scholarly journals Discontinuation rate and associated factors among contraceptive implant users in Kersa district, southwestern Ethiopia

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Gali Nega ◽  
Muluemebet Abera ◽  
Afework Tadele
Keyword(s):  
Side Effects ◽  
Data Collection ◽  
Group Discussion ◽  
Binary Logistic Regression ◽  
Counselling Services ◽  
Southwestern Ethiopia ◽  
Induced Abortions ◽  
Unwanted Pregnancies ◽  
Contraceptive Implant ◽  
Long Acting

Abstract Background Subdermal contraceptive implant is the most widely used method of long-acting reversible contraception among Ethiopian women. Many, however, discontinue use early, which results in unwanted pregnancies and induced abortions and their associated complications. The aim of this study is to determine the rate of and reasons for discontinuation of the contraceptive implant among users in the Kersa district of southwestern Ethiopia. Methods A mixed-method study was carried out between March and April 2019 among 475 women who had been using the contraceptive implant between January 2015 and August 2016 in the Kersa district. Systematic random sampling was used for quantitative data collection and purposive sampling was used for qualitative data collection using 8 focus group discussion and 56 In-depth interviews. A binary logistic regression was carried out for bivariate and multivariable analyses. Results One hundred and ten (23.2 %) contraceptive implant users requested removal before 2.5 years of use. The main reasons for the discontinuation were side effects, followed by a desire for pregnancy or to switch to another contraceptive method and misconceptions. Implant discontinuation was associated with a lack of information prior to insertion on the effectiveness of modern contraception (adjusted odds ratio [OR] 2.0; 95 % confidence interval [CI] 1.13, 3.55), being served by a midwife or nurse (adjusted OR 1.8; 95 % CI 1.04, 3.23), and not being told to return to the health facility if any side effects were experienced (adjusted OR 1.8; 95 % CI 1.01, 3.19) (all p < 0.05). Conclusions Almost a quarter of the study participants discontinued use of the contraceptive implant before the due date. Public health interventions should focus on providing adequate awareness for family planning users, trainings for the health care workers on effective counselling services, especially on side effect and misconceptions.

scholarly journals Use of long-acting reversible contraception among adolescents and young women in Kenya

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241506
Author(s):  
Wambui Kungu ◽  
Anne Khasakhala ◽  
Alfred Agwanda
Keyword(s):  
Young Women ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Secondary Data ◽  
Binary Logistic Regression ◽  
Educational Goals ◽  
Unintended Pregnancies ◽  
Unwanted Pregnancies ◽  
Long Acting ◽  
Living Children

The Kenya Demographic and Health Survey (KDHS 2014) revealed changing patterns in the contraceptive use of young women aged 15–24, shifting from injectable methods to implants. Long-acting reversible contraception (LARC) is user friendly, long-term, and more effective than other modern methods. It could be a game-changer in dealing with unintended pregnancies and herald a new chapter in the reproductive health and rights of young women. This study determined the factors associated with LARC use among adolescent girls and young women to expand the evidence of its potential as the most effective method of reducing unwanted pregnancies among the cohort. This study analysed secondary data from KDHS 2014 using binary logistic regression. The findings showed a rise in LARC use (18%), with identified predictors of reduced odds being aged 15–19 [OR = 0.735, 95% CI = 0.549–0.984], residence (rural) [OR = 0.674, CI = 0.525–0.865], religion (Protestant/other Christian) [OR = 0.377, CI = 0.168–0.842], married, [OR = 0.746, CI = 0.592–0.940], and region (high contraception) [OR = 0.773, CI = 0.626–0.955], while the number of living children showed increased odds for 1–2 children [OR = 17.624, CI = 9.482–32.756] and 3+ children [OR = 23.531, CI = 11.751–47.119]. This study established the rising popularity of LARC and identified factors that can be addressed to promote it. Its increased uptake could help Kenya achieve the International Conference on Population and Development 25’s first and second commitments on teenage pregnancies and maternal and new-born health, thus promoting the health, wellbeing, educational goals, and rights of this critical cohort. This study can guide the accelerated efforts needed in Kenya’s march towards the five zeros of unmet need for contraception, teenage pregnancies, unsafe abortions, preventable maternal deaths, and preventable neonatal/infant deaths.

