Postpartum women’s knowledge and planned use of contraception in Myanmar

BackgroundMaternal mortality in Myanmar is one of the highest in the WHO South-East Asian region. Additionally, the country has a high unmet need for contraception and low rates of uptake of long-acting reversible contraceptive methods (LARCs) including intrauterine devices (IUDs) and implants. Engagement with health professionals around the time of a birth is an ideal opportunity for women to access contraception but immediate postpartum provision is not widely offered in Myanmar.MethodsWe undertook a cross-sectional survey of women immediately postpartum at two hospitals in Yangon to investigate their knowledge, and past use of, contraceptive methods and their plans for postpartum contraception including perceptions of implants and IUDs. Four trained obstetrics staff collected data using electronic tablets between January 2017 and January 2018.ResultsOf the 1755 participants, 55.1% had used pills and 42.2% injectables. In contrast, only 0.5% had used an IUD and 0.3% an implant. Few women (4.4%) anticipated starting contraception immediately postpartum and only a minority would consider future use of an implant (36.9%) or an IUD (13.0%). Fear of side effects was the major barrier to future implant and IUD uptake, reported by 64.5% and 62.5%, respectively.ConclusionsWomen in maternity care in Yangon have some awareness of IUDs and implants but many hold misconceptions about their side effects leading to reluctance to use. Reducing the unmet need for contraception and improving maternal outcomes in Myanmar could be achieved by improving education, policy and practice around immediate postpartum contraception provision, with a particular focus on LARC methods.

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Myths, beliefs, and conspiracies about COVID-19 Vaccines in Sindh, Pakistan: An online cross-sectional survey

10.22541/au.161519250.03425961/v1 ◽

2021 ◽

Author(s):

Qamar Abbas ◽

Fatima Mangrio ◽

Sunil Kumar

Keyword(s):

Side Effects ◽

Cross Sectional Study ◽

Vaccine Uptake ◽

Cross Sectional Survey ◽

Chi Square ◽

Cross Sectional ◽

Web Based ◽

Major Barrier ◽

Polio Vaccination ◽

Relationship Of

Abstract Background Pakistan has already encountered intense opposition to polio vaccination due to myths and misinformation, now the unfavorable opinions of COVID-19 vaccinations among the population would have catastrophic consequences for attempts to end the pandemic. Methods A web-based cross-sectional study was conducted in the general population of Sindh, Pakistan in January 2021. 31 items based on vaccines availability, safety, and myths, the questionnaire was designed and randomly distributed through a google form link. Results were analyzed using descriptive and Chi-square tests. Results A total of 774 responses were recorded from 23 districts of Sindh, Pakistan. The majority of participants (n=00, 00.0%) were not aware of the presence of the COVID-19 vaccine in Pakistan. Results found the significant relationship of conspiracies and myths with an education level of participants, to make Muslims infertile, illiterate showed (Yes n=45, No=27) while postgraduate (Yes n=11, No=88) (χ2 = 109.6, P> 0.000). Participants showed doubt about the safety of vaccines, (Yes n= 464, 59.9%, No= 310, 40.1%). Other responses related to side effects of the vaccine were also highly significant, participants showed that vaccine side effects (Yes n= 462, 59.7%, No= 312, 40.3%), Pregnant or breastfeeding women should not get vaccinated (Yes n= 468, 59.8%, No= 311, 40.1%) and people with underlying conditions should not get vaccinated (True n= 389, 50.3%, False= 385, 49.7%). Conclusion The proportion of varying public doubts in vaccines’ safety and efficacy and the presence of myths, conspiracies will be a major barrier to vaccine uptake.

