Contraceptive Safety Research Articles

Exploring barriers to vasectomy adoption among married men in Dadra and Nagar Haveli

Introduction and aim. Vasectomy was introduced in India in 1992 and is the most effective, simple, and safe permanent method of contraception yet its use is very limited among the population. The study’s objectives were to assess the knowledge, attitude, and perception towards vasectomy and the barriers to adoption among married men in Dadra and Nagar Haveli. Material and methods. A cross-sectional hospital-based study was conducted on married male attendants of patients and data were collected on sociodemographic details, knowledge regarding vasectomy, their attitude and perceptions towards vasec tomy, and their intention of using vasectomy in the future. Results. Out of 300 participants, 258 (86%) participants have heard of vasectomy as a contraceptive method, and only one participant has undergone vasectomy. The majority (285; 95%) of the participants agreed that family planning is also a responsi bility of males while nearly two-third (185; 61.7%) of them were not willing to undergo vasectomy in the future. Procedure-re lated factors, post-procedure-related factors, social factors, availability of alternate contraceptive methods, and preference for tubectomy were the barriers to the adoption of vasectomy. Conclusion. There is a need to provide correct information and counseling about vasectomy and non-scalpel vasectomy to eligible couples to increase the acceptance of vasectomy as a safe, effective, and cheaper method of contraception.

Over-the-counter access to hormonal contraception: a global perspective.

Oral contraceptive pills are among the most popular contraceptives worldwide, including among adolescents, and are available over the counter in over 100 countries. However, when a prescription is required, oral contraceptives may be difficult to obtain, particularly for adolescents. Recent approvals of over-the-counter progestin-only pills in the United Kingdom and United States have brought widespread attention to this topic. Progestin-only pills, including the norgestrel pill recently approved for over-the-counter use in the United States, are highly effective and may be used safely without a prescription or medical monitoring, including by adolescents. These pills are associated with relatively high user satisfaction. Although over-the-counter availability may improve contraceptive access overall, issues related to insurance coverage and out-of-pocket cost may continue to pose practical barriers to access for many individuals. Over-the-counter oral contraceptives are an appropriate and important contraceptive option for many adolescents. Over-the-counter availability has the potential to increase access to safe and effective contraception in the United States, United Kingdom, and other countries where a prescription is currently required. Future research on use patterns among adolescents is needed, as are advocacy efforts and policies to ensure access and affordability.

Progestogen only contraception in women with congenital heart disease

Background There is little information of progestogen-only contraceptives in patients with congenital heart disease (CHD) on the long-term. Objective To evaluate the use of contraception in patients with CHD. We studied both short-acting reversible contraceptives (SARCs), oral progestin-only pills (POPs) and long-acting reversible contraceptives (LARCs): intrauterine devices (IUD-IPs) and subdermal implants both impregnated with progestogens (SI-IPs). Study design Retrospective study of all women attending the preconception clinic. Contraceptive methods were classified in three TIERs of effectiveness before and after consultation. ESC classification regarding pregnancy risk, WHOMEC classification for combined oral contraceptive safety was collected. Results Six hundred and fifty-three patients. A significant proportion of them switched from TIER 3 to TIER 2 or 1 (p < .001) after consultation. One hundred and ninety-nine patients used POPs, 53 underwent IUD-IPs implantation and 36 SI-IPs, mean duration was 58 ± 8, 59 ± 8 and 53 ± 38 months, respectively. Conclusions Because of their safety and efficacy, IUD-IPs and SI-IPs should be considered as first-line contraception in patients with CHD.

Contraception for antiphospholipid syndrome and systemic lupus erythematosus (according to the recommendations of the European Alliance of Associations for Rheumatology/American College of Rheumatology, EULAR/ACR)

