary data analysis of calendar data from the 2015–16 Myanmar Demographic Health Survey. The dependent variable is discontinuation of contraception within 12 months among episodes of contraceptive use in the 5 years before the survey among women age 15–49. Multivariable logistic regression was used to identify the predictors of contraceptive discontinuation.ResultsThe 12-month discontinuation rate for all contraceptive methods was 39%. The discontinuation rates for short-term methods were remarkably high (43% for pills and 42% for injectables), while the rate for long-term methods was very low (7% for intrauterine devices and 0.2% for implants). Discontinuation while still in need of contraception was high (55%) although 28% of those women switched to other modern methods. Multivariable logistic regression showed the factors associated with contraceptive discontinuation were a woman’s age, location (state/region), wealth, and number of births within the past 5 years.ConclusionsThe high rate of discontinuation while in need is very alarming given goals to reduce the unmet need for family planning in Myanmar. Family planning programs must ensure timely, informed method-switching by women who discontinue contraception, especially among women for whom discontinuation is the highest (age 45–49, middle and richest wealth quintile, regions where high discontinuation and multiparity); increase the availability of long-term contraceptive methods, and improve counseling that ensures clients’ informed and voluntary choice of family planning services.