Male involvement in family planning in Northern Nigeria: A review of literature

Background: Demand and utilization of family planning (FP) in Northern Nigeria has been consistently low. Evidence from literature has demonstrated that male involvement in FP programming can be successful in increasing demand for FP services. Materials and Methods: A search of peer-reviewed and gray literature was carried out to explore the status of male awareness and utilization of FP methods, and the barriers to male involvement in FP, in Northern Nigeria. Results: Males in the region generally have a good awareness of FP. However, they had negative perceptions, low levels of usage of FP, and poor spousal communication about FP.Sociocultural and religious barriers played major roles in hindering male involvement in FP. Misconceptions about FP, such as that FP is a woman's activity and that it also encourages promiscuity among women, were factors limiting its acceptance. Conclusion: There is a need to address the misconceptions and equip men with complete and correct information about FP. There is also a need for research on effective strategies to address the sociocultural and religious barriers to male involvement in FP in Northern Nigeria and the development of effective culturally sensitive male-involvement FP initiatives

Determinants of unmet need for modern contraception andreasons for non-use among married women in rural areas of Burkina Faso

Burkina-Faso (TFR=6.0) is among the top-ten high fertility countries world-wide and CPR (15) among women is low. This study examined the factors associated with non-use of modern contraception among married women residing in the rural areas of Burkina-Faso. The study used 2010 Burkina Faso Demographic and Health Survey data-set and focussed on married women aged 15-49 years (n=7;191). Chi-square and logistic regression techniques were used for the analysis (a=5). Mean number of living children was significantly higher among women who have UNMC (3.92) than those with met need (3.01). Modern CPR and UNMC among married women was 12.7 and 40.7 respectively. The multivariate analysis reveals that being married more than once increases the likelihood of UNMC (OR=1.304; C.I=1.0821.571; p0.05). Husbands' approval of FP is a protective factor of UNMC (OR

Marcos normativos da anticoncepção de emergência e as dificuldades de sua institucionalização nos serviços públicos de saúde / Legal framework of emergency contraception and the difficulties of its institutionalization in public health services

Este artigo discute as dificuldades de implementação da Anticoncepção de Emergência (AE) nas práticas do Sistema Único de Saúde, no período de 2000 a 2008, mediante revisão crítica da literatura sobre o tema e análise de documentos oficiais. Aponta avanços no âmbito da legislação em saúde para a utilização da AE, os quais permitem oficialmente reconhecê-la no país como alternativa contraceptiva em situações emergenciais, para além dos casos de violência sexual. O levantamento da literatura nacional e internacional, centrada na América Latina e em alguns estudos da Europa, dos EUA e do Canadá, suscita questões referentes à não-incorporação dessas normas nas práticas cotidianas dos serviços de saúde, revelando representações sociais difíceis de serem revertidas em pouco tempo. Documentos oficiais do MS e do CFM foram analisados para construção do marco legal e político-institucional que pauta a discussão. Os resultados mostram paradoxos entre as normas asseguradas e as práticas existentes nos serviços de saúde: dificuldade no acesso e utilização da AE via serviços públicos de saúde; a pílula do dia seguinte (PDS) é comumente considerada abortiva por profissionais de saúde, usuárias e seus parceiros; embora pesquisas apontem aumento significativo do uso desse método, há resistência dos serviços a disponibilizá-lo; persiste a ideia recorrente no senso comum de que a AE levaria os usuários, principalmente adolescentes, a abandonar outros métodos contraceptivos de uso regular, inclusive preservativo, fato não confirmado pelos estudos realizados, pois eles indicam que os adolescentes que recorrem à AE são os que usam tal método.

This paper discusses the difficulties to implement emergency contraception (EC) in Brazilian Public Health Service, from 2000 to 2008, based on critical literature review and analysis of official documents on the theme. It shows advancements in health legislation, concerning the use of EC, that allow to recognize officially EC in Brazil as an emergency contraceptive alternative, beyond cases of sexual violence. The critical literature review - which includes data from Latin America, mainly, and some European, American, and Canadian studies - brings out issues related to the non-use of these norms by public health services in its everyday practice. This situation reveals strong social representations that are not easy to be reversed at once. Official Health Ministry and National Medical Professional Board documents were analyzed, in order to establish the legal, normative, and politicalinstitutional frameworks that guide the discussion. The analysis displays paradoxes between the established norms and the health services practices, such as: trouble accessing and using EC through public health services; health professionals and potential users commonly relate the morning after pill (MAP) to abortion; there is noticeable resistance of health services to making that method available, although researches point out substantial increase in its use; and there persists the idea that EC would lead users, especially teenagers, to abandon regular contraceptive methods, like condom - a fact not confirmed by the reviewed studies, once they show that teenagers that resort to EC are the ones that regularly use condom.