Maintaining and strengthening the health of the population is one of the primary functions of society. Inadequate understanding of the importance of contraception by the medical community and its application by society can lead to the population’s reproductive health becoming compromised. Basic knowledge of effective and safe contraceptive methods is important for every rheumatologist, as reproductive health affects both the general condition of patients and the course of the main rheumatic diseases (RH). This is particularly true for patients with antiphospholipid antibody (aPL) positivity, antiphospholipid syndrome (APS) and systemic lupus erythematosus (SLE). The presence of aPL/APS, as well as the activity of SLE, are the main factors determining the choice of contraceptive method and the risk of hormonal contraception in patients with RH. Meanwhile, the use of appropriate (highly effective and safe) contraceptive therapy in this category of patients allows not only to plan the birth of a child, but also to avoid unwanted pregnancy in cases of disease activity, the use of embryotoxic and teratogenic drugs, as well as to carry out optimal treatment of concomitant pathology, which the supervising rheumatologist should be well aware of. This publication is devoted to the consideration of the main issues of contraception in the most “vulnerable” category of patients with RH – with positive aPL, APS and SLE.

Quality Health Services for Adolescents: Assessing Awareness and Use of Adolescent Sexual Reproductive Health Services in Keta, Ghana

ABSTRACT Introduction Although adolescents have access to sexual and reproductive health services, they encounter a variety of obstacles, including limited access to safe abortion and contraceptives, early pregnancy and parenthood, and a high occurrence of sexually transmitted infections. This research assessed the awareness and use of adolescent sexual reproductive health services in the Keta Sub-district of Ghana. Methods A cross-sectional study using a quantitative method of analysis and the administration of a structured questionnaire to 350 adolescents between the ages of 14 and 19 in the Keta Sub-district was conducted. Results Of the 10 services covering adolescent sexual and reproductive health, 75% of participants were aware only of comprehensive sex education. Only 27% were aware of sexually transmitted infection prevention and care services. Awareness was 13% or lower for the remaining eight services. Only 24% had used an adolescent sexual reproductive health service. Conclusion Awareness of adolescent sexual reproductive health services and their use is low in the Keta Sub-district. To improve access to sexual and reproductive health information, sub-district health services should create school-based satellite clinics for adolescents. Adolescents’ ambassadors should be created to educate peers on adolescent issues, especially sexual and reproductive health.

Ferritin-nanocaged aggregation-induced emission nanoaggregates for NIR-II fluorescence-guided noninvasive, controllable male contraception

Controllable contraception in male animals was demonstrated through the utilization of gold nanorods' photothermal effect to accomplish mild testicular hyperthermia. However, the challenges arising from testicular administration and the non-biodegradability of nanoparticles hinder further clinical implementation. Therefore, a straightforward, non-invasive, and enhanced contraception approach is required. This study explores the utilization of human heavy chain ferritin (HFn) nanocarriers loaded with aggregation-induced emission luminogens (AIEgens) for noninvasive, controllable male contraception guided by Near-Infrared-II (NIR-II) fluorescence imaging. The HFn-caged AIEgens (HFn@BBT) are delivered via intravenous injection and activated by near-infrared irradiation. Lower hyperthermia treatment induces partial damage to the testes and seminiferous tubules, reducing fertility indices by approximately 100% on the 7th day, which gradually recovers to 80% on the 60th day. Conversely, implementation of elevated hyperthermia therapy causes total destruction of both testes and seminiferous tubules, leading to a complete loss of fertility on the 60th day. Additionally, the use of AIEgens in NIR-II imaging offers improved fluorescence efficiency and penetration depth. The findings of this study hold significant promise for the advancement of safe and effective male contraceptive methods, addressing the need for noninvasive and controllable approaches to reproductive health and population control.

Analysis of Adolescent Reproductive Health Risk Factors in Purwakarta Regency, Indonesia

Adolescent reproductive health is an important issue in Indonesia. This study aims to analyze risk factors for adolescent reproductive health in Purwakarta Regency, Indonesia. This research used a cross-sectional survey method involving 400 teenagers aged 15-24 years. Data was collected through questionnaires. Data analysis used the Chi-square test. The research results show that risk factors for adolescent reproductive health in Purwakarta Regency include: Low adolescent knowledge about reproductive health (OR: 2.17; 95% CI: 1.45-3.24); Risky sexual behavior, such as having had premarital sexual relations (OR: 2.88; 95% CI: 1.99-4.19); Unsafe use of contraceptives, such as not using contraceptives at all (OR: 2.87; 95% CI: 1.99-4.19); Lack of adolescent access to reproductive health services (OR: 2.67; 95% CI: 1.87-3.83). The conclusion of this study shows that efforts need to be made to increase teenagers' knowledge about reproductive health, reduce risky sexual behavior, increase the use of safe contraceptives, and increase teenagers' access to reproductive health services.

