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2.
Title: Intrauterine devices: an effective alternative to oral hormonal contraception.
Source: Prescrire International. 2009 Jun;18(101):125-30.
Abstract: (1) Intrauterine devices (IUDs) are placed in the uterine cavity with the objective of providing long-term contraception, mainly by preventing fertilisation. The best-known IUDs contain copper, but there is also an IUD delivering levonorgestrel, a progestin; (2) How effective are these devices, and what are their adverse effects? To answer these questions, we analysed the literature using the standard Prescrire methodology; (3) T-shaped copper IUDs, with a copper surface area of 380 mm2 on 3 arms, and the levonorgestrel-releasing device, have similar contraceptive efficacy as combined oral contraceptives that are used correctly. In contrast, IUDs are more effective than oral contraception used incorrectly; (4) Among IUD users, there are on average about 6 pregnancies per 1000 woman-years. There is less experience with the levonorgestrel IUD which seems to be at least as effective as copper IUDs; (5) The rare intrauterine pregnancies that occur in women using an IUD generally end in miscarriage. About 25% of these pregnancies end in a live birth if the device is left in place, compared to about 90% if the device is removed; (6) Ectopic pregnancies are rarer in IUD users than in women who do not use contraception. However, about one in 20 pregnancies that occur in women using an IUD is ectopic; (7) The IUD is expelled in about 5% to 10% of cases within 5 years, and expulsion recurs in about 30% of these women; (8) Problems such as difficult insertion, pain, bleeding and syncope are reported in less than 1.5% of cases overall; (9) Uterine perforation during insertion is rare, occurring in 0.6 to 16 cases per 1000 insertions, regardless of the type of IUD. The risk of perforation is higher when the IUD is inserted less than 4 to 6 weeks after delivery or elective abortion; (10) During the first 3 months after insertion, the risk of pelvic infection is slightly higher than in the general population, especially in women with pre-existing asymptomatic Chlamydia trachomatis infection. There are about 6 pelvic infections per 1000 woman-years of IUD use. Routine antibiotic prophylaxis is unnecessary. The interview and physical examination may lead to diagnosis of C. trachomatis infection or other sexually transmitted infections. In these cases, treatment may be needed before IUD insertion. Women must be warned that IUDs do not protect them from sexually transmitted diseases; (11) Menstrual bleeding is often heavier in women with cooper IUDs than in women who do not use IUDs, and may be associated with menstrual pain; (12) The levonorgestrel IUD is associated with a marked reduction in menstrual blood loss and irregular bleeding; amenorrhoea occurs in 35% of women after 2 years of use. The levonorgestrel IUD also has hormonal adverse effects such as headache, acne, breast tension and functional ovarian cysts; (13) IUDs can safely be used in breastfeeding women, immediately after a pregnancy, in cases of diabetes or HIV infection, during nonsteroidal antiinflammatory drug therapy, and after an ectopic pregnancy. The only problems occurring in women who have never had children are pain during insertion and more frequent expulsions; (14) A copper IUD is a first-line contraceptive method for women with a history of deep venous thrombosis, pulmonary embolism, or coronary events; (15) It is better to postpone IUD insertion when the woman has a genital tract infection or unexplained vaginal bleeding; (16) IUD insertion is an effective alternative to "morning-after" hormonal contraception.
Language: English
Keywords:
GLOBAL | LITERATURE REVIEW | IUD | CONTRACEPTIVE MODE OF ACTION | IUD COMPLICATIONS | IUD EXPULSION | INSERTION | IUD SIDE EFFECTS | CONTRACEPTIVE EFFECTIVENESS | CONTRACEPTIVE SAFETY | PREGNANCY, ECTOPIC | UTERINE PERFORATION | Contraceptive Methods | Contraception | Family Planning | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Safety | Public Health | Pregnancy Complications | Diseases | Perforations
Document Number: 342301

