Long-term Contraception Research Articles

Overpopulation and Procreative Liberty

ABSTRACT A few decades ago, there was a lively debate on the problem of overpopulation. Various proposals to limit population growth and to control fertility were made and debated both in academia and in the public sphere. In the intervening decades, however, the idea of limiting population growth became taboo in policy discussions and was completely ignored in philosophy. More recently, there has been a small revival of anti-natalism in population policy and social philosophy. This is in part due to the growing recognition that the demographic transition might not be completed all around the world before overpopulation causes irreversible social, political, or environmental harm. Several proposals have been made to limit family size and lower fertility. However, all of these proposals are based on incentives only, and all are strictly voluntary: in their discussion, involuntary fertility control is considered coercive and therefore thought to necessarily involve a gross violation of procreative liberty and personal autonomy. The aim of this paper is to demonstrate that anti-natalist population policies need not involve the violation of procreative liberty and personal autonomy. To show this, I revive two radical proposals from the old debate. The first involves mandatory long-term contraception; the second involves the introduction of tradeable procreation entitlements. I show that contrary to what many people believe, these policies can be defended on the basis of broadly liberal principles. Not only do they not conflict with procreative liberty and personal autonomy, but they can actually increase liberty and promote autonomy.

Duration of Hormonal Contraception and Risk of Cervical Cancer

The use of long hormonal contraceptives can disrupt the balance of estrogen in the body, resulting in abnormal cell changes. This study aimed to determine a correlation between the duration of hormonal contraception and risk of cervical cancer. This study used a case-control design. The population were patients who had examined at a cancer installation and obstetrics-gynecology polyclinic Dr. Sardjito Hospital in 2018. Case samples were 95 women have cervical cancer diagnosis and control were 95 women with a negative pap smear. Sampling with random sampling. Dependent variable cervical cancer and independent variable the duration of hormonal contraception are obtained from medical records. Cervical cancer is assessed by doctor’s diagnosis. Data analysis used logistic regression. Results showed that 44.7% of samples used long-term hormonal contraception (over 5 years). Length of use of hormonal contraception had a significant correlation with the incidence of cervical cancer (p-value < 0.01). Hormonal contraceptive use more than 5 years have a risk 4.2 times (95% CI 1.01-5.69) of cervical cancer than using less than 5 years after being controlled with the first marriage age and parity

Factor Analysis of the Low Use of Intra Uterine Device (IUD) Contraception in East Java in 2015

Intrauterine Device (IUD) is one type of contraceptives that is made from flexible plastic and implanted in the uterus. The IUD is included as a long-term contraception which is very effective in regulating the distance of pregnancy, is reversible, and can be worn by women of all reproductive ages. Therefore, the government is doing all kinds of effort to the number of IUD users. Surprisingly, the number of women using the IUD has kept decreasing every year. This study aims to analyze the factors affecting the low use of IUD contraception in East Java in 2015. The data were obtained from the Mid-term Development Plan Survey in 2015 by taking a sample from all the women who were willing to be interviewed in the Mid-term Development Plan Survey in East Java Province with the following characteristics: being 15–49 years of age, being married, not getting pregnant, and were still using contraceptions. There were 1,220 respondents who could be interviewed. The result of binary regression testing with a significant degree of 5% yielded three significant variables, namely age (P-value = 0.002), education (P-value = 0.000), and birth control service (P-value = 0.000). Healthy women who were around 15–19 years old, had low education, and had limitted access to private birth control services tended to avoid the IUD contraception more. Therefore, it is expected that the government is making cooperation with the related sectors in an attempt to increase the use of IUD contraceptives in the East Java Province in 2015 with more emphases on age, education and birth control service locations.

Factor Analysis of the Low Use of Intra Uterine Device (IUD) Contraception in East Java in 2015

Intrauterine Device (IUD) is one type of contraceptives that is made from flexible plastic and implanted in the uterus. The IUD is included as a long-term contraception which is very effective in regulating the distance of pregnancy, is reversible, and can be worn by women of all reproductive ages. Therefore, the government is doing all kinds of effort to the number of IUD users. Surprisingly, the number of women using the IUD has kept decreasing every year. This study aims to analyze the factors affecting the low use of IUD contraception in East Java in 2015. The data were obtained from the Mid-term Development Plan Survey in 2015 by taking a sample from all the women who were willing to be interviewed in the Mid-term Development Plan Survey in East Java Province with the following characteristics: being 15–49 years of age, being married, not getting pregnant, and were still using contraceptions. There were 1,220 respondents who could be interviewed. The result of binary regression testing with a significant degree of 5% yielded three significant variables, namely age (P-value = 0.002), education (P-value = 0.000), and birth control service (P-value = 0.000). Healthy women who were around 15–19 years old, had low education, and had limitted access to private birth control services tended to avoid the IUD contraception more. Therefore, it is expected that the government is making cooperation with the related sectors in an attempt to increase the use of IUD contraceptives in the East Java Province in 2015 with more emphases on age, education and birth control service locations.