scholarly journals Study of depot medroxyprogesterone acetate as an extended postpartum contraceptive at SCB medical college and hospital, Cuttack

2021 ◽  
Vol 10 (4) ◽  
pp. 1484
Author(s):  
Sagarika Samal ◽  
Lucy Das
Keyword(s):  
Side Effects ◽  
Infant Mortality ◽  
Medroxyprogesterone Acetate ◽  
Contraceptive Use ◽  
Age Groups ◽  
Socioeconomic Group ◽  
Medical College ◽  
Unwanted Pregnancies ◽  
One Year ◽  
Long Acting

Background: Increase in contraceptive use during the postpartum period substantially reduces the rate of maternal and infant mortality by preventing unplanned and unwanted pregnancies. Injectable Medroxy Progesterone acetate (DMPA) is one long acting reversible safe and effective method for postpartm contraception. Aims and Objectives to study the acceptance, efficacy, side effects and compliance of DMPA as an extended postpartum contraceptive at SCB Medical College, Cuttack.Methods: The study includes 76 women between 6weeks to 1year postpartum who had chosen DMPA as contraceptive after counseling regarding the basket of choices. DMPA injection was given within 7 days of menstruation if it has returned or at any time after being confirmed that woman is not pregnant with a back up for first 7days. Subsequent injections were given at three monthly intervals and followed up for one year after the first injection for pregnancy rate, side-effects, discontinuation and patient satisfaction.Results: Maximum females were from the combined age groups 25-29 (39.47%) and 20-24 years (35.52%). 46.1% women belong to lower middle socioeconomic group. The most common menstrual problem was amenorrhea in 47.36% followed by scanty bleeding in 22.36%. 25% discontinued after 1st dose of injection, which is the maximum. The commonest reason for discontinuation observed was menstrual problems (37.93%) followed by use of other methods of contraception (17.24%). Out of 76, 23 women were not satisfied (30.26%), main reason of dissatisfaction being menstrual problems. Failure rate was nil.Conclusions: The study concludes that DMPA is a very effective, safe, and long acting contraceptive with no effect on lactation. Proper counseling can improve the acceptance and compliance.

scholarly journals Early contraceptive implants removal and its associated factors among women using implants at a National Referral Hospital, Kampala Uganda

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Gerald Ssebatta ◽  
Dan Kabonge Kaye ◽  
Scovia Nalugo Mbalinda
Keyword(s):  
Side Effects ◽  
Rural Areas ◽  
Error Variance ◽  
Cross Sectional Study ◽  
Early Discontinuation ◽  
Cross Sectional ◽  
Factors Associated ◽  
Counselling Services ◽  
Unwanted Pregnancies ◽  
Contraceptive Implants

Abstract Background Early discontinuation of implant contraceptive methods and reasons for discontinuation remains a major concern for family planning programs. Early discontinuation is related to higher rates of the overall fertility rate, unwanted pregnancies leading to possibly induced abortion. There is paucity of data on the practice of discontinuation of contraceptives in developing countries. The objective of the study was to determine the magnitude of early implants discontinuation among women receiving implants services in the study area and the factors associated with it. Methods A cross-sectional study was conducted from 2nd January to 3rd March 2020. Data were collected from 207 women who had come to remove implants on socio-demographic characteristics, obstetric history, duration of implant, and reasons for wanting to remove the implant. We computed the proportion of those who removed the implant before 18 months (early discontinuation). To assess the factors associated with early discontinuation, we estimated the prevalence ratios with a generalized linear model of the poisson family with a log link and robust error variance. Results The proportion of early implant discontinuation was 87/207(42%). Factor associated with early implant discontinuation included; experience of side effects (PR = 1.1; 95% CI 1.03–1.24; P = 0.001), not having received pre-insertion counseling about the benefits and side effects of contraceptive implants (PR = 1.5; 95% CI 1.02–1.30; P = 0.019) and staying in rural areas (PR = 1.1; 95% CI 1.03–1.27; P = 0.014). Conclusion Nearly one in every two mothers have early discontinuation of contraceptive implants. Factors associated with early implant removal include; experience of side effects, lack of counseling services, and staying in rural areas. There is a need for intervention to address high prevalence of early contraceptive removal through improving on counselling services about possible side effects.

