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INTRODUCTION: This study explored adolescent and young adult preferences and experiences with telehealth-supported long-acting reversible contraceptive (LARC) services in New York City school-based health centers (SBHCs) during COVID-19. METHOD: Sequential mixed methods included post-LARC insertion surveys and in-depth interviews. RESULTS: Survey respondents (n = 45) were aged 14-21 years and predominantly Hispanic (53.3%). Only four respondents completed a postinsertion visit via telehealth. Most (82.2%) preferred in-person for future LARC visits; none preferred telehealth. Four themes emerged in interviews (n = 15): LARC self-efficacy and autonomy; SBHC convenience and accessibility; comfort with SBHC providers; and preference for in-person visits despite telehealth benefits. DISCUSSION: Although telehealth theoretically adds value to LARC service delivery, uptake and preference for telehealth in the SBHC context were low. Despite the perceived acceptability of telehealth, adolescents and young adults prefer in-person SBHC visits, suggesting SBHC access may eliminate barriers to care that telehealth seeks to overcome.
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Objective: To determine the frequency of contraceptive usage, the social barriers affecting their use, and the frequency of unplanned pregnancies during the COVID-19 pandemic Methodology: This is a prospective cross-sectional study carried out at the Department of Obstetrics and Gynaecology, Fazaia Ruth Pfau Medical College & PAF Hospitals from July 2020 to September 2020. All women of reproductive age attending the outpatient department were consecutively included. A pre-structured questionnaire was used for the purpose of collection of data. We obtained information regarding the use of contraception before and during the COVID-19 pandemic and the contraception methods used by these women. Furthermore, reasons for discontinuing contraception amongst those women who were using it earlier. The occurrence of pregnancy during pandemic was also noted. Results: Of the 350 women, 306 (87.4%) women practiced contraception before and 288 (82.3%) practiced it during the lockdown. Of 306 women practicing contraception before the lockdown, 265 (86.6%) continued practicing during the lockdown as well. Condom 145 (50.3%) and withdrawal method 116 (40.3%) were the most used methods amongst the 288 women practicing contraception during the lockdown. The noticeable increase in the number of those using withdrawal method was due to the lack of consultation following the fear of getting COVID (17 women, 41.5%) and no access to the clinic (14 women, 34.1%). These were the most common reasons for not using contraception, amongst the 41 women practicing contraception before the pandemic. Pregnancies were reported by 93 (26.6%) women out of whom 75 (80.6%) reported these to have been unplanned. Conclusion: The COVID pandemic has largely affected the utilization of contraceptives among women who were already practicing different contraceptive methods. Moreover, unplanned pregnancies are increasingly reported by women.
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Background: Contraceptives are an important component of women's reproductive health care, as they not only reduce the number of unwanted pregnancies, but also improve reproductive function. However, oral contraceptives are known to increase the risk of venous thromboembolism. This risk is increased by infection with the COVID-19 virus that predisposes patients to both venous and arterial thrombosis as a result of excessive inflammation, platelet activation, aggravated endothelial dysfunction, and congestive events. If these patients have hereditary thrombophilia, the risk of venous thromboembolism becomes fatal. Case report: The paper describes a clinical case of a patient with total portal vein thrombosis, who have been taking oral contraceptives for a long time and recovering from the novel coronavirus infection. Studying the blood coagulation system and folate cycle genes, by using PCR, has revealed a gene mutation in the plasminogen activator inhibitor (serpine). The authors demonstrate the data of spiral computed tomography of the abdominal organs, as well as changes in laboratory parameters. Conclusion(s): A balanced approach is required when prescribing combined oral contraceptives during the COVID-19 pandemic, especially in women with prothrombotic mutations.Copyright © A group of authors, 2023.
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Background: With the onset of COVID-19 pandemic, the life of humankind had changed a lot. With a change in health-care approach, contraception became a non-essential service and faced a downfall. Aims and Objective: This study objective is to find out the changes in contraceptive usage in a tertiary care center. Materials and Methods: The study is a retrospective observational study, in which contraceptive usage was compared between 2019 and 2020. Data obtained from record section of the institute were used as source. Attendance in Gynecological Outpatient Department, admission in maternity ward, and delivery rates were also compared between 2 years. Results: Total contraceptive usage was decreased by 11.1% in 2020. Long-acting reversible contraceptives or short-acting both types were decreased in 2020, but maximum decrease was barrier method condom by 25.1% and oral contraceptive pills by 24.9%. Hospital maternity ward admission was less by 7% and delivery rates by 2.4%. Only medical termination of pregnancy showed an increased trend in 2020. Conclusion: Pandemic also had caused a toll in family planning, and thus, overall decrease in usage was seen which can be detrimental to population control.
