scholarly journals The Promise of the Dual Prevention Pill: A Framework for Development and Introduction

2021 ◽  
Vol 3 ◽  
Author(s):  
Barbara A. Friedland ◽  
Sanyukta Mathur ◽  
Lisa B. Haddad

Women of reproductive age need multipurpose prevention technology (MPT) products to address two overlapping health risks: unintended pregnancy and HIV. Currently, condoms are the only available MPT, however male condoms are not within the control of a woman, and the use of female condoms has been limited by low acceptability and cost. Oral pre-exposure prophylaxis (PrEP) is highly effective for HIV prevention, yet uptake and adherence among women have been low to date. Women globally need more options for HIV and pregnancy prevention. Several MPTs for simultaneous HIV and pregnancy prevention are in various stages of development and clinical testing, although most are many years away from market launch. A dual prevention pill (DPP), a daily oral pill combining oral contraceptives and PrEP, both of which are licensed, approved products in many low- and middle-income countries (LMIC), is likely to be the fastest route to getting an MPT product into the hands of women. The DPP is one option that could enhance method choice, particularly for women who are already using oral contraceptives. By leveraging the oral contraceptive market and reaching women currently using condoms or with an unmet need for contraception, the DPP has the potential to increase the uptake of PrEP. The successful rollout of the DPP will require careful consideration of user-, provider-, and product-centered factors during product development and introduction. Early attention to these interrelated factors can help ensure that the DPP has the ideal characteristics for maximum product acceptability, that effective and quality services are designed and implemented, and that users can make informed choices, demand the product, and use it effectively. The proposed framework outlines key considerations for the effective development and introduction of the DPP, which could also facilitate integration models for future MPTs.

Author(s):  
Anita Pal ◽  
Jeetendra Yadav ◽  
Sunita . ◽  
Kh. Jitenkumar Singh

Background: Many women in low and middle-income countries would like to limit or delay their pregnancy, but they do not enough access to consistent use of modern contraceptive methods. The concept of unmet need for family planning is focus to reproductive health policies, as it endures serious implications for the women, the child, family and the whole society. The aims of the study are to assess the spatial dimensions of extent of unmet need for family planning and also identify association between individual, household, community and district level covariates with the level of unmet need for family planning among married women of reproductive age group in Bihar, India.Methods: The study uses data from fourth round of the National Family Health Survey (NFHS-4). To meet the objective the analysis included descriptive, spatial visualization, spatial autocorrelation and multilevel logistic model. In the first step of analysis the multivariate analysis was used to know the levels of unmet need for family planning by selected background characteristics.Results: This study indicating that nearly one in five or more women experiences unmet need for family planning suggests that the problem remains of considerable magnitude and that action is needed to fill the gap in contraceptive use, which is currently estimated at a lowest 24 percent. Apart from providing a current estimate of unmet need, our study identified a number of relevant socioeconomic and demographic factors likely to shape the probability that a women experiences unmet need. It is observed across individual level, community/psu level and district level.Conclusions: Considering this fact, family planning program in Bihar should also focus on eliminating misconceptions and fear about contraception through proper counselling of couples and information, education and communication activities in the community and try to improve the quality of advice and care services related to family planning.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Muhammad Farhan Asif ◽  
Zahid Pervaiz ◽  
Jawad Rahim Afridi ◽  
Ghulam Abid ◽  
Zohra S. Lassi

