scholarly journals Experiences, Preferences, and Needs of Adolescents and Urban Youth in Contraceptive Use in Conakry, 2019, Guinea

2021 ◽  
Vol 2 ◽  
Author(s):  
Charlotte Bangoura ◽  
Nafissatou Dioubaté ◽  
Hawa Manet ◽  
Bienvenu Salim Camara ◽  
Mariama Kouyaté ◽  
...  
Keyword(s):  
Side Effects ◽  
Young People ◽  
Service Delivery ◽  
Sex Education ◽  
Sexual Pleasure ◽  
Religious Leaders ◽  
Contraceptive Methods ◽  
Duration Of Action ◽  
Proven Efficacy ◽  
The Cost

Introduction: The use of contraceptive methods is very low in Guinea, particularly among adolescents and young people. The purpose of this study is to analyze the experiences and expectations of adolescents and young people regarding the use of contraceptive methods in 2019 in Conakry, Guinea.Methods: We conducted a 6-month qualitative and descriptive study. Data were collected through individual in-depth interviews and focus group discussions with adolescents and young people, health providers and health policy makers. Two approaches of deductive and inductive analysis were used to synthesize the main insights from the data.Findings: Twenty-six participants were included in this study. Adolescents and young people have personal, family and community experiences that positively or negatively influence their contraceptive needs and preferences. Positive experiences include the relative cost of injectable forms, perceived absence of side effects of implants, proven efficacy and duration of action of the modern method used (implants and injectable form). Negative experiences included cost of implants remain high (15 Euros), perceived side effects including weight gain, pill compliance, method indiscretion, and low sensation of sexual pleasure for the condom. The preferences of the young participants were dominated by Implants and injectable forms that better meet their contraceptive needs. In terms of needs, the expectations expressed revolved around needs related to the health system, including sex education, reduction in the cost of some contraceptives (implants), availability of contraceptive methods, and equity in the provision of family planning services to adolescents and young people.Conclusion: Exploring the contraceptive experiences, needs and preferences of adolescents and young people reveals decision-making dilemmas. Adolescents and young people expressed their experiences in terms of the cost of preferred contraceptives (implants), side effects, proven efficacy, and duration of action. However, their decisions are still influenced by availability, equity in service delivery, and the involvement of parents and religious leaders in sex education. Decision-makers should then place particular emphasis on improving health service delivery, adolescent sexual and reproductive health, availability of preferred contraceptive methods at affordable cost, and a program on sexuality education with the involvement of parents and religious leaders and the promotion of condom use.

Principles of contraception

2020 ◽  
pp. 1626-1634
Author(s):  
Zara Haider
Keyword(s):  
Sex Education ◽  
Potential Risk ◽  
Contraceptive Method ◽  
Intrauterine Device ◽  
Unprotected Sex ◽  
Online Resources ◽  
Contraceptive Methods ◽  
Duration Of Action ◽  
The Public

There are many contraceptive methods available (increasing year on year) which can be classified as: hormonal and non-hormonal, longer lasting, and those with a shorter duration of action, reversible and irreversible. No contraceptive method is 100% effective (apart from abstinence) and where there is potential risk of conception due to unprotected sex or an error with a contraceptive regimen, the patient must be informed about methods of emergency (post-coital) contraception, the most effective being the post-coital intrauterine device (PCIUD). Education of the public about the benefits of contraception is vital and must be done in a timely way (e.g. through school sex education, media, and online resources).

scholarly journals Assessing the Cost-Effectiveness of Contraceptive Methods from a Health Provider Perspective: Case Study of Kiambu County Hospital, Kenya

2020 ◽  
Author(s):  
James Kiragu Ngacha ◽  
Richard Ayah
Keyword(s):  
Cost Effectiveness ◽  
Service Delivery ◽  
Cost Effective ◽  
Sub Saharan Africa ◽  
Contraceptive Methods ◽  
Donor Funding ◽  
Contraceptive Prevalence ◽  
Sub Saharan ◽  
The Cost

