Number Of Contraceptive Users Research Articles

A 10-year review of progestogen-only injectable contraceptive use at a private facility in Lagos, Southwest Nigeria

Background: Progestogen-only injectable contraceptives are affordable, long acting, and reversible. It can be administered by a trained nonmedical staff and does not require storage, making it specifically suitable for use in developing countries where contraceptive prevalence rates are low. Aim: This study aims to determine the sociodemographic characteristics of clients at the family planning clinic who accepted progestogen-only injectable contraceptives, their side effects, and discontinuation rates. Materials and Methods: In the retrospective study, clients who accepted and used progestogen-only injectable contraceptives at the Family Planning Clinic for over 10 years between August 1, 2008, and July 31, 2018, had their data collected using a structured pro forma. Results: Of the 197 clients who used progestogen-only injectable contraceptives during the study period, medical records of 181 (91.8%) of them were available and retrieved, while medical records of 16 were missing. The total number of contraceptive users during the same period was 1690, giving an acceptance rate of 11.7% for progestogen-only injectable contraceptives. The mean age of clients was 32.8 ± 6.2 years. Most (34.8%) of the participants were in the age group of 30–34 years. Most (95.6%) of the participants were married and 92.2% had at least a secondary school education. The majority (55.8%) of the participants used it for child spacing, while 44.2% used it to limit their families. The discontinuation rate at 1 year was 72.4%. Of the 181 participants, 65 (35.9%) reported side effects. The most common side effect was menstrual disorders (30.9%). No pregnancy was reported during use. Conclusion: Progestogen-only injectable contraceptives are effective and safe. Sociodemographic characteristics of users, side effects, and efficacy are similar to other local studies. However, the acceptance rate is low and the discontinuation rate at 1 year is higher than in other centers.

Future trends in contraceptive prevalence and method mix in the developing world.

This study reviews existing methodologies for projecting future trends in contraception, evaluates the validity of the assumptions underlying these projections, proposes methodological improvements, and assesses the prospects for new methods of contraception in the coming decade. Demand for contraception can be expected to continue to rise rapidly for the next few decades as populations continue to grow and fertility declines to approach replacement level. As a result of these trends, the number of contraceptive users in the developing world is expected to rise from 549 to 816 million during the next 25 years, according to the most recent UN projection. An examination of the projection methodology found it to be reasonable. Projecting the future distribution of specific contraceptive methods is more difficult. Method choice is affected by trends in several factors, including access to different methods, user characteristics, and technology. The procedure employed by the Futures Group to project method mix was found to be less than optimally designed, and a new methodology is, therefore, proposed.

The global view of reproductive health.

Reproductive health is a condition in which the reproductive process is accomplished in a state of complete physical, mental and social well-being and is not merely the absence of disease or disorders of the reproductive process. The Daily Reproductive Health News in our global village does not paint a bright picture. The past few decades have witnessed a revolution in reproductive behaviour, with a major expansion in contraceptive use in developing countries. Between 1960-65 and 1985-90, the number of contraceptive users in all developing countries has increased from an estimate of 31 million to 381 million. The major expansion in contraceptive use in developing countries has consequences for the quality of life, for the present and for the future, for the society at large and for the individuals and their families. Major challenges, however, still lie ahead. There is a major unmet need for family planning. The rhetoric about population and family planning is not matched by allocation of resources.

Contraception and women's health.

More and more women all over the world are opting for fertility by choice not by chance. Contraceptive use has a tremendous impact on women's health. The ability to regulate and control fertility is a basic component of health, positively defined as a state of physical, mental and social well-being. Contraception is saving the lives of women around the world from the hazards of unwanted pregnancy. Optimal childbearing is also contributing to infant and child survival. Contraception has a complex relationship to sexually-transmitted diseases. Contraceptive safety is a major public health concern. The risk/benefit assessment will differ for different populations, for different individuals, and even for the same individual at different periods of life. The family planning movement started as a movement by women for women. Women's perspectives and women's concerns should guide the future of contraceptive research and development.