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Background: Contraceptives are an important component of women's reproductive health care, as they not only reduce the number of unwanted pregnancies, but also improve reproductive function. However, oral contraceptives are known to increase the risk of venous thromboembolism. This risk is increased by infection with the COVID-19 virus that predisposes patients to both venous and arterial thrombosis as a result of excessive inflammation, platelet activation, aggravated endothelial dysfunction, and congestive events. If these patients have hereditary thrombophilia, the risk of venous thromboembolism becomes fatal. Case report: The paper describes a clinical case of a patient with total portal vein thrombosis, who have been taking oral contraceptives for a long time and recovering from the novel coronavirus infection. Studying the blood coagulation system and folate cycle genes, by using PCR, has revealed a gene mutation in the plasminogen activator inhibitor (serpine). The authors demonstrate the data of spiral computed tomography of the abdominal organs, as well as changes in laboratory parameters. Conclusion(s): A balanced approach is required when prescribing combined oral contraceptives during the COVID-19 pandemic, especially in women with prothrombotic mutations.Copyright © A group of authors, 2023.
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Background: Contraceptives are an important component of women's reproductive health care, as they not only reduce the number of unwanted pregnancies, but also improve reproductive function. However, oral contraceptives are known to increase the risk of venous thromboembolism. This risk is increased by infection with the COVID-19 virus that predisposes patients to both venous and arterial thrombosis as a result of excessive inflammation, platelet activation, aggravated endothelial dysfunction, and congestive events. If these patients have hereditary thrombophilia, the risk of venous thromboembolism becomes fatal. Case report: The paper describes a clinical case of a patient with total portal vein thrombosis, who have been taking oral contraceptives for a long time and recovering from the novel coronavirus infection. Studying the blood coagulation system and folate cycle genes, by using PCR, has revealed a gene mutation in the plasminogen activator inhibitor (serpine). The authors demonstrate the data of spiral computed tomography of the abdominal organs, as well as changes in laboratory parameters. Conclusion(s): A balanced approach is required when prescribing combined oral contraceptives during the COVID-19 pandemic, especially in women with prothrombotic mutations.Copyright © A group of authors, 2023.
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BACKGROUND: Given the high burden of adverse sexual and reproductive health outcomes (SRH) and low levels of school attendance among adolescent girls in Kenya, this study sought to elucidate the association between school attendance and SRH outcomes among adolescent girls in Homa Bay and Narok counties. METHODS: This study uses baseline quantitative data from the mixed-methods evaluation of the In Their Hands (ITH) program which occurred between September to October 2018 in Homa Bay and Narok counties. In total, 1840 adolescent girls aged 15-19 years participated in the baseline survey, of which 1810 were included in the present analysis. Multivariable logistic regression models were used to assess the association between school attendance (in- versus out-of-school) and ever having sex, condom use during last sex, and ever pregnant, controlling for age, orphan status, income generation, religion, county, relationship status, and correct SRH knowledge. RESULTS: Across the 1810 participants included in our study, 61.3% were in-school and 38.7% were out-of-school. Compared to adolescent girls who were in-school, those out-of-school were more likely (AOR 5.74 95% CI 3.94, 8.46) to report ever having sex, less likely (AOR: 0.21, 95% CI 0.16, 0.31) to have used a condom during their last sexual intercourse, and more likely (AOR: 6.98, 95% CI 5.04, 9.74) to have ever been pregnant. CONCLUSIONS: School attendance plays an integral role in adolescent girls' SRH outcomes, and it is imperative that policy actors coordinate with the government and community to develop and implement initiatives that support adolescent girls' school attendance and education.
Adolescent girls in Kenya experience poor sexual and reproductive health outcomes (SRH) and have low levels of educational attainment. In this study, we aimed to examine if school attendance was associated with sexual and reproductive health outcomes among adolescent girls aged 15 to 19 years in Homa Bay and Narok counties in Kenya. The study used data from the evaluation of the In Their Hands (ITH) program which occurred between September to October 2018. A total of 1840 adolescent girls years participated in the baseline survey, of which 1810 were included in this study. We found that compared to adolescent girls in-school, those who were out-of-school were significantly more likely to report ever having sex, less likely to have used a condom during their last intercourse, and more likely to have ever been pregnant. This study found that attending school plays an important protective role in the SRH of adolescent girls. Therefore, it is important to develop and implement initiatives to support adolescent girls' school attendance, and ultimately their education attainment.