DETERMINAN PEMILIHAN METODE KONTRASEPSI JANGKA PANJANG PADA AKSEPTOR KB AKTIF DI PUSKESMAS PEDAMARAN

<span lang="IN">Determinant of the selection of long-term contraceptive methods on family planning acceptors in Pedamaran community health center. </span><span lang="EN"> The population problem faced by Indonesia is a large population with a low quality of life. Uncontrolled population rate will cause baby booming so information needs to be disseminated about the benefits of family planning (FP). Long-term contraceptive method has a high level of effectiveness and can reduce the rate of population growth. </span><span lang="EN">This study aim to determine the factors that affect the selection of long-term contraceptive methods in active family planning acceptors.</span><span lang="EN">This study used a cross-sectional study design and using</span><span lang="IN"> simple random sampling</span><span lang="EN"> technique, consisted of 243 acceptors. Analyzes of data were univariate analysis, bivariate analysis using chi-square test with α = 0.05 and 95% confidence interval value, and multivariate analysis using binary logistic regression.</span><span lang="EN">Based on multivariate analysis was the variables significantly related to the selection of long-acting contraception include </span><span lang="IN">age (p = 0.01; OR = 2,24; 95% CI: 1,17-4,29), education (p = 0.01; OR = 0,31; 95% CI: 0,13-0,75) and number of children (p = 0.03; OR = 2; 95% CI: 1,05-3,81).</span><span lang="EN"> Thus, age was the variable that had the greatest impact on determining the selection of long-acting contraception.</span><span lang="IN">The </span><span lang="EN">acceptors with ≥ 35 years old, low educated and have >2 children more likely to choose long-acting contraception. It is hoped that family planning workers can educate and persuade people of all ages with </span><span lang="IN">different educational backgrounds so total fertility rate can be reduce.</span>

AUTHOR REPLY

Vasectomy is the safest and most cost-effective means of long-term permanent contraception, and is easily and safely performed in the office setting, under local anesthesia. Although some patient factors, such as body habitus, prior failed vasectomy, or extreme anxiety, may warrant consideration of vasectomy under sedation, these instances are infrequent and cannot account for the finding that approximately 18% of all vasectomies were performed in the ambulatory surgery center (ASC setting) during the study period. The increase in healthcare costs associated with performing a vasectomy in the ASC versus the office setting is substantial, and is compounded by the increased use of non-essential ancillary services, such as pathologic evaluation of vasal segments, which are also more commonly employed in the ASC setting.

Determinant Use of Long-Term Contraceptive Methods in Sangurara Community Health Center Area Palu City

Long-term contraceptive method is contraception that is used to delay pregnancy, birth spacing, stop fertility for a long period of time and even it can last a lifetime and is very effective in preventing unwanted pregnancies and also more cost-effective, but it does not provide protection against Sexually Transmitted Infection (STIs). The long-term contraceptive method consists of an IUD, Implants and sterilization. Study aims is to determine the relationship between economic status, the role of health officers, and partner support on the use of the long-term contraceptive method in the working area of Sangurara Community Health Center, Tatanga Subdistrict, Palu. The type of this research was quantitative with a cross-sectional study approach. The sample in this study were active Family Planning acceptors in the working area of Sangurara Community Health Center, Tatanga Subdistrict, Palu, as many as 100 people. The sampling technique used was a simple random sampling. Data analysis was performed using the chi-square test. The results showed that there was a relationship between economic status and the use of Long-term contraceptive method (ρ = 0,000), there was a relationship between the role of the health officers and the use of Long-term contraceptive method (ρ = 0,001), and there was a relationship between partner support and the use of Long-term contraceptive method (ρ = 0,001). Counseling or complete information on contraceptive methods was needed for family planning acceptors in order to be able to choose and use the qualified long-term contraceptive method in terms of their effectiveness

Development of a Long-Term Drug Delivery System with Levonorgestrel-Loaded Chitosan Microspheres Embedded in Poly(vinyl alcohol) Hydrogel.