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Prevalence and determinants of unmet need for contraception in North Gonja District, Ghana

BMC Women s Health ◽

10.1186/s12905-020-01077-4 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Anthony Wemakor ◽

Humphrey Garti ◽

Nawaf Saeed ◽

Obed Asumadu ◽

Bede Anyoka

Keyword(s):

Family Planning ◽

Child Outcomes ◽

Unmet Need ◽

Educational Status ◽

Childbearing Age ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Exact Test ◽

Study Population ◽

Unmet Need For Contraception

Abstract Background Unmet need for contraception contributes to the burden of unwanted pregnancies, which are correlated with a host of adverse maternal and child outcomes. The aim of this study was to determine the prevalence and identify the determinants of unmet need for contraception in North Gonja District, Ghana. Methods A cross-sectional survey involving 386 randomly selected women of childbearing age was conducted in North Gonja district, Ghana, with the use of a questionnaire in household interviews. Women were classified as having unmet need for contraception if they were fecund, sexually active and wished to postpone the next birth or halt childbearing completely but were not using any form of contraception. Chi-square/Fisher’s exact test and logistic regression analysis were used to identify the determinants of unmet need. Results The mean age of the study population was 26.1 (±8.4) years and awareness on contraception was almost universal in the district (95.9%). The overall prevalence of unmet need for contraception was 38.9%, with 27.5% having unmet need for limiting and 12.2% unmet need for spacing. In multivariate analysis, compared to women aged 25–29 years, those aged 20–24 years [Adjusted Odds Ratio (AOR) 0.26; 95% Confidence Interval (CI) 0.11–0.58] and 30 years and above (AOR 0.25; 95% CI 0.09–0.73) were less likely to have unmet need for contraception. However, uneducated women (AOR 5.06; 95% CI 1.07–24.01) compared with those educated to tertiary level; those unaware of family planning (AOR 3.93; 95% CI 1.12–13.80) compared to those aware; and those who had not previously practised contraception (AOR 1.81; 95% CI 1.09–3.00) compared to those who did were more likely to have unmet need. Conclusions The present study found high prevalence of both awareness on and unmet need for contraception among the study population. Unmet need for contraception is associated with age, educational status, awareness on family planning and previous contraception practice. Educational campaigns to promote contraception should prioritize women of middle age and low educational status. Further studies are needed to understand the low correlation between awareness on and unmet need for contraception.

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Prevalence of long acting and permanent contraceptive methods among married population in a selected rural community

Journal of Armed Forces Medical College Bangladesh ◽

10.3329/jafmc.v9i2.21846 ◽

2015 ◽

Vol 9 (2) ◽

pp. 93-99

Author(s):

Md Nasir Uddin ◽

Rowshan Ara

Keyword(s):

Side Effects ◽

Rural Community ◽

Contraceptive Method ◽

Secondary Level ◽

Armed Forces ◽

Age Group ◽

Contraceptive Methods ◽

Cross Sectional ◽

Long Acting

Introduction: Contraception is an essential method for reducing fertility rate. The long-acting and permanent contraceptive methods can adversely affect the health of the mother and the child. Objectives: The study was conducted to assess the prevalence of long acting and permanent contraceptive methods among married population in a selected rural community of Gazipur District. Methods: This was a descriptive type of cross sectional study conducted to explore the prevalence of long acting and permanent contraceptive methods among the adult married population in the rural community of Mulaid village under Telihati union of Sreepur Upazilla under Gazipur District. Sample size was 372 and purposive sampling technique was followed for data collection which was done by face to face interview using semi structured questionnaire. The data was analyzed by SPSS 16 software. Results: Majority (64.5%) of the respondents were female. Highest number of male respondents (44.7%) were in 20 to 30 years age group and highest number of the female respondents (45.0%) were in 15 to 25 years age group. Maximum male respondents (18.9%) were educated up to secondary level and maximum female respondents (29.6%) were educated up to secondary level. Out of total 372 respondents, 92% (344) were aware about contraceptive methods and 74.2% (277) of them used different kinds of contraceptive methods. 93 JAFMC Bangladesh. Vol 9, No 2 (December) 2013 Among them 75% (209) used short acting contraceptives, while 17% (48) used long acting contraceptives and 8% (21) used permanent methods. Out of 48 long acting contraceptive method users, maximum (64.6%) used Injection, 29.2% (14) used Implants and 6.2% (3) used I.U.C.D. Among permanent contraceptive methods users, 81.0% (17) used tubectomy and 19% (4) used vasectomy. Out of all Long Acting and Permanent Contraceptive Methods (LAPM) users, percentage of injection was 45% (27), I.U.C.D 5% (3), implant 20% (12) tubectomy 23.33% (14) and vasectomy 6.6% (4). Among the long acting method users(n=48), percentage of injection and implant usage were highest (injection: 60%--18, implant: 26.6%--8) among the respondents having more than two children and percentage of I.U.C.D. usage was highest i.e. 7.6%(3) among the respondents with two or less than two living children. Regarding side effects, among 66.6%(32) of long acting contraceptive method users, maximum i.e. 37.5%(12) mentioned amenorrhea and rest of the respondent(20) mentioned different side effects such as excessive menstruation, irregular menstruation, weight gain etc. Conclusion: Use of long term and permanent contraceptive methods among people is increasing day by day and this use increases with higher level of education, awareness and social and economic status. Still there is a need to intensify information; education, communication activities and this motivate the people to adopt long term and permanent contraceptive methods. DOI: http://dx.doi.org/10.3329/jafmc.v9i2.21846 Journal of Armed Forces Medical College Bangladesh Vol.9(2) 2013