Abstract Background: Kenya’s Contraceptive Prevalence Rate at 53% is low, with wide disparity among the 47 counties that make up the country (2% - 76%). Significant financial investment is required to maintain this level of contraceptive use and increase it to levels seen in more developed countries. This is in the context of a growing population, declining donor funding, limited fiscal space and competing health challenges. Studies have shown that long-term contraceptive methods are more cost-effective than short-term methods. However, it is unclear if this applies in Sub-Saharan Africa; with limited financial resources, lower social economic status among users, and publicly managed commodity supply chains, in vertical programs largely dependent on donor funding. This study assessed the cost-effectiveness of contraceptive methods used in Kenya.Methods: A cross-sectional study was undertaken in a county referral hospital in mid-2018. Purposive sampling of 5 Family Planning clinic providers and systematic sampling of 15 service delivery sessions per method was done. Questionnaire aided interviews were done to determine inputs required to provide services and direct observation to measure time taken to provide each method. Cost per method was determined using Activity Based Costing, effectiveness via couple year protection conversion factors, and cost-effectiveness was expressed as cost per couple year protection. Results: The Intra-Uterine Copper Device was most cost-effective at 4.87 US dollars per couple year protection followed by the 2-Rod Implant at 6.36, the 1-Rod Implant at 9.50, DMPA at 23.68, while the Combined Oral Contraceptive Pills were least cost-effective at 38.60 US dollars per couple year protection. Long-term methods attracted a higher initial cost of service delivery when compared to short-term methods.Conclusion: Long-term contraceptive methods are more cost-effective. As such, investing in long-term contraceptives would save costs despite higher initial cost of service delivery. It is recommended, therefore, that Sub-Saharan Africa countries allocate more domestic financial resources towards availability of contraceptive services, preferably with multi-year planning and budget commitment. The resources should be invested in a wide range of interventions shown to increase uptake of long-term methods, including reduction of cost barriers for the younger population, thereby increasing Contraceptive Prevalence Rates.

Young People and Cybersex in a Sexually Conservative Society

2011 ◽  
pp. 171-189 ◽  
Author(s):  
Komalsingh Rambaree
Keyword(s):  
Social Policy ◽  
Young People ◽  
Sex Education ◽  
Policy Making ◽  
Sexuality Education ◽  
Education Programme ◽  
Moral Values ◽  
Policy Implications ◽  
Religious Leaders ◽  
The Social

This chapter describes the process, explains the aspects, analyses the experiences and considers the social policy implications, of cybersex among young people from the sexually conservative Mauritian society. This chapter is based on a study, in which it is found that some of young people from Mauritius are involved in cybersex. The chapter therefore argues that Internet-based technologies are further breaking down ‘the traditional and moral values’, which some politicians, religious leaders and parents want to preserve through social policy related to sexuality education in Mauritius. A sexual rights-based approach to policy making and interventions for a formal sex education programme in Mauritius is found more appropriate within this particular context, and therefore recommended in this chapter. Finally, this chapter concludes that an appropriate formal sex education for young people should take into account the ‘Net Culture’ context within which contemporary young people are growing sexually in Mauritius.

Amiloride (Midamor®, Merck, Sharp and Dohme)

1981 ◽  
Vol 15 (2) ◽  
pp. 94-98 ◽  
Author(s):  
Helen L. Macfie ◽  
Carol L. Colvin ◽  
Philip O. Anderson ◽  
Eric A. Jackson ◽  
Alex A. Cardoni ◽  
...  
Keyword(s):  
Side Effects ◽  
Impaired Renal Function ◽  
Antihypertensive Effect ◽  
Diuretic Effect ◽  
Duration Of Action ◽  
Once Daily ◽  
Digitalis Therapy ◽  
Patient Tolerance ◽  
Complicating Factors ◽  
The Cost