Abstract Background Family planning services deliver a wide range of benefits to the well-being of females and the community. It can curtail the risk of maternal and neonatal mortality through the reduction in abortions and pregnancies. The government of Pakistan has been struggling to convince people about the usefulness of family planning programs. However, different factors related to social norms, values, and culture are important to determine the success of these programs. One such factor is the patriarchal structure of Pakistani society where most of the household decisions are made by men. The objective of this research is to examine the role of the husband’s attitude towards the usage of contraceptives for the unmet need of family planning (UMNFP) among married women of reproductive age (MWRA) in Pakistan. Method The dataset of Pakistan Demographic and Health Survey 2017–18 is utilized to examine the role of the husband’s attitude towards the usage of contraceptives in UMNFP among MWRA in Pakistan. Results The UMNFP was considerably lower among MWRA between 40 years and above compared to women 15–19 years. The odds of UMNFP were higher among women and men who were educated up to the primary level compared to those with no education. Odds of UMNFP were higher among women from the poor wealth quintile compared to the poorest wealth quintile; similarly, it was significantly lower among women who were from the richer and the richest wealth quintile compared to the poorest wealth quintile. The odds of UMNFP were lower among women who were employed compared to those who were not employed. Lastly, the odds of UMNFP were higher among women whose husbands opposed to using contraceptives, who perceived that there was a religious prohibition for such use and when a decision on the contraception use was solely made by the husband. Conclusions Husband’s attitude towards the usage of contraceptives is an important predictor of UMNFP. Liaising with the community and religious leaders to persuade people particularly men about the usefulness of family planning programs and encouraging men to understand their women’s say in using contraceptives should be encouraged.


Author(s):  
Abdul-Aziz Seidu ◽  
Bright Opoku Ahinkorah ◽  
Ebenezer Agbaglo ◽  
Albert Apotele Nyaaba

Abstract Background Existing evidence suggests that there has been a surge of overweight and obesity in low- and middle-income countries around the world. In this study we investigated the prevalence and factors associated with overweight and obesity among women in Mali. Methods We conducted the study among 5198 women using the 2018 Mali Demographic and Health Survey data. We used binary logistic regression for the analysis and pegged statistical significance at p<0.05. Results The prevalence of overweight and obesity was 26.9%. The likelihood of overweight and obesity was high among women 40–44 y of age (adjusted odds ratio [AOR] 5.94 [confidence interval {CI} 4.10 to 8.60]), those who were widowed/divorced/separated (AOR 1.59 [CI 1.04 to 2.43]), those with secondary education (AOR 1.41 [CI 1.13 to 1.75]), richest women (AOR 3.61 [CI 2.63 to 4.95]), those who watched television at least once a week (AOR 1.28 [CI 1.07 to 1.52]) and those who lived in the Kidal region (AOR 10.71 [CI 7.05 to 16.25]). Conversely, the likelihood of overweight and obesity was low among women who belonged to other religions compared with Muslims (AOR 0.63 [CI 0.43 to 0.92]). Conclusions This study found a predominance of overweight and obesity among women in Mali. The study showed that age, marital status, education, religion, region of residence, wealth status and frequency of watching television are associated with overweight and obesity among women in Mali. It is therefore critical for public health promotion programs in Mali to sensitize people to the negative effects associated with overweight and obesity. This implies that policies aimed at controlling overweight and obesity in Mali must take these factors into consideration.


GYNECOLOGY ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. 101-107
Author(s):  
Vera N. Prilepskaya ◽  
Lana L. Bostandzhian

Since the first pill, there has been a significant evolution of hormonal contraception: low- and micro-dose drugs have appeared, drugs with components as close as possible to endogenous hormones have been developed, new dosage regimens and routes of contraceptive administration have been created. Modern combined oral contraceptives are not only used to prevent unwanted pregnancies, but are also widely used to treat a number of gynecological and non-gynecological diseases. In recent years, two new combined oral contraceptives with folate supplementation have been developed. The main purpose of adding folate to contraceptives is the prevention of fetal malformations, which is ensured by an increase in the level of folate in the body of women of reproductive age against the background of contraception and after its withdrawal.