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Reproductive Health , Sexual Behavior , Pregnancy , Female , Humans , Adolescent , Cross-Sectional Studies , Reproductive Health/education , Kenya , SchoolsABSTRACT
BACKGROUND: Postpartum sterilization in Thailand has relatively few barriers compared to other countries. The procedure is covered by some healthcare plans, and paid out-of-pocket for others. We aim to determine if healthcare coverage and other socioeconomic factors affect the rate of postpartum sterilization in an urban, tertiary hospital. METHODS: We conducted a secondary analysis of data from a retrospective cohort of 4482 postpartum women who delivered at our hospital. Multivariable logistic regression was conducted to determine if sterilization reimbursement affects immediate postpartum sterilization rate. RESULTS: Overall immediate postpartum sterilization rate was 17.8%. Route of delivery and parity were similar in those who were reimbursed and those who were not. Women aged over 25 were more likely to have a healthcare plan that does not cover postpartum sterilization. Women whose healthcare plan reimbursed the procedure trended towards postpartum sterilization when compared to women who were not (aOR 1.05, 95% CI 0.86-1.28, p-value = 0.632). Women who delivered via cesarean section were more likely to undergo sterilization at the time of delivery (aOR = 5.87; 95% CI 4.77-7.24, p-value = < 0.001). Women aged 40-44 years were 2.70 times as likely to choose sterilization than those aged 20-24 years (aOR = 2.70; 95% CI 1.61-4.53, p-value < 0.001). CONCLUSIONS: Healthcare coverage of the procedure was not associated with increased postpartum sterilization in our setting.
Postpartum sterilization is an effective and popular method of contraception. In our hospital, postpartum sterilization is easily accessible compared to other countries where there are barriers such as mandatory waiting time, limited operating rooms and anesthesiologists. We examine factors that affect sterilization rates and found that older women and women with more children were more likely to choose postpartum sterilization. We also found that women who delivered by cesarean section were more likely to choose sterilization. Interestingly, whether the woman's healthcare plan covers postpartum sterilization does not affect the likelihood of sterilization.
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Cesarean Section , Sterilization, Tubal , Pregnancy , Female , Humans , Retrospective Studies , Tertiary Care Centers , Postpartum Period , Delivery of Health Care , Socioeconomic FactorsABSTRACT
OBJECTIVE: To review cases of acute macular neuroretinopathy (AMN) after COVID-19 vaccination and add a similar case to the literature. METHODS: A thorough PubMed search was conducted, and data from studies describing AMN after COVID-19 vaccination were extracted, tabulated, pooled, and reviewed. RESULTS: We present a case of AMN in a young woman 5 days after immunization with the BBIBP-CorV (Sinopharm) COVID-19 vaccine. Data from 21 cases were pooled and reviewed. The most frequent vaccines among the cases were recombinant ones (13/21), followed by mRNA-based (6/21) and inactivated vaccines (2/21). Only one patient (5%) was male. Seventeen over twenty-one (81%) were young women, ages 18-33. Most cases (14/21; 67%) reported recent/concurrent use of contraceptive medication. In 90% of cases (19/21), symptoms appeared within 8 days of vaccination. A confined wedge-/oval-shaped lesion morphology was more frequent than a diffuse, semilunar one. Resolution of symptoms took 4 to over 15 weeks. CONCLUSION: Attention should be paid to the history of vaccination and contraceptive use in patients with sudden-onset visual symptoms. Optical coherence tomography is integral to the detection of AMN-related abnormalities.
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COVID-19 Vaccines , COVID-19 , White Dot Syndromes , Adolescent , Adult , Female , Humans , Male , Young Adult , Acute Disease , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Vaccination/adverse effectsABSTRACT
Background: With the onset of COVID-19 pandemic, the life of humankind had changed a lot. With a change in health-care approach, contraception became a non-essential service and faced a downfall. Aims and Objective: This study objective is to find out the changes in contraceptive usage in a tertiary care center. Materials and Methods: The study is a retrospective observational study, in which contraceptive usage was compared between 2019 and 2020. Data obtained from record section of the institute were used as source. Attendance in Gynecological Outpatient Department, admission in maternity ward, and delivery rates were also compared between 2 years. Results: Total contraceptive usage was decreased by 11.1% in 2020. Long-acting reversible contraceptives or short-acting both types were decreased in 2020, but maximum decrease was barrier method condom by 25.1% and oral contraceptive pills by 24.9%. Hospital maternity ward admission was less by 7% and delivery rates by 2.4%. Only medical termination of pregnancy showed an increased trend in 2020. Conclusion: Pandemic also had caused a toll in family planning, and thus, overall decrease in usage was seen which can be detrimental to population control. [ FROM AUTHOR]
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This mini review explores the impact of the COVID-19 pandemic on adolescent sexual and reproductive health. We conducted a rapid review of the literature across three databases, with a particular focus on the African continent. Few studies have specifically focused on adolescents in Africa and this paper contributes to this paucity of research. Findings revealed the unintended consequences of the pandemic. Studies across several countries showed that the respective lockdown measures restricted adolescents' access to sexual and reproductive health services. The literature also showed increases in adolescent pregnancies during the lockdown, along with increases in reports of sexual violence against adolescents. We conclude this paper by offering recommendations to address these unintended consequences and potentially improve adolescent sexual and reproductive health in African communities.
