scholarly journals Postpartum implanon/nexplanon uptake in a tertiary hospital in West Africa

Author(s):  
Kwaku Asah-Opoku ◽  
Kareem Mumuni ◽  
Vincent J. Ganu ◽  
Ali Samba

Background: The postpartum period is viewed as an opportune period for uptake of contraception. Ghana has an unmet need for family planning of 30%. This study sought to determine the postpartum Implanon/Nexplanon uptake among women at a tertiary hospital.Methods: This was a retrospective study that analysed 391 Implanon/Nexplanon insertions between 2012 and 2015 at the reproductive health and family planning unit at the Korle-Bu teaching hospital.Results: Almost 69% (391/565) of all Implanon/Nexplanon insertions conducted between 2012 and 2015 were conducted in the postpartum period. Out of these postpartum insertions, 2.3% were done in the immediate postpartum period, 27.6% were done during the interval postpartum period and 70.1% were in the delayed postpartum period. Age and implant insertion status (first time ever or continuing) were significant determinants of postpartum Implanon/Nexplanon insertions. Compared to women less than 20 years of age, women in the age group 20-29 and 30-39 were 76% (AOR=0.24, CI=0.62-0.97) and 80% (AOR=0.20, CI=0.05-0.86) respectively less likely to have postpartum Implanon/Nexplanon  insertions done. Continuing users of implant insertions were 45% (AOR=0.55, CI=0.37-0.82) less likely to have post-partum Implanon/Nexplanon insertions done compared to first ever users.Conclusions: There is a high uptake of postpartum Implanon/Nexplanon use among patients who receive implant insertions at the Korle-Bu Teaching Hospital. However immediate postpartum Implanon/Nexplanon insertions are low. There is the need to educate women and couples on the benefits of immediate postpartum implant insertion to avoid rapid repeat pregnancies.

Author(s):  
Radhika Chethan ◽  
Anitha G. S. ◽  
Savitha C.

Background: Post partum contraception is the best evidence based intervention in prevention of pregnancy and abortion related maternal morbidity and mortality in the developing countries. The unmet need for contraception among women in the postpartum period can be effectively fulfilled by post partum insertion of IUCD, in a single visit under the Government scheme of providing free maternity services during institutional delivery. Despite optimal efforts by family planning program, very few couples are opting for spacing methods and lack of awareness has resulted in discontinuation of family planning methods particularly PPIUCD. This study is designed to study the practices of PPIUCD and causes for discontinuation at follow up in our hospital. The objectives of the study were study PPIUCD practices at Vanivilas hospital; causes for discontinuation of PPIUCD.Methods: Prospective study done at Vanivilas hospital attached to Bangalore Medical College and Research Institute from January 2014 to December 2014. Women admitted and delivered at VVH, were counselled. CuT 380A was inserted in accepters who fulfilled the Medical Eligibility Criteria and had no contraindications for PPIUCD. They were followed up till June 2016.Results: There were 2072 PPIUCD insertions in one year, out of which 1244 were post placental, 139 were in immediate postpartum and 689 were intra caesarean insertions. Fifty four (54) women discontinued PPIUCD during follow up .Main causes for removal were menstrual abnormalities (19), pain abdomen (13), wanting sterilisation procedure (12) and marital disharmony.Conclusions: PPIUCD is an effective, safe, reversible method of long term contraception with high reported expulsion and low perforation rate, compared to interval insertion. More research is needed in the field of PPIUCD to enhance awareness and acceptance in the community. Awareness and counselling the eligible couples during ante natal care can improve acceptance and compliance of PPIUCD continuation rates.


2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Chet Kant Bhusal ◽  
Sigma Bhattarai