Factors Influence the Interest of Couples of Childbearing Age in Choosing IUD Contraception

One of many efforts to reduce the birth rate through the Family Planning (KB) program is by inviting couples of reproductive age (PUS) to use contraceptives. IUD is one of the most effective and safe long-term contraceptives, but in reality, it is still less attractive to PUS. This study aims to determine the factors that influence the interest of PUS in choosing IUD. This study was a quantitative study with a correlation design using a cross sectional approach. The population in this study is 1,780 PUS with a sample size of 181 selected using accidental sampling technique. Data analysis was univariate and bivariate with chi square test. The results of the correlation test for knowledge showed a P-value of 0.020 (P &lt;0.05), while the results for income showed a P-value of 0.010 (P &lt;0.05), and the results for husband support showed a P-value of 0.015 (P &lt;0.05). It can be concluded that there is a relationship between knowledge, income as well as husband's support and the interest of PUS in choosing IUD. It is recommended that health workers can provide education in the form of health promotion to family planning acceptors related to IUD, in order to increase the coverage of family planning acceptors. In addition, it is hoped that health workers can increase the frequency of providing counseling on the advantages of IUD both personally and in groups to increase information and maternal interest in using IUD.

Perception of women on safety and efficacy of contraceptives: A comparative study.

Contraceptive information and services are fundamental to the health and human rights of all individuals. Low contraceptive use is a major challenge faced in India. To determine whether a lack of awareness of contraceptive methods was a factor, we assessed the perception of women on contraceptive methods, their safety and efficacy and further determined whether their demographic background played any role in their perception. Reproductive-aged women from both rural and urban backgrounds of Bangalore and Tumkur, Karnataka, were individually questioned in a community setting using both Google Forms and personal interviews from September 2022 to December 2022. The questions consisted of limited demographic information and specific questions related to the knowledge and beliefs of women on the efficacy and safety of contraceptive methods and assessed situational awareness. Although awareness was more amongst urban women (99.1%) compared with rural women (79%), the practice was significantly higher amongst rural women (63.2%) compared with urban women (36.7%). Perception showed variations with respect to age, education, religion and parity. A major religion-wise disparity was observed. With regard to safety, oral contraceptive pills (60.9%) and condoms (51.8%) were unanimously perceived to be the most and least harmful to health. The most commonly perceived short-term complications were found to be body changes, and mood swings, tiredness and infertility with no data to support the claim were the most commonly chosen long-term complication. From the study, we concluded that more educated women were not immune to misinformation. The efficacy rates of different methods were highly underestimated with methods with higher failure rates perceived to be more effective. Results demonstrate that women are ill-informed about the long-term complications of various methods.

Development of a serious game for learning about safe sex and contraception in adolescence

Objetivos: desenvolver um serious game em aplicativo mobile para aprendizagem sobre sexo seguro e contracepção com a participação ativa dos adolescentes; e avaliar conteúdo, aparência e usabilidade da tecnologia com adolescentes e experts . Método: trata-se de uma pesquisa aplicada, de produção tecnológica sobre o desenvolvimento de um serious game , realizada em duas etapas: desenvolvimento da tecnologia propriamente dita; e avaliação do conteúdo, aparência e usabilidade do aplicativo. Adolescentes de uma escola pública da cidade de São Paulo-Brasil participaram da etapa de desenvolvimento da tecnologia . A avaliação foi realizada pelos adolescentes e experts nas áreas de saúde coletiva e tecnologia em saúde. Seguiram-se os critérios: aspectos educacionais, interface do ambiente e recursos didáticos. Resultados: desenvolveu-se Prinventon App ® , um serious game ambientado em uma cidade virtual, projetado para abordar a sexualidade na adolescência. O aplicativo obteve 90% de respostas positivas e apresentou Índice de Validade de Conteúdo de 0,80, sendo considerado adequado. As sugestões e apontamentos foram acatados e implementados. O serious game foi considerado interessante e importante diante do tema abordado. Conclusão: a tecnologia desenvolvida pode auxiliar os adolescentes na aprendizagem sobre sexo seguro e contracepção, ao abordar, de maneira lúdica e realística, a sexualidade na adolescência.