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Among the problems that affect families in several developing countries such as the Democratic Republic of Congo (DRC) there is poverty due to the drop in income and the difficult general economic situation hampered by the Corona virus pandemic which constrains the inhabitants of this country, especially the city dwellers, to resort to multiple survival strategies. This situation weakens most families to exercise their functions, in particular that of a body for the socialization and protection of its members. According to the Ministry of Health, among adolescent girls aged 16 to 21, who represent 41% of the female population of the survey. Getting pregnant comes from the fact that adolescent girls are not informed about how their bodies work, they often do not know the fertile periods, they also ignore the use of condoms as a contraceptive method, as well as the false information that adolescents exchange about sexuality to convince their female partners. (DHS 2014). Indeed, in the city of Gbadolite and, most families with single mothers are prey to conflicts often find their outcome in violence, hatred, defamation or even divorce of the parents, the extent of which cannot be allow different social analysis that is the demographer hence the interest in circumscribing the motivations that contribute to their occurrence and in suggesting possible solutions so that works of youth prepared for their family responsibilities and social.Alternate :Parmi les problèmes qui affectent les familles dans plusieurs pays en voie de développement comme la République Démocratique du Congo (RDC) y figure la pauvreté due à la baisse des revenus et la conjoncture économique générale difficile entravé par la pandémie à Corona virus qui contraignent les habitants de ce pays, surtout les citadins à recourir à des stratégies de survies multiples. Cette situation affaiblit la plupart des familles à exercer leurs fonctions, notamment celle d'instance de socialisation et de protection de ses membres. Selon le Ministère de santé, parmi les adolescentes âgées de 16 à 21 ans et qui représentent 41% de la population féminine de l'enquête. Tomber enceinte vient du fait que les adolescentes et ne sont pas informées sur le fonctionnement de leur corps, elles ne savent pas souvent les périodes fécondes, elles ignorent également l'utilisation des préservatifs comme moyen contraceptif, ainsi que des fausses informations que les adolescents échangent au sujet de la sexualité pour convaincre leurs partenaires féminins. (EDS 2014). En effet, dans la ville de Gbadolite et, la plupart des familles qui ont des filles-mères sont en proie à des conflits trouvent souvent leur dénouement dans la violence, la haine, la diffamation voire le divorce des parents dont l'ampleur ne peut laisser différente analyse sociale qu'est le démographe d'où l'intérêt à circonscrire les motivations qui concourent à leur survenance et à suggérer des pistes des solutions pour que s'édifient à Gbadolite des oeuvres d'une jeunesse préparée à ses responsabilités familiales et sociales.
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Upstream selected clinical sites for recruitment based on patient volume, current state of contraceptive care, regional variation, patient demographics, and health center buy-in to implement Upstream's program with fidelity. Programming content for both teams included the following: 1. educating and coaching clinicians and support staff on how to provide patient-centered contraceptive counseling that is free of bias or coercion;2. providing technical assistance to stock the full range of contraceptive methods;3. supporting billing and coding to optimize reimbursement ofcontraceptive services and methods;4. revising or creating department or agency policies to enable highquality, sustainable practice change related to contraceptive care;5. incorporating a pregnancy intention screening or contraceptive needs assessment question, contraceptive counseling, and documentation of contraceptive method use into clinical workflows, often including the hospital's or agency's electronic health record (EHR) system;6. establishing strategies to ensure that a patient can receive their desired contraceptive method on the same day as their visit, including long-acting reversible contraceptive (LARC) methods;and 7. enhancing emergency contraception services. The additional programming areas and technical assistance of the Upstream intervention with partner health practices included: (1) training all agency staff on current best practices and clinical knowledge of high-quality contraceptive care;(2) coordinating clinician precepting for LARC placement and removal;(3) where necessary, providing funding to stock the full range of contraceptive methods;and (4) providing patient education materials for use during clinical visits. EVALUATION STRATEGIES AND EARLY FINDINGS At the outset of the Massachusetts initiative, both teams and representatives from the Massachusetts Department of Public Health and Massachusetts' Medicaid program worked collaboratively to design an evaluation plan for the fiveyear project.