Peer Reviewed

Title: Oral contraceptives for functional ovarian cysts.
Source: Obstetrics and Gynecology. 2009 Sep;114(3):679-80.
Abstract: BACKGROUND:: Functional ovarian cysts are a common gynecological problem among women of reproductive age worldwide. When large, persistent, or painful, these cysts may require operations, sometimes resulting in removal of the ovary. Since early oral contraceptives were associated with a reduced incidence of functional ovarian cysts, many clinicians inferred that birth control pills could be used to treat cysts as well. This became a common clinical practice in the early 1970s. OBJECTIVES:: This review examined all randomized controlled trials that studied oral contraceptives as therapy for functional ovarian cysts. SEARCH STRATEGY:: We searched the databases of CENTRAL, MEDLINE, POPLINE, and EMBASE, as well as clinical trials databases (ClinicalTrials.gov and ICTRP). We also examined the reference lists of articles and wrote to authors of identified trials to seek articles we had missed. SELECTION CRITERIA:: We included randomized controlled trials in any language that included oral contraceptives used for treatment and not prevention of functional ovarian cysts. Criteria for diagnosis of cysts were those used by authors of trials. DATA COLLECTION AND ANALYSIS:: Two authors independently abstracted data from the articles. One entered the data into RevMan and a second verified accuracy of data entry. For dichotomous outcomes, we used Peto odds ratios with 95% confidence intervals (CIs). For continuous outcomes, we calculated mean differences with 95% CI. MAIN RESULTS:: We identified seven randomized controlled trials from four countries; the studies included a total of 500 women. Treatment with combined oral contraceptives did not hasten resolution of functional ovarian cysts in any trial. This held true for cysts that occurred spontaneously as well as those that developed after ovulation induction. Most cysts resolved without treatment within a few cycles; persistent cysts tended to be pathological (e.g., endometrioma or para-ovarian cyst) and not physiological. AUTHORS' CONCLUSION:: Although widely used for treating functional ovarian cysts, combined oral contraceptives appear to be of no benefit. Watchful waiting for two or three cycles is appropriate. Should cysts persist, surgical management is often indicated.Grimes DA, Jones LB, Lopez LM, Schulz KF. Oral contraceptives for functional ovarian cysts. Cochrane Database of Systematic Reviews 2006, Issue 4. Art. No.: CD006134. DOI: 10.1002/14651858.CD006134.pub2. Copyright the Cochrane Collaboration, reproduced with permission.
Language: English
Keywords:
GLOBAL | RESEARCH REPORT | LITERATURE REVIEW | INCIDENCE | OVARIAN CYSTS | ORAL CONTRACEPTIVES | TREATMENT | EXAMINATIONS AND DIAGNOSES | Measurement | Research Methodology | Diseases | Contraceptive Methods | Contraception | Family Planning | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 342569

4.
Title: Plan B for 17-year olds.
Source: Medical Letter On Drugs and Therapeutics. 2009 May 18;51(1312):40.
Abstract: The FDA has announced that it will lower the age for over-the-counter access to the emergency contraceptive Plan B from 18 to 17 years old. In a randomized, controlled trial, the two 0.75-mg levonorgestrel tablets in Plan B, taken 12 hours apart beginning within 72 hours after unprotected intercourse, decreased the overall pregnancy rate to 1.1% (11/976) of women who requested emergency contraception. The sooner the drug is taken after coitus, the more effective it is. Nausea and vomiting can occur with Plan B. Fetal malformations have not been associated with pregnancies that occurred despite use of levonorgestrel-only emergency contraception. (full-text)
Language: English
Keywords:
UNITED STATES OF AMERICA | USFDA | ADOLESCENTS | EMERGENCY CONTRACEPTION | ADMINISTRATION AND DOSAGE | PROGRAM ACCESSIBILITY | Developed Countries | North America | Americas | USPHS | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Contraception | Family Planning | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Program Evaluation | Programs | Organization and Administration
Document Number: 341625

6.
Title: Contraceptive use among postpartum women - 12 states and New York City, 2004-2006.
Author: Centers for Disease Control and Prevention (CDC)
Source: MMWR. Morbidity and Mortality Weekly Report. 2009 Aug 7;58(30):821-6.
Abstract: Postpartum use of highly effective contraceptive methods can prevent unintended pregnancies and ensure adequate birth spacing. Unintended pregnancies and short interpregnancy intervals are associated with adverse maternal and infant outcomes. In 2001, the year for which the most recent data are available, 49% of all pregnancies were unintended, and 21% of women gave birth within 24 months of a previous birth. Two Healthy People 2010 goals are to increase the percentage of intended pregnancies to 70% (objective 9-1) and to reduce the percentage of births occurring within 24 months of a previous birth to 6% (objective 9-2). To estimate the prevalence and types of contraception being used by women 2-9 months postpartum, CDC analyzed data from the 2004-2006 Pregnancy Risk Assessment Monitoring System (PRAMS) from 12 states and New York City. This report summarizes those results, which indicated that 88.0% of postpartum women reported current use of at least one contraceptive method; 61.7% reported using a method defined as highly effective, 20.0% used a method defined as moderately effective, and 6.4% used less effective methods. Rates of using highly effective contraceptive methods postpartum were lowest among Asian/Pacific Islanders (35.3%), women who had wanted to get pregnant sooner (49.9%), women aged >or=35 years (53.0%), and women who had no prenatal care (54.5%). State policy makers and health-care providers can use these results to promote use of highly effective contraception among postpartum women and target interventions for those with particularly low rates of usage, including women with no prenatal care.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | DATA ANALYSIS | POSTPARTUM WOMEN | ETHNIC GROUPS | CDC | CONTRACEPTIVE USAGE | CONTRACEPTIVE METHODS CHOSEN | CONTRACEPTIVE EFFECTIVENESS | PREGNANCY, UNPLANNED | AGE FACTORS | TITLE 19 MEDICAL ASSISTANCE | Developed Countries | North America | Americas | Research Methodology | Puerperium | Reproduction | Cultural Background | Population Characteristics | Demographic Factors | Population | USPHS | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Contraception | Family Planning | Reproductive Behavior | Fertility | Population Dynamics | Public Assistance | Grants | Financial Activities | Economic Factors
Document Number: 342395