Development of a serious game for learning about safe sex and contraception in adolescence

Objetivos: desarrollar un serious game en aplicación móvil para el aprendizaje sobre sexo seguro y anticoncepción con la participación activa de los adolescentes; y evaluar contenido, apariencia y usabilidad de la tecnología con adolescentes y expertos. Método: se trata de una investigación aplicada, de producción tecnológica acerca del desarrollo de un serious game , realizada en dos etapas: desarrollo de la tecnología propiamente dicha; y evaluación del contenido, apariencia y usabilidad de la aplicación. Adolescentes de una escuela pública de la ciudad de São Paulo-Brasil participaron en la etapa de desarrollo de la tecnología. Ya la evaluación fue hecha por los adolescentes y expertos en las áreas de salud colectiva y tecnología en salud. Se siguieron los criterios: aspectos educacionales, interfaz del ambiente y recursos didácticos. Resultados: se desarrolló Prinventon App ® , un serious game ambientado en una ciudad virtual, diseñado para abordar la sexualidad en la adolescencia. La aplicación obtuvo 90% de respuestas positivas y presentó Índice de Validez de Contenido de 0,80, siendo considerado adecuado. Las sugerencias y apuntes fueron acogidos e implementados. El serious game fue considerado interesante e importante ante el tema abordado. Conclusión: la tecnología desarrollada puede ayudar a los adolescentes en el aprendizaje sobre sexo seguro y anticoncepción, al apuntar abordar, de manera lúdica y realista, la sexualidad en la adolescencia.

Hubungan Peningkatan Berat Badan Dengan Penggunaan Alat Kontrasepsi Suntikan 3 Bulan di Puskesmas Sudiang Tahun 2023

Many women have found difficult in determining contraception tools, since there is no much safe and effective contraception. One contraceptive method which is considered to be quite ideal is that 3 month contraceptive injection. 3 month contraceptive injection is a type of contraceptive injection containing only progestin, it is injected every 3 months. There are lots of benefits from the using of this contraceptive. Nevertheless, there are also several weaknesses of this contraceptive, one of them is that the matter of weight gain. Based on that finding, it takes a study that aims to determine the correlation between weight gain and the use of contraceptive injections 3 month in Puskesmas Sudiang year of 2023. This type of research is analytic survey through cross sectional study. The sample in this study taken by purposive sampling, the number of samples in this study were 52 respondents. The research instrument was observation sheet, in which it was analyzed through Chi square test. The results of this study showed that there is a significant correlation between weight gain and the use of contraceptive injections of 3 month, it is showed P = 0.00 &lt; ɑ = 0.05. Thus, when we use the 3 month contraceptive injection, it should be followed by the changing of lifestyle such as healthy diet, rest frequent and regular exercise.

Syphilis: Is it Back with a Bang?

Syphilis was brought under control with the advent of penicillin. However, in recent times, a rise in the incidence of syphilis has been reported by Centers for Disease Control and Prevention (CDC). To study the clinical and epidemiological profile of patients with syphilis attending sexually transmitted infection (STI) clinic at tertiary care center. Observational, cross-sectional analysis of sociodemographic, clinical, and investigational data of all syphilis patients visiting STI clinic from August 2019 to July 2021 was done and analyzed. Out of 1330 STI patients that attended the clinic, 15.04% (n = 200) were diagnosed with syphilis, among them 72% (n = 144) were males, and 28% (n = 56) were females, with male-to-female ratio of 2.5:1. Of these 24.5% (n = 49) had primary, 44.5% (n = 89) had secondary, 30.5% (n = 61) had latent, and 0.50% (n = 1) had congenital syphilis. Among secondary syphilis patients, rash was the most common presentation seen in 43 patients, followed by condyloma lata in 30, palmoplantar syphilis in 17, oral mucous patch in 3, and iridocyclitis in 3 patients. Human immunodeficiency virus (HIV) was positive in 16.5% (n = 33). Herpes genitalis was the most common coinfection among 25 patients who were diagnosed with mixed venereal disease. RPR titer was positive in all 200 patients, with 1:16 titer being most common. India is experiencing a new trend in the prevalence of syphilis, mainly due to the changes in risk behavior, misconceptions, and social stigma associated with STIs, improved laboratory diagnosis, and increased public awareness. Particularly secondary and latent stages have shown a rising trend over the past few years. Awareness about safe sexual practices and contraception is very important to control the current resurgence.