Iud use throughout the world: past, present and future

IUDs go as far back as the time of Hippocrates. In the early 1920s some German physicians used silkworm gut often with silver or gold wire in the uterus to prevent pregnancy. In the early mid-1900s an Israeli physician had inserted rings in 329 women and the failure rate was 2.5/100 years of exposure. At about the same time in Japan among 937 women intrauterine metallic and polyethylene rings had failure rates of 1.3% and 1.7% respectively. The Population Council made 36 grants for studies on intrauterine contraception during 1962-1963. The IUD accounts for about 20% of currently used contraceptive methods. It is the second most used method of contraception in developing countries (23% vs. 45% for sterilization). Countries with the most IUD users are the larger population countries (e.g. China = 67 million and Indonesia = 4.2 million). There is usually a discrepancy between IUD figures derived from national probability sample surveys and those derived from service statistics. In fact service statistics usually overestimate contraceptive use. The UNFPA asked countries with the largest number of contraceptive users in the developing region to report expected number of contraceptive users in the future by method. India Bangladesh the Philippines Colombia and Mexico expect a modest increase in IUD users. Turkey expects a large increase (22-50% during 1988-2000). Vietnam which has many IUD users (74% of all users) expects to decrease the number of IUD users by 1%/year between 1988 and 2000. No country expects a significant decrease in IUD users. Worldwide about 100 million women use the IUD today. This amount is expected to increase by at least 25% in the next 10 years.

Family Planning Programs: Efforts and Results, 1982-89

According to a set of 30 indices that assess the strength of large-scale family planning programs in developing countries, a strong upward shift in effort scores occurred between 1982 and 1989. During that period, many countries established or augmented their family planning programs, and effort scores improved in all developing regions and in all four dimensions of effort--policies and stage-setting activities, service and service-related activities, record keeping and evaluation, and availability of contraceptive methods. By region, the sharpest improvement was not in East Asia, where levels were already high, but in sub-Saharan Africa, where the movement was clearly upward, from a low base. Earlier associations between program effort and fertility declines are reaffirmed, additive to the contribution of socioeconomic improvements. In order to compute scores ranging from zero to 30 for each of the 30 indices, a detailed questionnaire was sent to 4-6 respondents in each of 103 developing countries having more than one million population. Respondents included program staff, donor agency personnel, local observers, and knowledgeable foreigners. The scores indicate that developing countries are continuing to move toward more favorable policy positions and stronger implementation of action programs, with consequent fertility effects. For the fertility decline to match the medium population projections of the United Nations, however, a substantial enlargement in the number of contraceptive users is necessary, not only to compensate for the enlarging base of couples, but also to increase the proportion who use contraceptives.

Post Family Planning Acceptance Experience in the Caribbean: St. Kitts-Nevis and St. Vincent

This survey of family planning acceptors in 2 Caribbean countries indicates that women are effective contraceptors with all-contraception continuation rates similar to those in comparable studies. Clinic utilization patterns are erratic with only 15% of the acceptors keeping all of their follow-up appointments. The postacceptance fertility rates were only somewhat lower than those of the general population. Family planning acceptors had between 14% (St. Vincent) and 43% (St. Kitts-Nevis) of the live births. The service statistics systems which attempt to maintain a continuous count of active program users overestimate the number of contraceptive users by 63 to 138%. Few program acceptors switch to the commercial sector as a source of contraceptive supplies; the program was the current source of supply for 81 to 98% of the women using contraception at the time of the study. (authors)

Commercial Distribution of Contraceptives in Afghanistan: Actual and Potential Use of the Pharmaceutical Marketing System

A study of the use of pharmacies for the delivery of contraceptives was conducted in Afghanistan. It was found that pharmacies sold insignificant amounts of condoms and spermacides but the market for oral contraceptives was better. The estimated number of contraceptive users was 5588 in 1971 leaving a huge potential market. Problems to be overcome concerning the use of contraceptives are: 1) the Islamic virtue of a large family; 2) rumors about the side effects of orals; and 3) needed motivation and understanding of the use of orals. A survey of 12% of the countrys pharmacists in 1972 found that 80% were in favor of free birth control information and thought it would be good for business. It was concluded that by educating the pharmacists about the side effects and maternal child health advantages of family planning they could be used to extend family planning services to rural areas with their pharmacies acting as family guidance centers.