Meta-Analysis: The Influence of Knowledge, Education, and Husband's Support on The Selection of Long Acting Contraception Methods

The population is expected to increase by 8,5 billion persons in 2030 and 10,9 billion persons in 2100, population is growing at a rate of around 1,1% per year. One of population growth control by birth control with contraception. The most effective contraception is long-acting contraception, however, on IDHS (Indonesian Health Demographic Survey) only 13% of currently married women use long-acting contraception. Many factors affect contraceptive use among married women, such as knowledge, education, and husband’s support. The purpose of this study was to determine the effect of knowledge, education, and husband's support on the selection of MKJP. This study used meta-analysis with the search engines by Google scholar, PUBMED, science direct, and ProQuest. The study was selected using PRISMA and it was evaluated by AMSTAR. Data synthesis was conducted by STATA 16.0. The results of this study obtained by knowledge [OR = 0,99; 95% Cl : 0,90-1,08, p = 0,000; I2 = 74,8%], education [OR = 0,84; 95% Cl : 0,77-0,92, p = 0,000; I2 = 86,3%], and husband’s [OR = 0,94; 95% Cl : 0,69-1,20, p = 0,000; I2 = 81,5%]. This means that knowledge, education, and husband’s support have an impact on the use of long-acting contraception.

Acceptability and awareness of intrauterine contraceptive device among reproductive age women

Contraception is the intentional prevention of conception through the use of various devices, sexual practices, chemicals, drugs or surgical procedures. An effective contraception allows a physical relationship without fear of an unwanted pregnancy and ensures freedom to have children when desired. In this article we are going to see their utilization and awareness about usage of intrauterine contraceptive device (IUCD).

Perspectives of obstetricians and midwives on the provision of immediate postpartum intrauterine devices: a qualitative service evaluation

BackgroundImmediate postpartum intrauterine device (PPIUD) insertion is safe and effective but largely unavailable in Europe. Data on maternity staff views on the provision and implementation of PPIUD services are limited. The objective of this qualitative evaluation was to explore the views and experiences of obstetricians and midwives providing PPIUD within a UK maternity setting, in order to identify areas for improvement and inform service provision in other areas.MethodsQualitative health services research within two public maternity hospitals in Lothian (Edinburgh and surrounding region), UK. Interviews with 30 maternity staff (obstetricians n=8; midwives n=22) involved in PPIUD provision. Data were analysed thematically.ResultsMaternity staff were positive about the benefits of PPIUD for women. Midwives reported initial concerns about PPIUD safety, and the impact on workload; these views shifted following training, and as PPIUD was embedded into practice. Having a large pool of PPIUD-trained staff was identified as an important factor in successful service implementation. Having PPIUD ‘champions’ was important to address staff concerns, encourage training uptake, and advocate for the service to ensure continued resourcing.ConclusionsPPIUD in maternity services can help address unmet need for effective contraception in the immediate postpartum period. We emphasise the importance of widespread engagement around PPIUD among all healthcare professionals involved in the care of women, to ensure staff are informed and supported. Clinical champions and leaders play a key role in amplifying the benefits of PPIUD, and advancing organisational learning.

Post-abortion contraception: how to make the right choice?

More than 600 thousands abortions are performed annually in Russia. Women presenting for abortion care are often motivated by the pregnancy to use effective contraception; they are also at high risk for repeat unintended pregnancy. Contraceptive counseling and the supply of contraceptive methods are part of post-abortion care and positively influence the subsequent use of contraceptive methods. Oral contraceptives (OCs) following induced abortion offer a reliable method to avoid repeated abortion. Immediate administration of combined OCs after abortion may reduce vaginal bleeding time and amount, shorten the menstruation recovery period, and reduce the risk of complications and unintended pregnancies. Сombination of ethinylestradiol 30 g + drospirenone 3 mg demonstrates the advantages of a low estrogen dose with the antimineralocorticoid activity of drospirenone that is responsible for the drugs significant antiandrogenic and antimineralocorticoid effects, reflected clinically in lower rates of adverse events including less fluid retention. Сombination of ethinylestradiol 30 g + drospirenone 3 mg and Metafolin has similar contraceptive efficacy, side effect, safety and benefits profile to other drospirenone-containing contraceptives. The article presents the results of the latest studies about using of combined OCs (ethinylestradiol 30 g + drosperinone 3 mg and Metafolin) after abortion.