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Geospatial Distribution of Family Planning Services in Kira Municipality, Wakiso District, Uganda

Frontiers in Global Women's Health ◽

10.3389/fgwh.2020.599774 ◽

2021 ◽

Vol 1 ◽

Author(s):

Moses Tetui ◽

Tonny Ssekamatte ◽

Pierre Akilimali ◽

Judith Sirike ◽

Osvaldo Fonseca-Rodríguez ◽

...

Keyword(s):

Family Planning ◽

Local Governments ◽

Unmet Need ◽

Quality Data ◽

Modern Contraceptive ◽

Contraceptive Methods ◽

Cross Sectional ◽

Unintended Pregnancies ◽

Long Acting ◽

Privately Owned

Introduction: Access to family planning (FP) services remains a challenge, particularly in informal urban settlements. The unmet need for FP in these settings is high, with a correspondingly high prevalence of unintended pregnancies that may lead to unsafe abortions. However, there is a paucity of quality data on the distribution of FP services in such settings in Uganda. This paper described the geospatial distribution of FP services in Kira Municipality, Wakiso District, Uganda.Methods: This was a cross-sectional study in which we determined the availability and distribution of FP services in Kira Municipality. Community mapping and analysis were conducted using ArcGIS (version 10.1) and ArcGIS Online. Stata version 13.1 was used for data analysis. Chi-square test was used to compare the contraceptive provision and availability among facilities from informal and formal settlements.Results: Of the 176 healthcare facilities surveyed, only 42% (n = 74) offered contraceptives in informal settlements. The majority of the facilities were privately owned small clinics (95%). At least 80% of the facilities provided three or more modern contraceptive methods, with no difference (p = 0.107) between facilities in informal and formal settlements. Only 30.7% (p = 0.001) of the facilities provided at least one long-acting contraceptive. Similarly, 20 and 12% (p = 0.001) of the facilities had implants and intrauterine devices (IUDs) on the day of the survey. Almost 25% of the facilities did not offer contraceptive services (counseling and commodities) to unmarried adolescents.Conclusions: Most facilities were small privately-owned clinics, offering at least three modern contraceptive methods. The unavailability of long-acting reversible methods in the informal settings may affect the quality of FP services due to limited choice. The inequity in service provision that disfavors the unmarried adolescent may increase unwanted/unintended pregnancies. We recommend that local governments and partners work toward filling the existing commodities gap and addressing the discrimination against unmarried adolescents in such settings.

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Contraceptive Method Information and Method Switching in India

Sustainability ◽

10.3390/su13179831 ◽

2021 ◽

Vol 13 (17) ◽

pp. 9831

Author(s):

Md. Juel Rana ◽

Srinivas Goli ◽

Rakesh Mishra ◽

Abhishek Gautam ◽

Nitin Datta ◽

...