Contracepção transdérmica semanal: expandindo os limites do planejamento familiar / Weekly transdermal contraception: expanding the limits of family planning

Novos contraceptivos hormonais têm-se tornado disponíveis recentemente no arsenal médico, com características próprias, apresentando vantagens em face dos já conhecidos. Objetiva-se descrever um novo sistema transdérmico contraceptivo (CT) recentemente disponibilizado no Brasil, analisar a experiência internacional com esse método e fornecer dados de uma pesquisa comportamental realizada para conhecer a opinião de possíveis usuários do CT. O CT é utilizado uma vez por semana, por três semanas consecutivas, e, na quarta semana, livre do adesivo, ocorre o sangramento de privação. Pode ser utilizado em diversas partes do corpo, exceto as mamas. Libera diariamente 20 ug de etinilestradiol e 150 ug de norelgestromina, progestágeno de 3ª geração, em níveis constantes. A eficácia do CT é de 99,4 (percentual), Índice de Pearl de 0,7. O controle do ciclo/perfil de efeitos colaterais são adequados, comparáveis aos das pílulas. A adesão da paciente ao uso é superior no CT (88,7) comparada à pílula (79,2), p<0,001, não variando nas diferentes faixas etárias. A adesividade, estudada sob variadas condições de clima e atividade física, indicou taxa de descolamento total em torno de 1,7 (percentual). Estudo brasileiro recente demonstrou que 91 (percentual)de 500 pacientes estudadas referiram que usariam o método e 78 (percentual) o caracterizaram positivamente como "excelente", "muito bom" ou bom

Maternal mortality in India.

Authors worked on maternal mortality in India from 1992-94. This article is a review article on the basis of authors' experience. The article starts with the brilliant sentence, 'Maternal mortality in India is unacceptably high' and ends with the suggested strategies to solve the problem.

Trends, patterns and correlates of contraceptive use among Kuwaitis, 1984 - 1999

To document the changes in trends and patterns of contraceptive use from 1984 to 1999 and analyze the sociodemographic correlates of contraceptive use. A nationally representative household survey of Kuwaiti women of reproductive age was conducted in 1999 and compared with published data from three earlier national surveys. About 52% of Kuwaiti women were currently using some form of contraception and 79% had used it at some time in their life [ever-use]. Three fourths were using a modern method of contraception at the time of the survey. Oral contraceptive pills were the leading method, followed by IUCDs. Oral contraceptive use declined from 79 to 45% in the period 1984-1999. Use of withdrawal increased from 2% in 1987 to 11% in 1999. Multivariate analysis indicated that a higher age and parity, a higher level of education of both spouses, urban residence, and a lower desired fertility were associated with higher contraceptive use. Contraception is generally used for spacing children, with the wife being the main user. There is a continuing need to provide services and accurate information about the various methods of contraception

Norma de planificación familiar / Norms of family planning

Presenta la Norma de Planificación Familiar de los Servicios de Atención Integral a la Mujer, describe las disposiciones generales y sus especificaciones técnicas para la prestación de los servicios de planificación familiar e incluye la selección y aplicación de métodos anticonceptivos, destacando los elementos de promoción, información, orientación y consejería. El propósito de normar los servicios de salud integral a la mujer es contribuir a reducir la mortalidad materna y perinatal mejorando la oferta de servicios de planificación familiar; brindando información adecuada y oportuna a través de la educación para la salud y la consejería, de manera que les permita a las parejas e individuos tomar decisiones informadas acerca de su vida reproductiva, así como sobre el número y el espaciamiento de los hijos. Pretende normar las actividades de planificación familiar, con el enfoque de salud reproductiva, de conformidad con las políticas y estrategias del Ministerio de Salud, en un contexto de atención integral, basado en el enfoque de riesgo, la política de descentralización y la participación social y comunitaria, a fin de mejorar la calidad de vida y salud de la población nicaragüense

Evaluación de un programa de educación sexual sobre conocimientos, conducta sexual y anticoncepción en adolescentes / A sexual education program on knowledge, sexual behavior and contraception in adolescents

En América Latina se han desarrollado muy pocos programas de educación sexual basados en una investigación sistemática acerca de las necesidades de los jóvenes, y son todavía menos los que se han evaluado adecuadamente. La mayor parte de las evaluaciones presentan graves errores metodológicos y abarcan en su mayoría el conocimiento sexual y anticonceptivo, valorando en menor medida el comportamiento relacionado con el inicio de la actividad sexual y el uso de anticonceptivos. "Planeando tu Vida" es un programa de eduación sexual que se basa en investigaciones explicativas realizadas en México, mismo que fue evaluado con 1632 estudiantes de preparatorias públicas. Se seleccionaron al azar dos grupos de alumnos, uno de los cuales tomó el curso y el otro sirvió como control. Se realizaron tres mediciones: antes del curso, al terminar el curso y un seguimiento a los 6 meses. Los resultados muestran que: El curso no modificó la actividad sexual de los adolescentes. - Que si el curso se imparte antes de que los adolescentes hayan empezado a tener relaciones sexuales, se incrementa la posibilidad de que usen anticonceptivos. - Y que los adolescentes que tomaron el curso tuvieron un mayor conocimiento sobre sexualidad y anticonceptivos en el seguimiento. Los resultados obtenidos en el presente estudio tienen especial relevanacia en países de Latinoamérica, en donde la eduación sexual no forma parte de la mayoría de los programas escolares. Con base en los resultados de este estudio, el Instituto Mexicano de Investigación de Familia y Población (IMIFAP) está desarrollando programas y materiales para niños desde edad preescolar hasta preparatoria, incluyendo en éstos a maestros y padres