Background. Increase in population plays a decisive role in providing universal access to reproductive health; however, there is very limited evidence about the reason of unmet need among marginalized and tribal communities such as Tharus. This study aimed to determine the factors affecting unmet need of family planning among married Tharu women of Dang, Nepal. Methods. Community-based cross-sectional household survey among 650 married Tharu women of age group 15-49 in October 2015 to April 2016 was conducted in Dang district, Nepal. Randomly 3 wards were selected from each Tulsipur municipality, Hekuli Village Development Committee, and Pawan Nagar VDC. Results. The mean age and parity were 30±7.31 and 2±0.69, respectively. Out of 650 women, 47% were using contraceptives. Westoff model was used for calculating total unmet need which is 49%, where unmet need for limiting and spacing was 27% and 22%, respectively. Hence after combining the current users and total unmet need, total demand for family planning was 96%. After adjustment, significant relation was observed between number of living sons ≥ 1 and unmet need of family planning (OR= 0.4; CI=0.2-0.8, p=0.01 ), similarly for women education; lower secondary level (OR=0.3; CI=0.1-0.6, p=0.01) and secondary (OR=0.1; CI=0.03-0.4, p=0.01); husband education, lower secondary level (OR=0.3; CI=0.1-0.6, p=0.01) and secondary (OR=0.4; CI= 0.2-0.9, p=0.04); and husband occupation, wage labor (OR=0.6; CI=0.4-0.99, p=0.05). In addition, having very good knowledge about method was also significantly associated (OR=0.49; CI= 0.2-0.97, p= 0.04). Conclusion. Unmet need of family planning was significantly higher among less than secondary educated women. It is also predisposed by spouse education, partner’s occupation, and number of living sons. This study concerns the need for all stake holders to focus on strategic behavior communication program regarding reproductive health.


2019 ◽  
Vol 7 (4) ◽  
pp. e000089
Author(s):  
Paulo Henrique Pires ◽  
Ronald Siemens ◽  
Martins Mupueleque

ObjectiveTo increase knowledge, attitudes and practice of sexual and reproductive health and family planning and to reduce maternal and neonatal mortality rates in Mozambique.DesignAn implementation research project’s intermediate evaluation, applying two cross-sectional surveys. The surveys were planned for 316 subjects before and after interventions.SettingResearch performed in Natikiri district of Nampula province in northern Mozambique, targeting a suburban and rural populations in their homes.Participants452 people were surveyed (91 before, 361 after), all belonging to the Macua ethnic group.InterventionsA media campaign (2 weekly radio spots, bimonthly theatre performances) was performed for 8 months (2017 to 2018) and family health champions’ teachings (monthly home visits) performed for 3 months, on sexual and reproductive health and family planning. Outcome measures planned and measured were adolescent’s and adult’s knowledge, attitudes and practice about those. Data were analysed by gender, age group and frequencies, using a CI of 95% (p<0.5 statistically significant).ResultsRadio spots, community theatre and volunteer champions increased population’s knowledge about sexual and reproductive health and led to a more positive attitude toward family planning. Concerning attitude, results show differences between adults’ proportions before and after: (1) did you hear about sexual and reproductive health (p=0.0425); (2) knows project key messages (p<0.001); (3) knows prenatal visits importance (p=0.0301); (4) access to contraceptives was easy (p<0.001). Adolescents showed statistically significant differences before and after: (1) knows project key messages (p<0.001); (2) access to contraceptives was easy (p=0.0361). Family planning practice did not increase in both groups.ConclusionA health education intervention, using a media campaign and local volunteers, is useful to promote mother and child health. There is an unmet need for family planning and the use of modern contraception is below desired practice, needing further research about cultural barriers. Communication for behaviour change activities will pursue and impact will be assessed to document family planning practice improvement.


Author(s):  
Sravani Mukka ◽  
Madhavi Y.

Background: In India almost 65% of the women have an unmet need for family planning in the first postpartum year. Increasing rates of institutional deliveries creates an opportunity for providing quality post-partum family planning services. Post-partum Intrauterine contraceptive device (PPIUCD), a form of long acting reversible contraception (LARC) is one of the most affective and safest method available. The present study aims at evaluating the safety, efficacy, rate of acceptance and rate of discontinuation of Intra caesarean inserted contraceptive device Copper T-380A.Methods: This was a prospective study conducted at ESIC Medical College, Sanathnagar in women delivered by caesarean section during the period between March 2018 to February 2019. Recruitment was done based on the WHO medical eligibility criteria (MEC) for PPIUCD and also their willingness to participate in the study. Follow-up visits were scheduled at 6 weeks, 3 months and 6 months.Results: Of the 265 women fulfilling the WHO MEC, 180 (67.92%) were willing to participate in the study. Total acceptance rate was 67.7%. Majority of them belonged to the age group 21-30 years (80%) and para 2 (53.88). 93.3% of the women were literates. 12 (6.66%) cases lost to follow up and the complications were studied in the rest 168 women. During follow up -38.69% had missing strings, 12.5% menstrual disturbances, 4.76% abdominal pain and spontaneous expulsion in 4.1%. No cases of perforation and pregnancy were reported. Total continuation rate was 84%.Conclusions: PPIUCD is a safe and convenient option of contraception with low expulsion rates and high continuation rates.