National features of the new Chinese pronatalism

In 2016 the Chinese demographic policy, as a result of improving the regulation of population development, was radically reoriented to increase the birth rate. The rejection of «one-child policy» began with permission to have a second child, and soon was supplemented by second births stimulation. Taking into account the world pronatalism, socio-economic measures were applied. They showed that the most effective results can be achieved with the help of socio-economic tools that prevent deterioration of living conditions of families after childbirth. The regional diversity of China determines variability of such measures, but everywhere they begin with targeted «child» payments and the creation of conditions, which do not interrupt women’s professional career after pregnancy and delivery, then they are expanded through social help to families with children, tax relief, reduction of housing and education costs, as well as measures relevant for specific population groups (large families, single mothers, etc.). The main criterion of the assistance targeting is the number of children, but its size and forms depend on local capabilities. The importance of material factors of reproductive choice decreases with an increase of living standards, the conditions making it possible to combine parenthood and profession, large family traditions, gender of children, fertility preservation with safe contraception become more important. Measures, taking into account national specifics, include availability of assisted reproduction programs and promoting a modern three-child family among the population of reproductive age, a significant part of which belongs to the generation consciously focused on small family.

COMPARISON OF SATISFACTION AND OUTCOME OF PPIUCD AND INTERVAL IUCD AT A TERTIARY CARE CENTER IN WESTERN RAJASTHAN

Objectives: A prospective study is to compare satisfaction and outcome of post-placental intrauterine device (PPIUCD) and interval intrauterine device (IUCD) at a tertiary care center in western Rajasthan. Methods: This is an observational study on 150 women of reproductive age group (19–45 years) who had been inserted with copper-T 380A in postpartum period and within 6 weeks of delivery between July 21 and June 22, done at department of Obstetrics and Gynaecology, Dr. S. N. Medical College, Jodhpur, Rajasthan, India. Women were categorized into Group A (postpartum IUCD) and Group B (interval IUCD). In Group A, the Cu-T-380-A was inserted intrauterine in postpartum period. In group B, CuT-380-A was inserted after 4–6 weeks of delivery by withdrawal technique. Results: The risk of other complications such as bleeding, pain in lower abdomen, and infection is relatively high in interval IUCD insertion as compared to PPIUCD insertion (p&gt;0.05). The removal rate for bleeding and/or pain was found to be lower in PPIUCD group. Expulsion rate for group A (PPIUCD) was 6% and 2.66% in group B (p=0.257). Of total 13 removal, in group A, maximum 9 (69.23%) were removed at 6 months and 4 (30.77%) were removed at 6 weeks. Of total 16 removal, in group B, 13 (81.25%) were removed at 6 months and 3 (18.75%) were removed at 6 weeks. (0.752). Satisfaction rate for group A (PPIUCD) was 88.67% and 88% in group B. Conclusion: PPIUCD insertion is equally effective and safe method of contraception as interval IUCD insertion with lower incidence of side effects.

The impact of cascade training-A FIGO and WHO Department of Sexual and Reproductive Health and Research collaboration to improve access to quality family planning globally.

Globally, there are considerable barriers to accessing safe and effective contraceptive methods. Increased awareness and utilization among obstetricians and gynecologists (OB/GYNs) and allied health professionals of the WHO's tools and guidelines on contraception is a possible avenue to changing this. A cascade-training model, based on regional training-of-trainer workshops followed by national workshops, was used to share key WHO global family planning tools and guidelines among OB/GYNs in 29 countries across three regions-Anglophone Africa, Middle East and Mediterraean, and Francophone West Africa. Monitoring and evaluation was performed through pre- and post-knowledge questionnaires as well as in-depth interviews of key informants before and after the training was instituted. The training increased both participants' knowledge and understanding of the relevant guidelines, as well as their confidence in using them. Qualitative data suggested that this improved in-country clinical practice and influenced national policy through dissemination and engagement with country leadership. The cascade-training model was a practical, locally adaptable means of disseminating up-to-date WHO family planning guidelines and tools. It resulted in sustainable changes in many participating countries, including training curriculum updates, policy changes, and increased government engagement with family planning. Future iterations of the initiative would benefit from additional support for multidisciplinary training.