This study reports on the fabrication of a controlled release system for the delivery of levonorgestrel (LNG) for long-term contraception. LNG was encapsulated in chemically cross-linked chitosan (CS) microspheres, and microspheres presented a spherical geometry with a good particle size distribution (polydispersity index (PDI) < 0.1). The LNG-CS microspheres were classified based on their particle size range, <63, 63-125, and 125-300 μm, where the 125-300 μm particles were selected to be incorporated into a physically cross-linked and annealed PVA hydrogel matrix to prolong the drug release. PVA concentrations and the annealing treatment influenced the swelling behavior of PVA hydrogels. Fourier transform infrared (FTIR) spectroscopy indicated that CS was successfully cross-linked through the formation of a Schiff base; the PVA hydrogel was formed through hydrogen bonding without reacting with LNG, which was only physically entrapped, thus maintaining its stability. Differential scanning calorimetry (DSC) showed that freeze-thaw and annealing processes increased the degree of crystallinity in the PVA hydrogel. In vitro drug release assessments for all formulations showed zero order without any burst release. Over a period of 100 days, 34, 27, and 21% of LNG was released from the CS-LNG microspheres in the size ranges < 63, 63-125, and 125-300 μm, respectively, while only 14, 11, and 9% of LNG was released when the CS-LNG microspheres were incorporated into 10, 15, and 20% PVA hydrogels, respectively. The drug release kinetics exhibited both diffusion- and swelling-controlled mechanisms following the Korsmeyer-Peppas model. This work presents a promising delivery system for long-term contraception with controlled zero-order release behaviors.

Awarding Support Becomes a Dominant Factor in the Election of Family Planning in the Long-Term Contraception Method in Kampung KB

Indonesia’s Maternal Mortality Rate (MMR) is currently in the high category. One effort to reduce MMR is through family planning program. The family planning program contributes in reducing 32% all of maternal mortality by increasing the coverage of LARC users whose achievements are currently only 17.45%. One of the biggest influences on the escalation of LARC users is psychosocial support from the environment. The objective of this study analyzed the relationship between emotion, informational, instrumental, and appraisal supports from the environment with the LARC use in the Kampung KB. The research used an observational analytic design with a cross-sectional approach to 100 respondents that acceptor KB. Statistic analysis used the chi-square and logistic regression. The results of this study showed that the emotional, instrumental and appraisal support were associated with LARC use, based on the p values of 0.028, 0.019 and 0,001, respectively. Appraisal support became the dominant factor in choosing LARC in Kampung KB with an odds ratio (OR) 5,000. It meant that a woman who got appraisal support from the environment have 5,000 times higher to have an opportunity to use LARC than the woman who did not get the appraisal support. ABSTRAK Angka Kematian Ibu (AKI) Indonesia saat ini masih dalam kategori tinggi. Salah satu strategi menurunkan AKI adalah program KB. Program KB berkontribusi dalam menurunkan 32% dari seluruh kematian ibu dengan cara meningkatkan cakupan pengguna KB MKJP yang saat ini capaiannya hanya 17,45%. Peningkatan pengguna KB MKJP salah satunya dipengaruhi oleh dukungan psikososial dari lingkungan. Penelitian ini bertujuan menganalisis hubungan antara dukungan emosional, informasional, instrumental, dan penghargaan dari lingkungan dengan penggunaan KB MKJP di Kampung KB. Penelitian ini menggunakan desain analitik observasional dengan pendekatan cros-secsional terhadap 100 responden akseptor KB. Analisis statstik yang digunakan adalah uji chi-square dan regresi logistik. Hasil penelitian menunjukkan bahwa dukungan emosional, instrumental dan penghargaan berhubungan dengan penggunaan KB MKJP di Kampung KB, dengan masing-masing nilai p yaitu 0,028, 0,019, dan 0,001. Sementara, dukungan informasional tidak berhubungan dengan nilai p lebih dari 0,05. Dukungan penghargaan menjadi faktor dominan dengan nilai ood rasio (OR) sebesar 5,000. Seseorang yang memperoleh dukungan penghargaan dari lingkungan akan 5,000 kali berpeluang memilih menggunakan KB MKJP dibanding dengan yang tidak memperoleh dukungan penghargaan.