2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P161-P161
Author(s):  
Faiz Tanwee

Objectives 1) To find out the duration of onset of intracranial complications following middle ear and paranasal sinus infection in B-thalassaemia. 2) To find out the contributory factors for such complications. Methods A retrospective study of thalassaemic children who suffered from intracranial complication following ear and sinus infections between Jan '02- Oct '04, was done at a tertiary hospital Male', Maldives. Follow-up data were obtained from National Thalassaemia Centre. Patients' demographic pattern, thalassaemic status, Desferroxamine therapy, duration of the ear/nose symptom, the intracranial complications, the treatment and the outcomes were noted. We didn't include 3 patients, for whom full data were not available. Results We found the records of a series of 5 consecutive patients out of 94 thalassaemic patients which were referred with different ear and nose infections and were treated for intracranial complications. All patients were in the age group of 10–15 years. All were female. Spread of infection from the ear was more common than the spread from sinuses (3 out of 5 patients). The intracranial complications developed in these patients within few days (<5 days) of presentation in the clinic. All of the patients were on regular blood transfusion with desferroxamine therapy but none had spleenectomy. Most common organism found was klebsiella. Conclusions Persistent anaemia, repeated transfusion, iron overload, and hypersplenism are the major contributory factors for frequent infections in thalassaemics. Natural thinning of the bony cortex and remodelling of skull in thalassaemics can be considered as an additional factor for the rapid development of intracranial complications.


Author(s):  
Vinay K. Nirvanappa ◽  
Soumya G. Hegde

<p class="abstract"><strong>Background:</strong> Leprosy is a chronic mycobacterial infection and is still a major health hazard in India.</p><p class="abstract"><strong>Methods:</strong> This was a retrospective study over 12 years of all cases diagnosed clinically as leprosy in a tertiary hospital at Hassan district, Karnataka. Confirmation of diagnosis was based on slit skin smear and biopsy was done in doubtful cases.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of 214 patients, 152 were males and 62 were females. The prevalence was maximum in the age group 21-30 years. Borderline group formed the major part of the spectrum, consisting of 154 (71.96%) patients. Maximum patients 97 (45.3%) were of borderline tuberculoid (BT) leprosy, followed by 59 (27.57%) cases of borderline lepromatous leprosy (BL). 25 (11.68%) cases had tuberculoid leprosy (TT) and 20 (9.34%)cases were of lepromatous leprosy among which 3 were diagnosed as histoid leprosy. 6 patients had pure neuritic leprosy and 4 patients were in relapse.</p><p><strong>Conclusions:</strong> Even though leprosy is eliminated, it continues to be a public health problem in our country. Stricter surveillance for early diagnosis and treatment is needed to eradicate leprosy from India.</p>


Author(s):  
Ramesh Devidas Pawar ◽  
Shital Pratapsing Solanke

Background: Unmet need is the discrepancy between reproductive intentions and birth control practices. If the unmet needs remained neglected it leads to population explosion which is one of the greatest threats to India’s economic, social and political development.  A community-based study was carried out in rural areas with the objective to find the prevalence of unmet need for family planning and its socio-demographic determinants among married women of reproductive age.Methods: A community based cross sectional study was conducted between January to June 2019. After calculation of sample size 670 participants were selected by simple random sampling method.  Predesign and semi structured Performa was used for data collection. Data was collected and analyse using Epi Info 7.Results: Unmet needs of family planning among the study subject was 31.19% (57.58% for the spacer and 42.42% for limiter). It was significantly higher among the Muslim (66.67%) and Boudh (40.38) religion. It was higher among Illiterate (40.82%), women residing in joint families (72.16%). Unmet need of family planning was significantly associated with age of women, religion, educational status of women and their husbands, occupation, type of family, no of children the women have and age at marriage.Conclusions: Unmet needs among married women in the reproductive age group was still high and was significantly associated with age of women, religion, educational status of women as well as their husband, occupation, type of family, number of children the women had and age at marriage.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Benju Pandit

Aim: To analyse the demographic factors and parity in women influencing choice of contraceptive methods. Methods: This is a hospital record based retrospective study at Bhaktapur hospital, a tertiary hospital in a span of 6 months from October 2020 to March 2021. Data were collected from medical record and descriptive analysis was done. Results: There were 142 women taking contraceptive service in six months.Implant was the most commonly used method of contraception (48%), followed by the IUCD (26%), Injectable (16%) and OCP (10%). Age group of 20-39 had more acceptance of contraception as compared to adolescent and women above 40. More the parity more usage of long acting reversible contraception was found. Conclusion: The most common contraceptive method used among women was implant. Client having two or more children are more to receive long acting contraception.


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