Amiloride is a potassium-sparing diuretic that is pharmacologically similar to triamterene. It has been widely used abroad for several years, alone and in combination with hydrochlorothiazide. As a potassium-sparing agent, amiloride appears to be approximately as effective as triamterene and spironolactone and to have a longer duration of action than triamterene, allowing once daily dosing. The diuretic effect of amiloride is mild, as are all agents that act at distal tubular sites. Amiloride appears to have an antihypertensive effect approximating that of the thiazides and spironolactone – an advantage over triamterene, which is devoid of antihypertensive effects. Amiloride will probably be most useful as a potassium-sparing agent in combination with the thiazide and loop diuretics. It should be kept in mind, however, that many patients on thiazide diuretics do not need supplemental potassium or potassium-sparing agents if they have no other complicating factors, such as digitalis therapy. When hypokalemia causes symptoms, a potassium-sparing agent may have advantages over oral potassium supplements in patient tolerance and compliance. Because of the possibility of tumorigenicity and estrogenic side effects, spironolactone's popularity has been decreasing in recent years. Amiloride will probably be a strong competitor of triamterene and spironolactone because of its longer duration of action than triamterene and, from early indications (cf. ticrynafen), more benign side effects than spironolactone. The drug should be used with great caution, if at all, in patients with impaired renal function, however. The benefits of amiloride will have to be weighed against the cost of the drug in individual patients.

Perspectives on the Therapeutic Benefits of Arginine Supplementation in Cancer Treatment

2019 ◽  
Vol 19 (7) ◽  
pp. 913-920
Author(s):  
Fabiani L. R. Beal ◽  
Pedro R. Beal ◽  
Juliana R. Beal ◽  
Natan Carvalho-Neves ◽  
Octávio L. Franco ◽  
...  
Keyword(s):  
Amino Acid ◽  
Side Effects ◽  
Cancer Treatment ◽  
Treatment Strategies ◽  
Endothelial Permeability ◽  
The Elderly ◽  
Therapeutic Benefits ◽  
Cell Growth And Differentiation ◽  
The Cost ◽  
Arginine Supplementation

Background: Arginine is considered a semi-essential amino acid in healthy adults and the elderly. This amino acid seems to improve the immune system, stimulate cell growth and differentiation, and increase endothelial permeability, among other effects. For those reasons, it has been theorized that arginine supplementation may be used as an adjuvant to conventional cancer therapy treatments. Objective: This review aims to evaluate the existing knowledge of the scientific community on arginine supplementation in order to improve the efficacy of current cancer treatment. Results: Despite the continued efforts of science to improve treatment strategies, cancer remains one of the greatest causes of death on the planet in adults and elderly people. Chemo and radiotherapy are still the most effective treatments but at the cost of significant side effects. Conclusion: Thus, new therapeutic perspectives have been studied in recent years, to be used in addition to traditional treatments or not, seeking to treat or even cure the various types of cancer with fewer side effects.

Twitter Analysis of the Nonmedical Use and Side Effects of Methylphenidate, and User Sentiment about the Drug (Preprint)

2019 ◽  
Author(s):  
Jungu Kim ◽  
Su Cheol Kim ◽  
Jaegwon Jeong ◽  
Myeong Gyu Kim
Keyword(s):  
Side Effects ◽  
Social Networking ◽  
Brand Names ◽  
Social Networking Services ◽  
Hyperactivity Disorder ◽  
Search Terms ◽  
Nonmedical Use ◽  
Twitter Analysis ◽  
Sentiment Score ◽  
The Cost