FAKTOR-FAKTOR YANG MEMPENGARUHI PEMILIHAN METODE KONTRASEPSI (Kasus di Kecamatan Seberang Ulu I Kota Palembang)

Trend in the use of contraceptive methods in Palembang city shows that injections and pills are the most dominant method used for family plan. Data from BKKBN of Palembang city in 2014 showed that injections and pills were the most widely used each has for 40% and 27%. Whereas according to the BKKBN is one of right way to limit births following the family planning program through the Long-Term Contraception Method (LTM) such as implants, Intra Uterine Device and Method of Operation.The purposes of this research are to know about the distribution of contraceptive used according to the type and to find out the factors that affect the selection method beetween the dominant long-term contraception and short-term by the woman of fertile ages. The methods used were survey research methods, techniques of data collection were by observation and interview using the questionnaire, the analytical techniques used were univariable (descriptive), bivariable (chi-square and t-test) and multivariable (logistic regression).The results of this study shows that use of injections remains a trend of the election method of contraception by woman of fertile ages in Palembang city. The gender of the child owned by fertile age couple became the dominant factor which influences the selection of long-term contraception method and Non LTM. This was proven by the result of the multivariate logistic regression statistical test with a significant value of 0,000 &lt; 0,05.

Evaluating the vertical HIV transmission risks among South African female sex workers; have we forgotten PMTCT in their HIV programming?

BackgroundFemale sex workers (FSW) have a greater HIV burden compared to other reproductive-aged women and experience high incidence of pregnancies. However, there are limited data on mother-to-child transmission of HIV in the context of sex work. This study assessed the uptake of prevention of mother-to-child transmission (PMTCT) services to understand the vertical HIV transmission risks among FSW in South Africa.MethodsFSW ≥18 years were recruited into a cross-sectional study using respondent-driven sampling (RDS) between October 2014–April 2015 in Port Elizabeth, South Africa. An interviewer-administered questionnaire captured information on demographics, reproductive health histories, and HIV care, including engagement in PMTCT care and ART. HIV and pregnancy testing were biologically assessed. This analysis characterizes FSW engagement in HIV prevention and treatment cascades of the four prongs of PMTCT.ResultsOverall, 410 FSW were enrolled. The RDS-weighted HIV prevalence was 61.5% (95% bootstrapped confidence interval 54.1–68.0). A comprehensive assessment of the four PMTCT prongs showed gaps in cascades for each of the prongs. In Prongs 1 and 2, gaps of 42% in consistent condom use with clients among HIV-negative FSW and 43% in long-term high efficacy contraceptive method use among HIV-positive FSW were observed. The analyses for prongs three and four pertained to 192 women with children < 5 years; 101/192 knew their HIV diagnosis prior to the study, of whom 85% (86/101) had their children tested for HIV after birth, but only 36% (31/86) of those who breastfed retested their children post-breastfeeding. A substantial proportion (35%, 42/120) of all HIV-positive women with children < 5 years of age were HIV-negative at their last delivery and seroconverted after delivery. Less than half (45%) of mothers with children < 5 years (45/101) were on ART and 12% (12/101) reported at least one child under five living with HIV.ConclusionThese findings show significant gaps in engagement in the PMTCT cascades for FSW, evidenced by sub-optimal uptake of HIV prevention and treatment in the peri/post-natal periods and insufficient prevention of unintended pregnancies among FSW living with HIV. These gaps result in elevated risks for vertical transmission among FSW and the need for PMTCT services within FSW programs.

Counseling, Motivation of Midwives on IUD KB Acceptors, and Usage of IUD KB in Working Area of Dermayu Public Health Center Seluma District