2021 ◽  
Author(s):  
Abiyu Abadi Tareke ◽  
Ermias Bekele

Abstract Background: Family planning is a key method for reducing population growth and improving maternal and child health by spacing births and preventing unwanted pregnancies. have an unmet need for family planning is defined as women believed to be sexually involved but are not using some form of contraception, either do not want to have more children (Limiting) or want to delay their next birth for at least two years, (Spacing).Methods: The data for this study arrived from the Ethiopia Demographic Health Surveys in 2005, 2011, and 2016 to investigate trends and Predictors of change of unmet need for family planning among reproductive age women in Ethiopia. A pooled weighted sample of 26,230 (7761 in 2005, 9136 in 2011 and 9,333 in 2016 Ethiopian demographic health surveys) reproductive-age women used for this study. For the overall trend (2005-2016) multivariate decomposition analysis for non-linear response outcome was calibrated to identify the factors contributed to the change of unmet need for family planning. The Logit based multivariate decomposition analysis utilizes the output from the logistic regression model to assign the observed change in in unmet need for family planning over time into two components. Stata version 16.0 was used to analysis the data.Result: among reproductive age women in Ethiopia the magnitude of unmet need for family planning decreased from 39.6% in 2005 to 23.6% in 2016. From the decomposition analysis change of unmet need for family planning was due to change in characteristics and coefficients. About nine in ten changes in unmet need for family planning was attributable to the difference in coefficients. Factors that associated with the change of unmet need for family planning over the last 11 years were educational status, birth order, and desired number of children.Conclusion: Remarkable change in unmet need for FP was observed between the period of 2005 and 2016. Both change in characteristics and coefficient were the contributing to observed change. Majority of the change in unmet need for FP was due to difference in coefficient over the study period. Mainly the change of unmet need for FP was due to change in women having birth order of five and above, having secondary education and women who desired number of children below five.


2021 ◽  
Author(s):  
Jason Mulimba Were ◽  
SAVERIO STRANGES ◽  
Ishor Sharma ◽  
Juan-Camilo Vargas-Gonzalez ◽  
M. Karen Campbell

Introduction: The majority of the populations in Low-and Middle-Income Countries (LMICs) are encountering the double burden of malnutrition (DBM): the coexistence of both undernutrition and overnutrition sequalae. With DBM being a new phenomenon in research, little is known about its etiology, operational definitions and risk factors influencing its manifestation. The proposed scoping review is aimed at mapping literature with regards to the DBM phenomenon among preschool children and women of reproductive age in LMICs who are among the most high-risk groups to encounter DBM. Methods: A comprehensive literature search will be conducted in the following electronic databases: MEDLINE, EMBASE, Scopus, CINAHL, LILACS and ProQuest Dissertations & Thesis Global. Additionally, searches in other government and institutional sources (World Health Organization website and university repositories) and forward and backward citation tracking of seminal articles will also be done. Two reviewers will independently conduct title and abstract screening and full text screening. Similarly, data extraction and coding will independently be done by two reviewers. Information extracted from included literature will be analysed qualitatively using thematic analysis approach and reported as per the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Ethics and Dissemination: Ethical approval is not required for this study because the review is based on literature from publicly available sources. The dissemination of our findings will be done through presentations in relevant conferences and publication in a peer-reviewed journal.


2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Abebe Tadesse G/Meskel ◽  
Habtamu Oljira Desta ◽  
Elias Teferi Bala

Background. It is estimated that more than 142 million married women in developing countries have an unmet need for family planning. This study is aimed at identifying factors associated with the unmet need of family planning among married women of reproductive age in Toke Kutaye district, Ethiopia in 2019. Methods. A community-based cross-sectional study was conducted in Toke Kutaye district from March 1–30, 2019. A systematic random sampling technique was used to select 494 reproductive-age women who were married during data collection. Data were collected using a pretested structured questionnaire. Bivariate and multivariate logistic regression analyses were used to assess factors associated with the unmet need of family planning at 95% CI with a p value of ≤ 0.05. Result. The prevalence of unmet need for family planning in the Toke Kutaye district was 23.1% [95% CI (19.2-26.7)], with 15.2% for spacing and 7.9% for limiting. Women’s education [AOR, 3.64, 95% CI: 1.43-9.25], number of living children [AOR, 2.63, 95% CI: 1.37-5.05], husband disapproval of family planning [AOR, 3.68, 95% CI: 2.20-6.16], and discussion with healthcare providers on family planning [AOR, 0.20, 95% CI: 0.13-0.37] were significantly associated with unmet need for family planning. Conclusion. The prevalence of unmet need for family planning was high. Therefore, program managers, partners, and health workers should work to address the gaps in maternal education, the number of living children, partner disapproval of family planning, and discussion on family planning issues through enhancing female education, awareness on family planning, and male involvement in family planning services.


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