Adolescent pregnancy and current contraceptive use among adolescent and young women aged 16-24 years in Durban and Soweto, South Africa

Background High rates of adolescent pregnancies in South Africa continues to be a pressing public health concern. This study examines (1) the prevalence of current contraceptive use; and (2) the independent association between adolescent pregnancy and effective contraception use. Methods This study uses baseline cross-sectional data from a youth-centered sexual and reproductive health (SRH) cohort study among youth (aged 16–24) in Soweto and Durban (2011–2017). Among 207/253 females reporting consensual sexual activity, crude and adjusted logistic regression examine associations between ever having an adolescent pregnancy (aged 15–19) or pregnancy at age 20–24 (ref no pregnancy) and effective contraception use (barrier and/or hormonal methods) in the last 6 months. Results Over one-third (34.3%, n = 71) of females reported a history of adolescent pregnancy and 13.0% (n = 27) had a pregnancy at age 20–24. Nearly all (95.9%, n = 94) first pregnancies were unintentional. Current effective contraceptive use was reported by 74.6% (n = 53) with an adolescent pregnancy, 66.6% (n = 18) of those pregnant at 20–24 years, and 46.8% (n = 51) of never pregnant females (p < 0.001). All effective contraceptive users pregnant at 20–24 years and 83% (n = 44) of the adolescent pregnancy group reported using hormonal methods vs. 52.9% (n = 27) of never pregnant females. In the adjusted model, a history of adolescent pregnancy was associated with 3.45 (95%CI = 1.75–6.82) times greater odds of effective contraceptive use (vs. no pregnancy). Conclusion suggest that adolescent females are accessing effective methods of contraception including hormonal methods only after a pregnancy event, highlighting the need for earlier provision of youth-friendly SRH services.

The Influence of Social Demographic Factors on the Use of Extended Post-Partum Family Planning Methods Among Post-Delivery Women in Tanzania

Extended Post-Partum Family Planning (EPPFP) refers to the prevention of unplanned and/or closely spaced pregnancies from six (6) weeks to 12 months period after childbirth. It is revealed that 61% of women in the world do not use effective contraception within 24 months postpartum to prevent unplanned pregnancy. This study examined the influence of social demographic factors on the use of Extended Post-Partum Family Planning (EPPFP) methods among post-delivery women from four selected health care facilities in Tanzania. 255 post-delivery women aged 15-49 years who delivered a child between January 1, 2019 and January 31, 2020 were subjected to a facility-based cross-section study design through convenience sampling. Data were analyzed by SPSS version 20; multiple regression analyses were done to establish the relationships between social demographic factors and the use of Extended Post-Partum Family Planning (EPPFP) methods. It was found that there is a significant relationship between social demographic factors and the use of Extended Post-Partum Family Planning (EPPFP). The study recommends provision of family planning education to the community through mass and social media.

Monitoring of safety using favipiravir: risk management of adverse drug reactions in clinical practice

Global experience with the clinical use of favipiravir is very limited. Its safety is for further study. Prevention of teratogenic effects (mandatory pregnancy test before starting therapy, compliance with effective contraception by both women and men), control of the level of uric acid, transaminases and ECG are of fundamental importance. Alertness is needed for new, insufficiently documented or previously unreported adverse events such as motor disturbances and falls. Patients should be fully informed about all the risks of therapy before starting it. Special attention is required to timely fill out the approved forms of notifications on the development of HP and report them in time according to the Order of the Federal Service for Surveillance in Healthcare of February 15, 2017 No. 1071 «On approval of the Procedure for the implementation of pharmacovigilance.»

Alignment of PrEP use and effective contraceptive use among East African women in HIV serodiscordant partnerships

Women who have a prevention mindset may opt for concurrent use of oral pre-exposure prophylaxis (PrEP) and all forms of contraception; we therefore assessed how contraception may influence PrEP use or vice versa. We analyzed data from Kenyan and Ugandan HIV-uninfected non-pregnant women in sero-discordant partnerships who were participating in the Partners Demonstration Project. Using multivariable generalized estimating equation models, we estimated the associations between effective contraceptive use and 1) PrEP dispensation 2) high effective PrEP use. Among the 311 women (93.1% of all those followed in the Partners Demonstration Project) median age was 29 years (interquartile range [IQR] 24.0–35.0) and 115 (37.0%) reported using effective contraception at baseline. All the women initiated PrEP during the study and moderately high PrEP adherence was recorded at 73.1% of visits over an average 7.5 months following PrEP dispensation. Women (14.8%) consistently used an effective contraceptive throughout study follow-up. PrEP dispensation was more frequent among those concurrently using effective contraception, (adjusted relative risk [aRR] = 1.19; 95% confidence interval [CI] = 1.08–1.32) and contraceptive use was more common among those on PrEP (aRR = 1.63; 95% CI = 1.18–2.25). Among East African women at high risk of HIV infection, PrEP dispensation was more frequent among women using effective contraception, indicating that family planning outlets may be efficient locations to deliver PrEP.