IUD contraception is a contraceptive that has a long period of time, is very effective and comfortable for nursing mothers, if released fertility will return soon. The purpose of this study was to study the relationship of counseling and motivation of midwives on IUD family planning acceptors with the use of IUD family planning in the working area of the Dermayu Public Health Center in Seluma District. The design used in this study is an analytical survey with a cross sectional approach. The population in this study were all active family planning participants from January to July 2018 in the work area of Dermayu Public Health Care Center which amounted to 813 people. The sample in this study amounted to 97 respondents. Taking techniques using Accidental Sampling techniques. Data collection uses primary data by distributing questionnaires to respondents. The results showed that 78.4% of mothers did not use IUD KB, 21.6% of mothers used IUD KB. 41.2% of mothers did not get counseling about family planning and 58.8% of mothers received good counseling. 71.1% of mothers have low motivation and 28.9% of mothers have high motivation. There is a significant relationship between counseling midwives on IUD KB acceptors with the use of IUD family planning in the working area of Dermayu Public Health Center in Seluma District with a weak category. There is a significant relationship between the motivation of midwives on IUD KB acceptors with the use of IUD family planning in the working area of Dermayu Public Health Center in Seluma District with the moderate category. It is expected that health workers can provide socialization and counseling to couples of childbearing age so that they can determine or choose appropriate long-term contraceptives. Keywords: counseling, motivation of midwives, usage of IUD

Changing Scenario in Indian Contraceptive Methods: A Glimpse Through a Tertiary Hospital Statistics.

The patient scenario of a tertiary hospital changes with the implementation of various national programmes in any country. These programmes are conceived after understanding the felt need of the society. Though IUCD was available as an interval method of contraception in the past also and was meant to be effective for 10years, the prerequisite to come again to the medical facility after 6weeks of childbirth for insertion resulted in almost all patients to dropout and only the highly motivated would come on their own. Post-partum insertion of IUCD at the time of childbirth or within 48h has addressed the need of contraception in the post-partum period as well as omitted the need for second visit to a health set-up. Earlier, after achieving the desired family goal of children, tubectomy was the preferred choice, irrespective of age of children but PPIUCD seems to have come up as a long-term reversible method of contraception. The present study was conceived to study the shift of method of long-term contraception from tubal sterilization and vasectomy to PPIUCD over a period of 8years from 2010 to 2017. This study was a retrospective analytical study conducted at the Department of Obstetrics and Gynaecology in Safdarjung Hospital between the years 2010 and 2017. The number of IUCDs inserted post-placental (i.e. within 10min of delivery of placenta) and within 48h (of vaginal childbirth) and intra-caesarean (intrauterine insertion while performing caesarean) were recorded and analysed. Also, sterilizations (tubectomy) and interval IUCD insertions done during this time period were compared. With the introduction of PPIUCD in national family programme, more women are inclining towards long-term spacing method and not resorting to sterilizations. PPIUCD is preferred over interval IUCD. PPIUCD is there to stay as a method of long-term contraception.

FAKTOR YANG MEMPENGARUHI PENGGUNAAN JENIS METODE KONTRASEPSI JANGKA PANJANG (MKJP) PADA WANITA MENIKAH USIA SUBUR DI PROVINSI JAWA TIMUR

Long-Acting and Permanent Method (LAPM) is a very effective method of contraception, but women of childbearing age majority use short-term contraceptive methods. The purpose of this study was to apply multinomial logistic regression analysis in predicting factors affecting Fertile Women in the use of LAPM in East Java Province in 2012. This research use secondary data that was result of Indonesia Demographic Health Surveys (IDHS) year 2012 using the number of 171 respondents. The results of this study indicated the variables that affected the use of LAPM of WUS age (p = 0.008), education level (p = 0,004), occupation (p = 0,029), source of family planning services (p = 0,000), residence area (p = 0.016). The conclusion of this study was age, educational level, occupation, source of FP services, and residential areas affecting the use of long-term contraceptive methods in women of childbearing age. Therefore the government through the National Family Planning Coordinating Board (BKKBN),­ still pay attention to the family planning program and ensure every community to implement family planning programs and educate and promote family planning programs to resolve the problems of the population.