BACKGROUND Methylphenidate, a stimulant used to treat attention deficit hyperactivity disorder (ADHD), has the potential for nonmedical uses such as study and recreation. In the era of active use of social networking services (SNSs), experience with the nonmedical use or side effects of methylphenidate might be shared on Twitter. OBJECTIVE To analyze monthly tweets about methylphenidate, its nonmedical use and side effects, and user sentiments about methylphenidate. METHODS Tweets mentioning methylphenidate from August 2018 to July 2019 were collected using search terms for methylphenidate and its brand names. Only tweets written in English were included. The monthly number of tweets about methylphenidate and the number of tweets containing keywords related to the nonmedical use and side effects of methylphenidate were analyzed. Precision was calculated as the number of true nonmedical use or side effects divided by the number of tweets containing each keywords. Sentiment analysis was conducted using the text and emoji in tweets, and tweets were categorized as very negative (less than -3), negative (-3 to -1), neutral (0), positive (1 to 3), or very positive (more than 3), depending on the sentiment score. RESULTS A total of 4,169 tweets were ultimately selected for analysis. The number of tweets per month was lowest in August (n=264) and highest in May (n=435). There were 292 (7.0%) tweets about nonmedical uses of methylphenidate. Among those, 200 (4.8%) described use for studying, and 15 (0.4%) described use for recreation. In 91 (2.2%) tweets, snorting methylphenidate was mentioned. Side effects of methylphenidate, mainly poor appetite (n=74, 1.8%) and insomnia (n=54, 1.3%), were reported in 316 (7.6%) tweets. The average sentiment score was 0.027 ± 1.475, and neutral tweets were the most abundant (n=1,593, 38.2%). CONCLUSIONS Tweets about methylphenidate were most abundant in May, mentioned nonmedical use for study or recreation, and contained information about side effects. Analysis of Twitter has the advantage of saving the cost and time needed to conduct a survey, and could help identify nonmedical uses and side effects of drugs.

Analysis of Media Outlets on Women´s Health: Interest on Contraceptives and their Side Effects, with Negative Perceptions of Tubal Ligation (Preprint)

2020 ◽  
Author(s):  
Miguel Angel Alvarez-Mon ◽  
Carolina Donat-Vargas ◽  
Maria Llavero-Valero ◽  
Alfredo Gea ◽  
Melchor Alvarez-Mon ◽  
...  
Keyword(s):  
Side Effects ◽  
Social Attitudes ◽  
Tubal Ligation ◽  
Contraceptive Methods ◽  
Health Habits ◽  
Menopausal Women ◽  
Negative Perceptions ◽  
Twitter Users ◽  
Post Menopausal ◽  
The U.S

BACKGROUND Media outlets influence social attitudes toward health habits. Analysis of tweets has become a tool for health research. OBJECTIVE The objective of this study was to investigate the distribution of tweets about women´s health and the interest generated among Twitter users. METHODS We investigated tweets posted by 25 major U.S. media outlets about pre-menopausal and post-menopausal women´s health between January 2009 and December 2019 as well as the retweets generated. In addition, we measured the sentiment analysis of these tweets as well as their potential dissemination. RESULTS A total of 376 tweets were analyzed. Pre-menopausal women´s health accounted for most of the tweets (75.3%). Contraception was the main focus of the tweets, while a very limited number were related to infertility (1.4%). With regards to medical content, the effectiveness of contraceptive methods was the most frequent topic (46.2%). However, tweets related to side effects achieved the highest retweet-to-tweet ratio (70.3). The analysis of sentiments showed negative perceptions on tubal ligation. CONCLUSIONS The U.S. media outlets analyzed focused their content on contraception, while Twitter users showed great interest in side effects.

scholarly journals Cost-effectiveness and feasibility of conditional economic incentives and motivational interviewing to improve HIV health outcomes of adolescents living with HIV in Anambra State, Nigeria

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Obinna Ikechukwu Ekwunife ◽  
Chinelo Janefrances Ofomata ◽  
Charles Ebuka Okafor ◽  
Maureen Ugonwa Anetoh ◽  
Stephen Okorafor Kalu ◽  
...  
Keyword(s):  
Viral Load ◽  
Cost Effectiveness ◽  
Service Delivery ◽  
Motivational Interviewing ◽  
Cost Effective ◽  
Economic Incentives ◽  
Additional Patient ◽  
Incentive Scheme ◽  
The Cost ◽  
The Impact

