Provider attitudes toward IUD provision in Zimbabwe: perception of HIV risk and training implications.

This study was conducted to assess providers' attitudes toward the provision of long-term methods of contraception, in particular the IUD, and provider concerns about human immunodeficiency virus (HIV) in the context of family planning (FP) services. The data were collected using self-administered structured questionnaires. Between 65% and 80% of the public and private providers thought that the IUD is a good contraceptive method for Zimbabwean women. In addition, the majority of these two provider groups felt that neither the IUD nor tubal sterilization (TL) posed much risk of HIV infection to the client. A significant number of providers (especially the public nurses), however, thought that the provision of TL put the provider at high risk of HIV infection and a significant proportion of public nurses were also concerned about provider risk associated with providing IUD and injectables. To address such concerns, future training interventions should emphasize appropriate infection prevention practices associated with surgical FP method provision. Nurses, in particular, should be informed about the magnitude of risk associated with FP service provision and ways to protect themselves. Logistic activities also need to be strengthened so that legitimate concerns among providers regarding lack of adequate infection prevention supplies (e.g. gloves) in the field can be addressed.

Changing men's attitudes and behavior: the Zimbabwe Male Motivation Project.

A multimedia communication campaign was conducted between 1988 and 1989 to promote family planning among men in Zimbabwe. The campaign consisted of a 52-episode semiweekly radio soap opera, about 60 motivational talks, and two pamphlets about contraceptive methods. Changes over time were measured by comparing a subset of a follow-up survey conducted from October to December 1989 to a baseline survey conducted from April to June 1988. Men exposed to the campaign were also compared to men who were not exposed. The follow-up survey revealed that the campaign reached 52 percent of men aged 18 to 55. Among married Shona-speaking men, use of modern contraceptive methods increased from about 56 percent to 59 percent during the campaign. Condom use increased from about 5 percent to 10 percent. Awareness and current use of modern contraceptives was also higher among men exposed to the campaign, primarily because of their greater awareness of condoms. Men exposed to the campaign were significantly more likely than other men to make the decision to use family planning and to say that both spouses should decide how many children to have.

Norplant in Zimbabwe: preliminary report.

During an ongoing study of a pre-introduction trial of Norplant in Zimbabwe, 197 women had the subdermal implant of six capsules containing levonorgestrel inserted between June and December 1991, at Parirenyatwa, Harare Hospital and Spilhaus. Acceptability and efficacy were high and no significant side effects had been observed. Three implants were removed due to local infection. Our initial experience indicates that the Norplant continuation rate is much higher than for any other reversible method of contraception and it is highly acceptable as a long term contraceptive.

PIP: Although NORPLANT has been successfully used by women in developing and developed countries for the past 16 years, pre- introduction studies are nonetheless needed to assess method demand and acceptability in given countries. This paper presents findings from a 9-month pre-introduction trial in Zimbabwe. NORPLANT is a subdermal implant of 6 capsules containing levonorgestrel which provides contraceptive protection to female clients over a period of 5 years. 197 sexually active, previously pregnant women aged 17-40 received the implant in 1991. A 98% continuation rate has been observed over the period, with no implants having been removed on medical grounds or due to menstrual disturbance. Most clients tolerate the side effects of spotting and occasional heavy periods. This high rate of continuation is no doubt the result of good pre-insertion counseling, method convenience, and method efficacy with limited side effects.