Keyword(s):

Side Effects ◽

Multinomial Logistic Regression ◽

Unmet Need ◽

Family Health ◽

Informed Choice ◽

Contraceptive Methods ◽

The Sustainable Development ◽

Comprehensive Method ◽

Contraceptive Discontinuation ◽

Long Acting

The stagnation in the unmet need for family planning and rise in contraceptive discontinuation rates are major concerns among researchers and policymakers in India. This study attempts to investigate the association between method information received by the users at the time of initiation and the switching of contraceptive methods in India. Using the fourth round of National Family Health Survey (NFHS) data (2015–2016), a multinomial logistic regression model has been applied to assess the net effects of method information received by the users on switching of contraceptive methods. The reuse of contraceptive methods is higher among those who were not provided any method information. The reuse is also higher among those who were informed only about the side effects. Overall, the users who received comprehensive method information are more likely to switch. Particularly, the users who were informed about how to manage side effects either alone or along with other method information have a higher likelihood of switching especially to long-acting reversible contraceptives (LARC). The findings call for program intervention to provide comprehensive method information to the users because it gives them the freedom to switch to more suitable methods. Thus, it would help in achieving the sustainable development goal (3.7) of informed choice of contraceptive methods.

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Treatment Challenges, Priorities, and Relationship with Healthcare Providers in HIV Care: A Cross-Sectional Survey of Portuguese Adults Living with HIV

European Journal for Person Centered Healthcare ◽

10.5750/ejpch.v8i3.1873 ◽

2020 ◽

Vol 8 (3) ◽

pp. 282

Author(s):

Antonio Antunes ◽

Ines Augusto ◽

Patricia Parada ◽

Chinyere Okoli ◽

Ama Appiah ◽

...

Keyword(s):

Side Effects ◽

Healthcare Providers ◽

World Health ◽

Hiv Care ◽

People Living With Hiv ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Related Quality ◽

Long Acting ◽

Living With Hiv

BACKGROUND: The World Health Organization’s definition of health focuses on health-related quality of life in all domains, not just the “absence of disease or infirmity”. We investigated various treatment challenges among People living with HIV (PLHIV) in Portugal.METHODS: We analyzed data for n=60 adult PLHIV with a confirmed diagnosis and on anti-retroviral therapy (ART) who participated in the 2019 Positive Perspectives Survey. Descriptive analyses were performed using R Version 3.6.1.RESULTS: Most participants were virally suppressed (97%), male (67%); <50 years (51%); and had ≥1 non-HIV comorbidity (70%). Overall, 15% reported trouble swallowing pills, 35% experienced ART side effects, 22% felt daily oral ART limited their life, 25% were stressed by their dosing schedule, 33% said daily oral dosing cued bad memories, while 63% said daily dosing reminded them of their HIV. These challenges were associated with treatment-avoidance behaviors; PLHIV reported missing ≥1 ART dose within the past month because of food requirements 27%, side effects 12%, concerns about long-term ART impacts 10%, and problems swallowing 5%. Overall, 73% were open to taking long-acting, nondaily ART if they remained virologically controlled. Only 35% overall perceived no communication barriers with their HCPs; these individuals had higher prevalence of optimal physical (86% vs. 49%, p=0.011) and mental health (86% vs. 36%, p<0.001) than those with a perceived barrier.CONCLUSION: For some PLHIV, taking pills daily was linked with diverse emotional challenges, including pill fatigue and anxiety. Clinicians should consider patient preferences when prescribing ART and engage PLHIV in treatment decisions.