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The Association of State and Territorial Health Officials Increasing Access to Contraception Learning Community project, conducted in collaboration with the Centers for Disease Control and Prevention's Division of Reproductive Health, implemented a series of learning communities with 27 multidisciplinary teams (from 26 states and one territory) between 2014 and 2018 to improve access to the full range of contraceptive methods. The Association of State and Territorial Health Officials, the National Association for County and City Health Officials, and the National Association of Community Health Workers will partner to build the community health workforce through collaboration with community-based organizations.8 In this next phase of "life with COVID," the expanded community workforce has an opportunity to pivot to addressing other public health priorities such as contraception access with trusted frontline workers in communities serving as a link between health and social services. During the COVID-19 pandemic, public health, clinical, and community organizations have been leading data collection activities to better understand the digital literacy and telehealth experiences of patients and providers and have been working closely with providers to expand services and the capacity of communities to deliver them.9 Examples include public health efforts to accomplish digital inclusion and telehealth equity assessments, the creation of "heat maps" identifying barriers and access points for unavailable specialty services,10 and training and employment of community members in places such as libraries as digital navigators to support telehealth services.11 Early in 2020, the Office of Population Affairs of the US Department of Health and Human Services authorized telehealth as an option for Title X family planning clinics across the country and announced $35 million in grants for the Title X program to support telehealth as a means of sustaining access to contraceptive health services.12 Including contraception access within such endeavors can enhance access to services, support clinical reach, and build capacity within communities.
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This journal issue includes 201 s of papers presented at the conference. Topics discussed include: association between cannabis use and COVID-19 and distress among adolescent patients;COVID-19 exposure and care-seeking behaviors among vulnerable urban adolescents and young adults;assessment of a poverty simulation in medical education;prevalence of chronic pelvic pain by sexual orientation in a large cohort of young women in the USA;confidentiality and patient satisfaction in adolescent telehealth visits;predictors of adolescent telemedicine visit no-shows during the COVID-19 pandemic;simulation of contraceptive access for adolescents using a pharmacist-staffed e-platform;foster caregivers and their role in contraception decision-making for adolescents in care.
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Despite the loss of support, contraceptive use in low- and middle-income countries prevented 135 million unintended pregnancies, 28 million unsafe abortions, and 140,000 deaths of women of reproductive age last year, according to the report. Jason Bremner, FP2030 “The focus for the next decade must be on building sustainability, with diversified funding streams and efficient use of resources,” says Jason Bremner, head of data and performance management at FP2030, a global partnership focused on family planning. See PDF] Adam Wexler, associate director for global health and HIV policy at the Kaiser Family Foundation, says that the funding decline in 2020 is largely driven by the UK, partly as a result of cuts to official development assistance resulting from COVID-driven economic contractions.
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This article provides information on the impact of a new coronavirus infection on the nature of menstrual function in gynecological patients in 2021–2022 years and methods for correcting menstrual irregularities. According to the data obtained as a result of the study, the degree of menstrual dysfunction in patients examined 6 months after suffering COVID-19 infection was higher than before the development of the disease due to the development of oligomenorrhea, amenorrhea and abnormal uterine bleeding. The results obtained in the course of our studies are consistent with the data of other authors, indicating a high percentage of menstrual irregularities after a coronavirus infection. Given the high significance of this problem, further in-depth studies in this direction are needed to elucidate the leading causes of such disorders. The effectiveness of the low-dose monophasic combined oral contraceptive belara has been shown both in monotherapy and in combination with the natural drug mastodinone as a corrective therapy for menstrual irregularities. A positive trend in reducing the manifestations of premenstrual syndrome, oligomenorrhea, secondary amenorrhea, abnormal uterine bleeding, algomenorrhea, convenience and safety of the use of drugs was established. The expediency of using the proposed therapy has been established. © 2022, Professionalnye Izdaniya. All rights reserved.
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Family planning is now viewed as a developmental behavior. It not only improves maternal and infant health but also is directly linked to the overall well-being of the family. India has a high unmet need and the use of modern contraceptives is not satisfactory though it has improved a lot currently. Achieving the FP 2020 goals an important activity of the government. Covid 19 pandemic has stood as a barrier in family planning service delivery. Experts voiced concerns about rising unwanted pregnancies, unsafe abortions during the pandemic, and the rise of maternal and infant mortality during the post covid period due to falls in contraceptive services. Perceived thoughts and reality is discussed.