Analysis of Maternal Mortality Due to Hypertension in Pregnancy in West Bandung

Hypertension in pregnancy is one of causes in maternal mortality in West Bandung District in 2017 and there are 11 mothers (39.28%) of 28 mortality cases, which is in the highest rank. Moreover, this research aimed at analyzing maternal mortality due to hypertension in pregnancy in West Bandung District. This research was qualitative research by utilizing grounded theory approach with constructivism paradigm. Sample of this research was the closest family and health personnels who knew the cronology of maternal mortality and there were 21 people from 8 mortality cases. The sample collection utilized purposive sampling technique. Meanwhile, the instruments of this research were researchers, interview guidance, stationery, and voice recorder. Validity test utilized triangulation technique. Technique of data collection was by in depth interview and the analysis process were by transcription, reduction, coding, categorization, and theme. The result of this research was known that factors, which had contribution against maternal mortality, was such as poor access of health service and it was caused by several things: PONED function that had not been optimal in handling hypertension in pregnancy, poor quality of health service, guidance in handling hypertension in pregnancy that had not been optimal, less optimal information from health service, health personnel’s poor knowledge about hypertension in pregnancy, and delay in referring to hospital. The next factor was unhealthy living behavior, such as mother who had risk of hypertension in pregnancy did not use long-term contraception, underwent quite high failure level in the use of long-term contraception, the mother was a missing patient from the referral, and not sensitive against emergency situation. Besides that, unknown or unexpected factors also became contribution against mortality, such as unclear demographic status; undesirable pregnancy; assuming that dying in pregnancy, having birth, and in postpartum period was martyred. In conclusion, factors that contributed against maternal mortality due to hypertension in pregnancy in West Bandung District were access of health service, healthy living behavior, and unknown even unexpected factors. However, the factors that really impacted against maternal mortality were access of health service and healthy living behavior. &#x0D; &#x0D; Keywords: Maternal mortality, Hypertension in pregnancy

Determinan Keikutsertaan Ibu Sebagai Akseptor Metode Kontrasepsi Jangka Panjang Pasca Persalinan (Studi Kasus di Fasilitas Kesehatan Tingkat Lanjutan Kabupaten Dharmasraya)

Postpartum family planning programs are effective and efficient measures to reduce maternal mortality and infant mortality due to unwanted pregnancies which have the potential to cause direct maternal death (abortion, eclampsia and prolonged labor) and indirectly to one component "4 Too "(too young, too old, too much and too close). The Sungai Dareh is the only advanced health facility in Dharmasraya Regency in Dharmasraya Regency with acceptors of long-term contraceptive method acceptors in a very slow or stagnant condition. The purpose of this study was to determine the most dominant factors related to the participation of postpartum mothers using long-term contraceptive methods. The research design was cross sectional. Primary data is taken during 2017, which is between February and Desember with a sample of 99 people in the Maternity Room at the regional public hospital Sungai Dareh. The analysis model used is a regression of the backward likelihood ratio method. The sampling technique uses purposive sampling. Based on the test results, the variables of poverty level, number of surviving children, health status, age level of respondents, level of education, purpose of using family planning methods, husband support and attitudes have a significant relationship with the participation of postpartum long-term contraceptive methods. While unrelated factors are the age of first marriage and the level of knowledge of the respondents. From the regression model produced, husband's support is the most dominant factor (p = 0.001, OR = 19.591 (95% CI: 3.227 - 118.927), so it can be concluded that husband's support influences the wife's decision in the participation of the postpartum contraceptive method.

A randomised controlled trial of potential for pharmacologic prevention of new-onset albuminuria, hypertension and diabetes in a remote Aboriginal Australian community, 2008-2013.

IntroductionWe conducted a double-blind randomised controlled trial in a remote-living Australian Aboriginal group at high risk for chronic disease to assess whether pharmacological treatment with angiotensin converting enzyme inhibitor (ACEi) could delay the onset of albuminuria, hypertension or diabetes in people currently free of those conditions.MethodsEligibility criteria in 2008 were age ≥18yr, blood pressure ≤140/90 mm/Hg, urinary albumin creatinine ratio (ACR) < 3.4 mg/mmol, normal levels of glycosylated haemoglobin, and, in females, infertility. A 2011 amendment allowed enrolment of fertile females using long-term contraception. “Treatment” was the ACEi perindopril arginine, or placebo, and participant events were ACR ≥3.4 mg/mmol and/or blood pressure >140/90 mm Hg and/or haemoglobin A1c >6.5%, and/or cardiovascular events. Results were analysed in 125 randomised participants who commenced treatment.ResultsRecruitment was low, especially of women, and dropout rates high: there were finally 60 and 65 people in the ACEi and placebo groups respectively. In females, there were no events among 10 in the ACEi group, versus 5 events among 17 in the placebo group, and longitudinal ACR, HbA1c and blood pressure levels supported probable benefit of ACEi. There was no benefit of ACEi in males, but a probable benefit on diabetes/hypertension events. With the genders combined, there was probable reduction of diabetes (zero vs 4 events, p = 0.068), and of diabetes or hypertension (zero vs 5 events, p = 0.037).DiscussionIn this high-risk population, ACEi probably delays development of albuminuria, diabetes and hypertension in females, and of non-ACR events overall. Repeat investigation with a larger sample size is warranted.