No-scalpel vasectomy — a new approach to male surgical contraception: a single center experience

BACKGROUND: No-scalpel vasectomy is a modern approach to performing vasectomy, in which access to the vas deferens is achieved through a puncture of the scrotum.&#x0D; AIM: To analyze of own experience in the use of no-scalpel vasectomy.&#x0D; MATERIALS AND METHODS: During the period from April 2017 to December 2022, 32 men underwent non-scalpel vasectomy at the Mother and Child Clinic Yaroslavl. Three operations were performed under intravenous anesthesia, 29 under local anesthesia. Occlusion of the vas deferens was achieved by excision of the fragment, coagulation of the lumen, ligation of the ends of the duct and fascial interposition.&#x0D; RESULTS: The average age of the patients was 39 years (range 35 to 62 years). All patients were married. The mean number of children in patients undergoing vasectomy was 2.3 0.4. In all cases, the reason for performing a vasectomy was cited by patients as dissatisfaction with other methods of contraception. The average operation time was 19.0 4.0 minutes. The average size of the scrotal skin puncture was 9.3 1.3 mm (range 7 to 11 mm). The severity of pain during surgery, as assessed on a visual analogue scale (VAS), varied from 1 to 3 points, with an average of 2.3 0.5 points. In the postoperative period, one patient developed acute epididymitis (3.1%), and one patient (3.1%) developed a small hematoma (up to 1 cm) in the area of the surgical wound. A week after surgery, 15 patients (46.8%) reported the presence of pain with a visual analogue scale score of 1 to 3 points, with an average of 2.2 0.7 points. One month after the operation, no pain was noted in any patient. The results of the study of the ejaculate 3 months after the operation showed the presence of azoospermia in 27 (84.4%) patients and the presence of single immobile spermatozoa (less than 100,000/ml) in 5 (15.6%) patients, which allowed us to state 100% occlusive effectiveness of vasectomy.&#x0D; CONCLUSIONS: No-scalpel vasectomy is a less traumatic and safe method of male surgical contraception. The operation under local anesthesia is associated with minimal discomfort for the patient. Maximum success rates can be achieved using the technique of vas deferens occlusion through excision of the fragment, coagulation of the lumen, ligation of the ends of the duct, and fascial interposition.

Abstract 13983: Reproductive Health Counseling and Experiences Among Females With Congenital Heart Defects: Results From the Congenital Heart Survey to Recognize Outcomes, Needs, and Well-Being

Introduction: The American Heart Association (AHA) recommends clinicians discuss reproductive health with women with congenital heart defects (CHD) beginning in adolescence due to their unique pregnancy and contraceptive needs. Therefore, we assessed reproductive health counseling and experiences among women with CHD, and differences by CHD severity. Methods: Women with CHD ages 19 to 38 years, identified in active, population-based birth defects registries from Arkansas, Arizona, and Atlanta, GA, completed the Congenital Heart Survey To Recognize Outcomes, Needs, and well-beinG (CH STRONG) from 2016 to 2019, including questions about reproductive health counseling, concerns and experiences. Prevalence estimates standardized to all CH STRONG-eligible women and adjusted prevalence ratios (aPR), calculated with multivariable Poisson regression, assessed differences by CHD severity. Results: Of 765 female respondents, 40.7% were 19-24 years, 66.7% were non-Hispanic white, and 67.7% had &gt; high school education. Overall, 21.3% received CHD-specific contraceptive counseling, 28.3% pregnancy counseling, and 12.8% advice to avoid pregnancy (Fig). Women with severe, compared to non-severe CHD, were more likely to receive clinician counseling about safe contraception (aPR=3.0, 95% confidence interval [CI]: 2.2-4.0), pregnancy (aPR=3.5, 95% CI: 2.7-4.6), and advice to avoid pregnancy (aPR=4.3, 95% CI: 2.9-6.5), and they were more likely to be concerned about their ability to have children (aPR=1.4, 95% CI: 1.1-1.8) and delay/avoid pregnancy (aPR=2.2, 95% CI: 1.5-3.2). No differences were seen in ever being pregnant (aPR=0.83, 95% CI: 0.6-1.1). Conclusions: Results suggest most women with CHD are not receiving AHA-recommended reproductive health counseling. Almost one in three women with severe CHD received clinician advice to avoid pregnancy, although AHA guidelines state pregnancy is contraindicated for few women with CHD.