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Unmet need for contraception among married women of reproductive age in rural Maharashtra

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20173846 ◽

2017 ◽

Vol 4 (9) ◽

pp. 3365 ◽

Cited By ~ 1

Author(s):

V. S. Tapare ◽

Malangori A. Parande ◽

Pradip S. Borle

Keyword(s):

Unmet Need ◽

Absolute Number ◽

Married Women ◽

Reproductive Age ◽

Additional Child ◽

Women Of Reproductive Age ◽

Cross Sectional Survey ◽

Cross Sectional ◽

First Child ◽

Unmet Need For Contraception

Background: The concept of “unmet need” for contraceptive points to the gap between women’s reproductive intention and their contraceptive behavior. About 12.8% of currently married women in India have an unmet need for contraception. The present descriptive cross-sectional survey was initiated to address the research questions regarding unmet need for contraception among married women of reproductive age group in rural Maharashtra.Methods: 400 married women of reproductive age living in rural area of Sangli district of Maharashtra state interviewed. The survey based on women’s response to survey questions regarding family information, fertility profile and attitude and practice of contraceptive use. Expanded formulation used for surveys to assess the size and characteristics of unmet need group, dividing it into distinct subgroups and to explore the reasons for unmet need using in-depth qualitative research. Data analyzed with absolute number and percentage of women having unmet need which is useful to set priorities in program for effective fertility control. The data was tabulated and analyzed using MS Excel.Results: Total unmet need for contraception was found 27.50% women, which comprises need for ‘spacing’ in 12.25% women, need for ‘limiting birth’ in 13.25% women and need for ‘appropriate contraception’ in 2.0% women among 400 married women of reproductive age. Most unmet need among younger women is for spacing birth (67.18%) while in older women above age 30 year; most unmet need (68.18%) is for limiting birth. The education of women does not affect significantly the unmet need for spacing and limiting birth. After first child the unmet need for spacing decreases with each additional child. On the contrary unmet need for limiting birth increases with each additional child after first child and it was maximum (96.55%) among women having 3 or more children.Conclusions: The study group expresses multiple reasons for the unmet need. Many of the reasons are not directly related to contraception. Most women with unmet need desire to use contraception in future favours spacing methods. People should have access to good quality information and services. Health education and motivation is needed to overcome these causes.

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Characterization and Treatment Goals of Patients on Long-Acting Injectable vs Oral Antipsychotics: Results from a Patient/Caregiver/Psychiatrist Survey

CNS Spectrums ◽

10.1017/s109285292000245x ◽

2021 ◽

Vol 26 (2) ◽

pp. 154-154

Author(s):

Heather M. Fitzgerald ◽

Jason Shepherd ◽

Hollie Bailey ◽

Mia Berry ◽

Jack Wright ◽

...

Keyword(s):

Real World ◽

Sufficient Evidence ◽

Treatment Goals ◽

Full Time ◽

Medication Regimen ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Course Of Illness ◽