CLINICAL INVESTIGATIONS OF A LONG-ACTING OESTRIOL (POLYOESTRIOL PHOSPHATE)

1961 ◽  
Vol 38 (1) ◽  
pp. 73-87 ◽  
Author(s):  
Christian Lauritzen ◽  
Semih Velibese
Keyword(s):  
Side Effects ◽  
Phosphoric Acid ◽  
Quantitative Data ◽  
Water Soluble ◽  
Cholesterol Concentration ◽  
Experimental Investigations ◽  
Clinical Investigations ◽  
Prolonged Duration ◽  
High Doses ◽  
Long Acting

ABSTRACT A description is given of experimental investigations and preliminary clinical experience with the long-acting oestriol compound polyoestriol phosphate – a water-soluble polymere of oestriol and phosphoric acid. The compound seems to exert all the physiologically important effects of oestriol. Even with high doses the hormone causes no proliferation of the endometrium and no withdrawal bleeding. It has no untoward effect on metabolism. It decreases slightly the cholesterol concentration (to the extent of ⅓–⅕ of the effect produced by long-acting oestradiol esters). The compound has a wide therapeutic range. No side-effects have been observed. Doses of 10 mg or more have a prolonged duration. Additional prolongation of the effect is largely dependent on dosage. To ensure an effect lasting for 4 weeks 40 mg polyoestriol phosphate (corresponding with 30 mg oestriol) is required – an amount which roughly corresponds with physiological quantitative data. The compound, which involves an interesting new principle of prolongation, was most effectively used in the treatment of menopausal symptoms and genital organic disorders. For these indications it can be recommended without reservation.

CONTRACEPTION IN DIABETIC PATIENTS

1974 ◽  
Vol 77 (3_Suppl) ◽  
pp. S87-S94 ◽  
Author(s):  
J. Wiese ◽  
M. Osler
Keyword(s):  
Side Effects ◽  
Contraceptive Method ◽  
Low Dose ◽  
Unplanned Pregnancy ◽  
Intrauterine Device ◽  
Diabetic Patients ◽  
Intrauterine Contraception ◽  
Unwanted Pregnancies ◽  
Unreliable Method ◽  
Retrospective Investigation

ABSTRACT A retrospective investigation was made of contraception in diabetic women delivered in our department in 1969 and 1970. Seventy-nine (69 per cent) answered the questionnaires. About one third had found the contraceptive instruction insufficient. A shift from conventional to intrauterine contraception and sterilization was seen, but nearly 25% of the patients were still using conventional methods, mainly the condom. The patients consider this an unreliable method. Thirty-three patients were using intrauterine contraception. Although 10 of them had bleeding irregularities, all were satisfied with the method. Sterilization had been performed on 17 patients, all of whom were fully satisfied and had experienced no side effects. Four of 11 insulin-requiring diabetics, who have used combined oestrogen-progesterone medication have had difficulties in the regulation of the diabetes. Of 24 unwanted pregnancies 12 occurred since the hospitalization in 1969 and 1970. In diabetic women the contraceptive method should either be sterilization, intrauterine device or low dose progestagens, and only in a few cases conventional. A thorough contraceptive instruction as well as a close control of the diabetic women are of importance in order to avoid unplanned pregnancy. The best way to achieve this is by having an out-patient clinic in connection with the obstetrical department to supervise contraception in all diabetic women in the area.

Social Media Literacy For Housewives In Kanoman Maguwoharjo Village, Sleman, Yogyakarta

2020 ◽  
Author(s):  
Dewi Novianti ◽  
Siti Fatonah
Keyword(s):  
Social Media ◽  
Focus Group ◽  
Data Collection ◽  
Focus Group Discussion ◽  
Media Literacy ◽  
Participant Observation ◽  
Group Discussion ◽  
Qualitative Approach ◽  
Research Subjects

