[Vaginal citology. Prevention and good health. Survey]. / Citologia vaginal. Prevencion y buena salud. Encuesta.

PIP: A 1993 survey of knowledge, attitudes and practices related to sexually transmitted diseases and other conditions included a series of questions for women on vaginal cytology. The survey was based on a subsample of the PROFAMILIA master sample. 15,080 persons were interviewed, including 6949 women 18-69 years old. The section on vaginal cytology began with a description of the procedure before the questions were asked. Among the total sample, 66.2% reported having undergone cervical cytology while 33.8% had not. 4.8% did not request the results. For the 61.4% of the sample that requested the results, 49.4% were normal, 11.1% were abnormal, and 0.9% did not know or were not given their results. Of those with abnormal results, 9.3% returned for another consultation and 1.8% did not. The proportion of women having cervical cytology exceeded 80% for women 30-49 years old. 69.9% of urban and 54.2% of rural women had been tested. 28.9% underwent the most recent test due to a personal decision, 24.7% on medical recommendation, 23.2% because of symptoms, 12.0% to prevent cancer, 3.2% for safety, 2.0% because a year had passed since the last test, 2.0% in response to a campaign, 1.6% because a friend suggested it, and 1.1% because they had never had it done. The symptoms that motivated the test were a discharge for 31.4%, pain for 30.0%, bleeding for 11.8%, itching for 5.5%, postpartum problems for 2.8%, burning for 2.5%, and cyst for 1.9%. Abnormal results were obtained in 40% of the women who had the test because of symptoms. The average number of times in the past 5 years that the test was done was 2.8. 9% of respondents had not had a test in the past 5 years, 26% had 1, 18% had 2, 12% had 3, 7% had 4, 16% had 5, and 11% had 6 or more. 64.4% of women under 25 and 39% over 60 had never had vaginal cytology. Rural women and the less educated were less likely to have had the procedure.^ieng

Increasing FP access in Brazil.

PIP: A 1979 survey of women aged 15-45 years from Sao Paulo, Brazil, concerning their contraception use demonstrates the impact of family planning, even without an official family planning program. 23% of the women were using the pill and 16% were sterilized. Very few used diaphragms, condoms, or IUDs. Although there is now an official family planning program in Brazil, only middle and upper class women have access to sophisticated means of birth control. Poor women are limited to tubal ligation which is often disguised as a cesarean section (the rate at some hospitals for this operation is 90%). Since the Integrated Project was introduced in 2 pilot areas in 1983, 12 branches, where community representatives run monthly discussion meetings and classes are held on family planning methods, have been established in the city. Nurses coordinate volunteer efforts. The program began in slum areas by utilizing the nurses and nurseries already in place to care for children of working women. New expansion will require integrating the family planning program into other established, nongovernmental organizations and working with municipal and state governments.^ieng

[Perception of reproductive risk factors]. / Percepción de factores de riesgo reproductivo.

The objective of this study was to identify risk perception on several factors related to reproductive health, with the goal of implementing an educational intervention based on detected needs. 405 women between 12 and 44 years were interviewed at home. 62.2% perceived the risk of pregnancy at 17 years and younger; 78.8% the risk of pregnancy at 35 years and older; 76.6% the risk of parity of 5 and higher; and 55.1% the risk of birth interval of 2 years and less. 60.5% recognized family history of birth defects, 80.2% age 35 years and older, and 84.4% rubella during pregnancy, as risk factors for newborns with congenital malformations. 27.7% identified history of a low birth weight and 61.0% birth interval of 1 year and less, as risk factors for low birth weight. The majority perceived the risk of tobacco, alcohol and drugs consumption during pregnancy, diseases with no treatment and deficient nutrition. There was an inconsistent influence of social and obstetric variables on risk perception. No linear correlation was detected. Health educators should recognize differences on knowledge and behavior of future receptors before an educational intervention starts.

PIP: 405 lower class women aged 12-44 in the Delegacion Miguel Hidalgo, Mexico City, were interviewed in their homes in an effort to identify patterns in their perceptions of reproductive risk factors. The women were interviewed in late 1989 with a largely precoded questionnaire containing items described in the literature as risk factors for pregnancy, low birth weight, and birth defects. 7.9% of the respondents were 12-15 years old, 17.3% were 16-20, 37.0% were 21-30, 24.4% were 31-40, and 13.3% were 41-44. 24.9% were single, 59.5% were married, and 12.0% were in free union. 7.9% had no education, 33.8% had primary, 33.8% secondary, 20.9% preparatory, and 3.5% professional educations. Among the 300 women who had children, 23.6% had 1, 48.9% had 2-3, and 28.3% had 4 or more. 22.7% had histories of abortion, 1.3% of stillbirths, 15.7% of premature labor, 11.3% of low birth weight infants, 4.7% of neonatal deaths, and 5.0% of infant death. 62.2% perceived the risk of pregnancy at 17 years or younger, 78.8% the risk of pregnancy at age 35 or over, 70.6% the risk of a 5th or higher order pregnancy, and 55.1% the risk of a birth interval of less than 2 years. The majority perceived smoking, drinking alcohol, untreated pathologies during pregnancy, and inadequate nutrition to be risk factors. 27.7% identified a history of low birth weight infants and 61.0% birth intervals of 1 year or less as risk factors for low birth weight. 60.5% recognized family history of birth defects, 80.2% maternal age of 35 or over, and 84.4% rubella during pregnancy as risk factors for congenital malformations. The influence of sociodemographic and obstetric variables on perception of risks was inconsistent and no linear correlations were detected. Health educators should recognize differences in levels of knowledge and behavior in the target population when the educational program is designed.