Current Medication ◽

Long Acting

AbstractBackgroundPatient preferences in schizophrenia (SCZ), including identification of key goals and outcomes for treatment and relative importance of certain treatment goals to patients, have been assessed by several studies. However, there continues to be a lack of sufficient evidence on US patient attitudes and perceptions towards treatment goals and pharmacotherapy options in SCZ, especially taking into context long-acting injectable antipsychotics (LAIs) in this disease area. This lack of evidence is further pronounced in caregivers of individuals with SCZ. The objective of this analysis was to characterize patients with SCZ on LAIs vs patients on oral antipsychotics (OAPs) and evaluate the treatment goals of patients in each group.MethodsThis was a real-world, cross-sectional survey of US psychiatrists, patients =18 years old with a diagnosis of SCZ, and caregivers. Data was collected using the Disease Specific Programme (DSP) methodology, which has been previously published. Psychiatrists (n=120) completed detailed record forms for next 8 consecutive outpatients and 2 inpatients matching inclusion criteria, including non-interventional clinical and subjective assessments. The same patients and their caregivers, if present, were invited by their psychiatrist to voluntarily complete a separate survey.ResultsOf 1135 patients on treatment where the physician provided survey data; 251 were on an LAI, and 884 were on an OAP. Mean (SD) time to SCZ diagnosis for those on an LAI was 10.3 (12.0) years vs 7.8 (10.5) years for those on OAPs. More patients in the LAI vs OAP group were being treated as an inpatient (27.1% vs 15.7%, respectively; p<0.0001). Patients on an LAI reported being on their current medication regimen for less time (mean 1.7 years) vs those on OAPs (mean 2.5 years) (p=0.0093). More patients on LAIs were unemployed due to disability vs those on OAPs (56.1% vs 39.5%, respectively), and less patients on LAIs were able to work part-time or full-time (21.1% or 4.1%) vs those on OAPs (23.2% or 11.4%). More patients on an LAI had a caregiver vs those on OAPs (37.3% vs 26.1%, respectively; p=0.0011). Regarding the most important treatment goals reported by patients, both groups reported similar preferences for decrease in disease symptoms (62% on LAI vs 65% on OAPs) and thinking more clearly (53% on LAI vs 46% on OAPs); however, a numerically higher proportion of LAI patients reported that the current medication helped decrease hospitalizations due to relapse vs those on OAPs (38% vs 32%, respectively).DiscussionGiven the characteristics of patients participating in this real-world survey, those on LAIs exhibited qualities which indicate a higher severity of illness vs those on OAPs. Results suggest that treatment with LAIs is still mainly being provided to patients later in the disease course and/or who have adherence problems, despite a growing body of evidence of utility in younger patients earlier in the course of illness.FundingOtsuka Pharmaceutical Development & Commercialization, Inc. and Lundbeck LLC

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Investigating unmet need for healthcare using the European Health Interview Survey: a cross-sectional survey study of Luxembourg

BMJ Open ◽

10.1136/bmjopen-2021-048860 ◽

2021 ◽

Vol 11 (8) ◽

pp. e048860

Author(s):

Valerie Moran ◽

Marc Suhrcke ◽

Maria Ruiz-Castell ◽

Jessica Barré ◽

Laetitia Huiart

Keyword(s):

Dental Care ◽

Unmet Need ◽

Mental Healthcare ◽

Wait Times ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Interview Survey ◽

European Health ◽

Prescribed Medicines ◽

European Health Interview Survey

ObjectivesWe investigate the prevalence of unmet need arising from wait times, distance/transportation and financial affordability using the European Health Interview Survey. We explore associations between individual characteristics and the probability of reporting unmet need.DesignCross-sectional survey conducted between February and December 2014.Setting and participants4004 members of the resident population in private households registered with the health insurance fund in Luxembourg aged 15 years and over.Outcome measuresSix binary variables that measured unmet need arising from wait time, distance/transportation and affordability of medical, dental and mental healthcare and prescribed medicines among those who reported a need for care.ResultsThe most common barrier to access arose from wait times (32%) and the least common from distance/transportation (4%). Dental care (12%) was most often reported as unaffordable, followed by prescribed medicines (6%), medical (5%) and mental health (5%) care. Respondents who reported bad/very bad health were associated with a higher risk of unmet need compared with those with good/very good health (wait: OR 2.41, 95% CI 1.53 to 3.80, distance/transportation: OR 7.12, 95% CI 2.91 to 17.44, afford medical care: OR 5.35, 95% CI 2.39 to 11.95, afford dental care: OR 3.26, 95% CI 1.86 to 5.71, afford prescribed medicines: OR 2.22, 95% CI 1.04 to 4.71, afford mental healthcare: OR 3.58, 95% CI 1.25 to 10.30). Income between the fourth and fifth quintiles was associated with a lower risk of unmet need for dental care (OR 0.29, 95% CI 0.16 to 0.53), prescribed medicines (OR 0.38, 95% CI 0.17 to 0.82) and mental healthcare (OR 0.17, 95% CI 0.05 to 0.61) compared with income between the first and second quintiles.ConclusionsRecent and planned reforms to address waiting times and financial barriers to accessing healthcare may help to address unmet need. In addition, policy-makers should consider additional policies targeted at high-risk groups with poor health and low incomes.

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