Social media is a necessity for everyone in communicating and exchanging information. Social media users do not know the boundaries of age, generation, gender, ethnicity, and religion. However, what is interesting is the user among housewives. This study took the research subjects of housewives. Housewives are chosen as research subjects because they are pillars or pillars in a household. If the pillar is strong, then the household will also be healthy. Thus, if we want to build a resilient and robust generation, we will start from the housewives. A healthy household starts from strong mothers too. This study aims to find out the insights of the housewives of Kanoman village regarding the content on smartphones and social media and provide knowledge of social media literacy to housewives. This study used a qualitative approach with data collection techniques using participant observation, interviews, focus group discussion (FGD), and documentation. The results of the study showed that previously housewives had not experienced social media literacy. Then the researchers took steps to be able to achieve the desired literacy results. Researchers took several steps to make them become social media literates. They become able to use social media, understand social media, and even produce messages through social media.

scholarly journals Oral and Palmitate Paliperidone Long-Acting Injectable Formulations use in Schizophrenia Spectrum Disorders: a retrospective cohort study from the CRUPEP First Episode Psychosis Intervention Program

2021 ◽  
Author(s):  
R Segarra ◽  
M Recio-Barbero ◽  
M Sáenz-Herrero ◽  
O Mentxaka ◽  
J Cabezas-Garduño ◽  
...  
Keyword(s):  
Side Effects ◽  
Retrospective Cohort ◽  
Intervention Program ◽  
Therapeutic Option ◽  
Cohort Analysis ◽  
Clinical Information ◽  
First Episode ◽  
Psychotic Episode ◽  
Schizophrenia Spectrum Disorders ◽  
Long Acting

Abstract Background Long-acting injectable antipsychotics (LAIs) may be a suitable therapeutic option for those patients in earlier stages of psychosis to avoid relapses and disease progression. Despite that, there is a lack of evidence in the literature regarding the use of LAIs in this profile of patients. Methods This is a retrospective cohort analysis to assess the efficacy, tolerability, and pattern of use of palmitate paliperidone long-acting injectable (PPLAI) formulations (1-monthly and 3-monthly) compared to oral paliperidone/risperidone in patients with a non-affective First Psychotic Episode(FEP) over a 12-month follow-up. Relevant sociodemographic and clinical information were assessed as well as main clinical scales: Positive and Negative Syndrome Scale (PANSS), Personal and Social Performance Scale (PSP), and Clinical Global Impression Scale (CGI-I and CGI-S). Results Forty-eight patients, 16 per arm, 20-50 year aged with a FEP were included. Significant improvements were registered for all treatment groups. Despite that, patients receiving PPLAI 1-monthly and PPLAI 3-monthly formulations obtained greater improvements than the oral group in the main domains assessed (p&lt;0.001). We found no statistically significant differences in hospitalizations between groups. Side effects were presented in 24% of patients. A trend towards reducing antipsychotic doses was observed in 43.8% of patients to achieve the minimum effective dose and avoid the occurrence of side effects. Conclusions To our knowledge, this is the first study assessing the use of palmitate paliperidone long-acting formulations versus oral risperidone or paliperidone in FEP. Treatment with PPLAI formulations seems to be an effective therapeutic choice at earlier stages of the disease.

Effectiveness and safety of modern treatment against nausea and vomiting induced by chemotherapy and radiotherapy

2021 ◽  
Vol 14 (1) ◽  
pp. 11-15
Author(s):  
Łukasz Hajac ◽  
Martyna Hajac ◽  
Adam Maciejczyk
Keyword(s):  
Side Effects ◽  
Serotonin Syndrome ◽  
Nausea And Vomiting ◽  
Effective Prevention ◽  
Important Group ◽  
Life Threatening ◽  
Treatment Changes ◽  
Long Acting ◽  
Methods Of Treatment

Nausea and vomiting are one of most frequent side effects of chemotherapy and radiotherapy. Effective prevention and treatment of these symptoms is essential for better quality of life for patients undergoing oncological therapies. Nausea and vomiting can be acute, delayed or anticipatory. Leading mechanisms and methods of treatment are different for each of those. Most often used groups of drugs are: 5-HT3-antagonists, glucocorticosteroids, NK1-antagonists. Another important group are neuroleptics, which are therapy of choice for anticipatory vomiting. Modern antiemetic medications are in most cases safe and effective. But as every treatment it causes risks of adverse events which may be serious and difficult to manage. It applies in particular to long-acting drugs. Most common side effects are headache, constipation and sedation. But more severe or life-threatening symptoms may appear, like intestinal obstruction and serotonin syndrome. Some of the drugs also come with risk of interacting with other treatment. Changes in pharmacokinetics may lead to additional toxicities. In elderly, especially with cardiac disease, in risk of ileus or cachexia these drugs shall be used with caution.