Application of Health Belief Model on Factors Influencing Long-Term Contraceptive Use

Background : Family planning is one of the strategies to reduce maternal mortality. Data in 2017 shows that in Indonesia, out of 37,338,265 couples of reproductive age there were 18.63% who did not do family planning. Women of reproductive age (WRA) who have not done family planning can affect reproductive health. This study aimed to analyze factors influencing long-term contraceptive method (LTCM) using health belief model theory. Subjects an d Met h od: This was a cross sectional study conducted in Sleman, Central Java, from March to April 2019. A sample of 220 women of reproductive age was selected by quota sampling. The dependent variable was LTCM use. The independent variables were perceived severity, perceived susceptibility, perceived benefit, cues to action, self-efficacy, education, and culture. The data was collected by questionnaire and analyzed by a multiple logistic regression. Results : Perceived severity (OR= 8.02; 95% CI= 2.62 to 24.51; p<0.001), perceived susceptibility (OR= 12.16; 95% CI= 3.65 to 40.42; p<0.001), perceived benefit (OR= 6.05; 95% CI= 2.10 to 17.40; p= 0.001), cues to action (OR= 6.98; 95% CI= 2.30 to 21.18; p= 0.001), self-efficacy (OR= 3.60; 95% CI= 1.23 to 10.52; p= 0.019), education (OR= 2.50; 95% CI= 1.40 to 10.41; p= 0.029), culture (OR= 6.65; 95% CI= 2.14 to 20.62; p= 0.001) increased long-term contraceptive use. Conclusions : Perceived severity, perceived susceptibility, perceived benefit, cues to action, self-efficacy, education, culture increase long-term contraceptive use. Keywords : family planning, long-term contraceptive, health belief model Correspondence: Ayu Dhiah Pitaloka. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: ayudhiahp@gmail.com. Mobile: +62812266896­2­­­­91 Journal of Health Promotion and Behavior (2019), 4(1): 55-63 https://doi.org/10.26911/thejhpb.2019.04.01.06

A Five–year review of female sterilization at the Lagos university teaching hospital, Lagos.

Background: Over the decades, female sterilization has become a highly effective, convenient, simple and safe method of long term contraception, attributable to technological and medical advances.Objective: This study aims at determining the uptake, indications, timing and surgical techniques of female sterilization in LUTH.Methodology: A retrospective study involving all female clients who had sterilization done at the Lagos University Teaching Hospital between January 2010 and December 2014. Clinical data were retrieved from the case files and analyzed with SPSS version 19. one hundred and eighteen clients were eligible, however only 115 case files could be located. Available case files had adequate information for the study.Results: There were 8,695 deliveries with 115 cases female sterilization, resulting in an incidence of 13 per 1000 births. The mean age at sterilization was 37.9 years. Completed family size was the main indication. Ninety percent of the clients had a postpartum procedure and Pomeroy's method was used in 76.5% of the clients.Conclusion: Female sterilization still has a role to play in family planning in our environment. Majority of the procedure were performed during planned caesarean section.Keywords: female sterilization, contraception, family planning, Pomeroy, tubal ligation.

FACTORS ASSOCIATED WITH PERSISTENCE OF HPV GENITAL INFECTION IN A SMALL COHORT OF ROMANIAN WOMEN.

SUMMARYThe aim of the study was to assess the role of behavioral factors in persistence of human papillomavirus (HPV) genital infection. Out of a cohort of 605 women included in a study of HPV infection prevalence, 142 HPV positive women (aged 18-57) were retested after a 12-month interval. None of the patients underwent surgical treatment during that period. Selected patients were asked for a second smear for cytologic analysis and HPV genotyping. A questionnaire that included information regarding reproductive health, sexual activity and smoking status was filled-in. After 12 months, 46 of 142 (32.39%) women had persistent HPV infection, with genotypes 16 and 18 found in 27 cases. On the other hand, 17 of 142 (11.97%) women had acquired new infections replacing the baseline genotypes. In our study, smoking (OR=2.320, p=0.0330) and sexual behavior (OR=5.333, p=0.0180 for more than three sexual partners; OR=2.427, p=0.0238 for cases where the partner was involved in another sexual relationship) were associated with viral persistence, while long-term contraception did not yield statistically significant results.