COMPARISON OF CONTINUATION OF POST-PLACENTAL INSERTION OF COPPER T AFTER CESAREAN SECTION AND NORMAL VAGINAL DELIVERY

Objective: The objective of this study was to assess the efficacy of post-placental copper T insertion following vaginal and cesarean delivery. Methods: This is a prospective study conducted for the period of 1 year on pregnant females undergoing deliveries at Department of Obstetrics and Gynecology, Sardar Patel Medical College and AGH, Bikaner. The total number of postpartum intrauterine contraceptive device inserted participants included in the study were 200, divided into two groups vaginal (group A) and lower segment cesarean section (LSCS) (group B) groups. Results: Mean age of the patients was 26.15±4.02 years. Most of the acceptors in both the groups were para-2 with 30% in vaginal group and 76% in LSCS group. The complaints at 6 weeks follow-up, in both groups, were similar, but the rate of removal was higher in vaginal group (9%) compared to LSCS group (2%). At 3 months follow-up, in vaginal group, the most common complaint was bleeding per vagina (PV) in 7.31% cases whereas missing thread 31.25% in LSCS group. Over a period of 3 months, the main reason for intrauterine contraceptive devices (IUCD) removal was bleeding PV in both group (six cases in vaginal group and three cases in LSCS group). Conclusion: Immediate post-partum insertion of IUCD appears to be safe and effective method of contraception.

Creating an Intercultural User-Centric Design for a Digital Sexual Health Education App for Young Women in Resource-Poor Regions of Kenya: Qualitative Self-Extended Double Diamond Model for Requirements Engineering Analysis

Background The stigmatization around sexual health due to culture, religious traditions, and norms leads to myths and a lack of available information and resources related to universal access to sexual and reproductive health services. Additional sexual health education not being part of the Kenya school curriculum leads to insufficient access to knowledge about safe contraception, menstruation, and female genital mutilation. A digital app could support and provide education and information for universal equal access, addressing United Nations Sustainable Development Goals 3, 4, and 5. Objective The study targeted the requirements for establishing a reusable framework to develop a successful accessible web-based sexual health education app and the behavioral intention to use it to obtain sexual health information by mainly young women in Kenya. Methods The double diamond model, with a problem room including the discover and define phases, enriched with cultural aspects and modeled to a self-expanded intercultural research model was used in a user-centered design thinking approach to develop a framework for requirements engineering analysis. For problem identification, semistructured pilot phase interviews based on Consolidated Criteria for Reporting Qualitative Research guidelines were conducted, followed by expert interviews for qualitative content analysis. A sample size of 12 pilot phase interviews and 5 expert interviews was determined using data saturation. The responses were coded and analyzed according to the affinity mapping method. Results The requirements engineering analysis showed potential enablers of and barriers to the use of a digital sexual health education app. Through this qualitative study, a conservative cultural background, classic text communication, and the influence of social affiliation within society were identified as barriers, which should be enhanced through visual and auditory channels as well as a fictional character in the app. Conclusions The developed intercultural research model provides an impetus to providing digital sexual health education, integrating culture-specific aspects in the design process, while focusing on cultural and religious stigmata. The reusable framework enables identifying and overcoming hurdles in providing information about taboo and intimate topics. The overall use of online education tools focusing on intimate topics is correlated with accessibility and understanding specific cultural needs while delivering content on a basic and comprehensive level. It helps the target user from a social conservative background and in resource-poor circumstances to benefit from a digital educational solution.