Abstract Background In sub-Saharan Africa, there is increasing mortality and morbidity of adolescents due to poor linkage, retention in HIV care and adherence to antiretroviral therapy (ART). This is a result of limited adolescent-centred service delivery interventions. This cost-effectiveness and feasibility study were piggybacked on a cluster-randomized trial that assessed the impact of an adolescent-centred service delivery intervention. The service delivery intervention examined the impact of an incentive scheme consisting of conditional economic incentives and motivational interviewing on the health outcomes of adolescents living with HIV in Nigeria. Method A cost-effectiveness analysis from the healthcare provider’s perspective was performed to assess the cost per additional patient achieving undetected viral load through the proposed intervention. The cost-effectiveness of the incentive scheme over routine care was estimated using the incremental cost-effectiveness ratio (ICER), expressed as cost/patient who achieved an undetectable viral load. We performed a univariate sensitivity analysis to examine the effect of key parameters on the ICER. An in-depth interview was conducted on the healthcare personnel in the intervention arm to explore the feasibility of implementing the service delivery intervention in HIV treatment hospitals in Nigeria. Result The ICER of the Incentive Scheme intervention compared to routine care was US$1419 per additional patient with undetectable viral load. Going by the cost-effectiveness threshold of US$1137 per quality-adjusted life-years suggested by Woods et al., 2016, the intervention was not cost-effective. The sensitivity test showed that the intervention will be cost-effective if the frequency of CD4 count and viral load tests are reduced from quarterly to triannually. Healthcare professionals reported that patients’ acceptance of the intervention was very high. Conclusion The conditional economic incentives and motivational interviewing was not cost-effective, but can become cost-effective if the frequency of HIV quality of life indicator tests are performed 1–3 times per annum. Patients’ acceptance of the intervention was very high. However, healthcare professionals believed that sustaining the intervention may be difficult unless factors such as government commitment and healthcare provider diligence are duly addressed. Trial registration This trial is registered in the WHO International Clinical Trials Registry through the WHO International Registry Network (PACTR201806003040425).

The Experiences and Perspectives of African-Australian Community Service Providers Who Work with At-Risk and Justice-Involved Youth

2021 ◽  
pp. 0306624X2110226
Author(s):  
Stephane Shepherd ◽  
Aisling Bailey ◽  
Godwin Masuka
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Young People ◽  
Service Delivery ◽  
Community Service ◽  
Service Providers ◽  
Professional Staff ◽  
Youth Justice ◽  
Complex Needs ◽  
Australian Community

African-Australian young people are over-represented in custody in the state of Victoria. It has been recognized in recent government and stakeholder strategic plans that African-Australian community service providers are well placed to help address the increasing complex needs of at-risk African-Australian youth. However little is known about the capacities of such providers to effectively contend with this growing social concern. In response, this study aimed to explore the perspectives and operational (service delivery and governance) experiences of African-Australian community organizations which provide services to at-risk young people in Victoria. Through a series of in-depth interviews with the leadership of eight key African-Australian service providers, we aimed to identify their perceived strengths, obstacles faced and proposed strategies to realize key objectives. Perspectives on key risk factors for young African-Australian justice system contact were also gathered. Several themes were extracted from the interviews, specifically (i) Risk factors for African-Australian youth justice-involvement (school disengagement, peer delinquency, family breakdown, intergenerational discord, perceived social rejection), (ii) The limitations of mainstream institutions to reduce African-Australian youth justice-involvement (too compliance focused, inflexible, business rather than human-centered, disconnected from communities and families), (iii) The advantages of African-Australian community service providers when working with African-Australian youth (community credibility, client trust, flexibility, culturally responsive), (iv) The challenges faced by African-Australian service providers (lack of funding/resources, professional staff shortages, infrastructural/governance limitations), and (v) “What works” in service provision for at-risk African-Australians (client involvement in program design, African staff representation, extensive structured programming matched with client aspirations, prioritizing relationship building, persistent outreach, mental health and legal literacy for clients and families). Implications for service delivery and social policy are discussed within.

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