scholarly journals Appraisal of Issues Influencing Soil-Steps Application for Sustainable Farmland Management in High-Potential District, Ethiopia

2018 ◽  
Vol 7 (3) ◽  
pp. 102
Author(s):  
Mehretie Belay
Keyword(s):  
Smallholder Farmers ◽  
Group Discussion ◽  
Household Head ◽  
Binary Logistic Regression ◽  
Northwest Ethiopia ◽  
Study Data ◽  
High Potential ◽  
Binary Logistic Regression Model ◽  
Chi Square ◽  
Chi Square Test

Soil damage by moving water is a somber predicament on farmlands in highland Ethiopia. Sizeable number of trial in farmland preservation has been executed to handle the crisis during the last tens of years. However, the attempts have not been vibrant to trim-down the danger to an attractive extent. This paper evaluates factors contributing to application of soil-steps (bunds) as sustainable farmland management technology (SFLMT) by smallholder farmers in one of the high-potential districts of northwest Ethiopia named Dangila Woreda (District). Mixed method triangulation designs involving concurrent acquisition and interpretation of quantitative and qualitative data were used in the study. Data were acquired from randomly chosen 201 farming households during the harvest seasons of 2011 and 2012. Ordered questionnaire, participatory field observation, key informant interview and focus group discussion were mechanisms employed during the data acquisition. Descriptive statistics (means, standard deviations and percentiles), Chi-square test, t-test and the binary logistic regression model were used to analyze the quantitative data. The qualitative information was textually narrated to augment the quantitative results. Findings of the investigation confirm that age of the household head, the number of household members, slope of the farmland, the size of the farmland held, households’ participation in indigenous labour-sharing activities and the number of farm tools owned were significantly increasing the building of soil-steps as SFLMT in the study district. Involvement in off-farm activities and pest invasions were considerably hindering farmers from building soil-steps on their farmlands. The results in general indicated that households’ access to livelihood assets are key promoters for farmers’ implementation of soil-steps on their farmlands. Local resource preservation and improvement trials should thus ponder on convalescing farmers’ material endowments to improve their capability to use soil-steps as SFLMT in their farming activities.

scholarly journals Assessing post-radiotherapy handover notes from a family physician perspective

2018 ◽  
Vol 25 (1) ◽  
pp. 49
Author(s):  
A. Dang ◽  
S. Miller ◽  
D. Horvat ◽  
T. Klassen-Ross ◽  
M. Graveline ◽  
...  
Keyword(s):  
Side Effects ◽  
Family Physicians ◽  
Essential Information ◽  
Treatment Side Effects ◽  
Counselling Services ◽  
Contact Information ◽  
Score Improvement ◽  
Information Treatment ◽  
Treatment Intent

Background Across our province, post-radiotherapy (rt) handover notes are sent to family physicians (fps) after rt. Based on previous fp feedback, we created a revised post-radiotherapy handover note with more information requested by fps. The purpose of this study was to determine whether the revised handover note improved the note as a communication aid.Methods Potential common and rare treatment side effects, oncologist contact information, and treatment intent were added to the revised handover note. Both versions were sent alongside a questionnaire to fps. Paired t-tests were carried out to compare satisfaction differences.Results There was a response rate of 37% for the questionnaires. Significantly greater clarity in the following categories was observed: responsibility for patient follow-up (mean score improvement of 1.2 on a 7-point Likert scale, p < 0.001), follow-up schedule (1.1, p < 0.001) as well as how and when to contact the oncologist (1.4, p = 0.001). Family physicians were also more content with how the institute transitioned care back to them (1.5, p = 0.012). Overall, fps were generally satisfied with the content of the revised post-rt handover note and noted improvement over the previous version. The frequency of investigations and institute supports initiated such as counselling services were suggested further additions.Conclusions The inclusion of potential treatment side effects, oncologist contact information, treatment intent and a well-laid out follow-up schedule were essential information needed by fps for an effective post-rt completion note. With these additions, the revised post-rt handover note showed significant improvement.

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