Title: Expanding access to injectable contraception.
Author: Family Health International [FHI]
Source: [Unpublished] [2009]. 12 p.
Abstract: A number of technological developments can make injections safer for administration, whether by health personnel, trained community workers or the women themselves: sub-cutaneous injections, which have less complications than intra-muscular injections; non-reusable disposable syringes Distribution by community health workers needs special attention to: the possibility that a woman is already pregnant (or seeking an abortion by using an injectable); the screening of women with pre-existing conditions or on medications; the need for counselling for side-effects (in particular: vaginal bleeding irregularities, amenorrhea, weight gain, delay in return to fertility); the safety of injections to the woman and to the health worker; the possible confusion between different injectables --provided by public and private sectors. To complement pre-service and in-service training, a number of job aids are available to support community workers providing injectables: medical eligibility criteria wheel to screen for eligibility; pregnancy checklist; simplified material for the management of side-effects (bleeding, amenorrhea, weight changes, etc). (Excerpt)
Language: English
Keywords:
GLOBAL | TABLES AND CHARTS | INJECTABLES | DEPO-PROVERA | CONTRACEPTIVE EFFECTIVENESS | CONTRACEPTIVE PREVALENCE | CONTRACEPTIVE AVAILABILITY | PROGRAM ACCESSIBILITY | COMMUNITY-BASED DISTRIBUTION | CONTRACEPTIVE SAFETY | MATERNAL MORTALITY | CAUSES OF DEATH | Contraceptive Methods | Contraception | Family Planning | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Usage | Program Evaluation | Programs | Organization and Administration | Nonclinical Distribution | Distributional Activities | Program Activities | Safety | Public Health | Health | Mortality | Population Dynamics | Demographic Factors | Population
Document Number: 331838

Title: Quick reference guide to family planning research.
Author: Family Health International [FHI]
Source: [Research Triangle Park, North Carolina], FHI, 2009 Jan. 51 p. (Research to Practice)
Abstract: This document is a summary of research and program findings that FHI believes could improve family planning and reproductive health services if they were more widely incorporated into policies and programs. The following topics are covered: Preventing Mother-to-Child Transmission of HIV through Family Planning; Integrating HIV Voluntary Testing and Counseling and Family Planning Services; Intrauterine Devices; Emergency Contraceptive Pills; Vasectomy; Male Condoms; Female Condoms; Standard Days Method; Eligibility Screening and Provider Checklists; Community-Based Services and Distribution; Youth (ages 10-24); Implants; Contraceptive Continuation; Male Circumcision and HIV; Contraceptive Counseling and Job Aids; Healthy Timing and Spacing of Pregnancies; Postpartum Family Planning.
Language: English
Keywords:
GLOBAL | CATALOG | RESEARCH ACTIVITIES | FAMILY PLANNING POLICY | CONTRACEPTIVE METHODS | HIV/FP INTEGRATION | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | EMERGENCY CONTRACEPTION | CONTRACEPTION CONTINUATION | MALE CIRCUMCISION | COMMUNITY-BASED DISTRIBUTION | COUNSELING | YOUTH PROGRAMS | POSTPARTUM PROGRAMS | Research Methodology | Population Policy | Social Policy | Policy | Political Factors | Sociocultural Factors | Family Planning | Contraception | Programs | Organization and Administration | Disease Transmission Control | Prevention and Control | Diseases | Contraceptive Usage | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Nonclinical Distribution | Distributional Activities | Program Activities | Clinic Activities | Family Planning Programs
Document Number: 331689

Title: Scientists recommend new design for female condom research.
Author: Family Health International [FHI]
Source: [Research Triangle Park, North Carolina], FHI, [2009]. [2] p. (Research Briefs on the Female Condom)
Abstract: As the result of a USAID-supported workshop organized by the nonprofit organization CONRAD, scientists have proposed a new design for studies testing the effectiveness of innovations in the female condom. For a female condom to gain regulatory approval in the United States, the U.S. Food and Drug Administration (FDA) currently requires that the product be tested in a large -- and often expensive -- phase III contraceptive-effectiveness trial. CONRAD held the workshop specifically so that experts on female condoms and semen biomarkers could explore acceptable alternatives to this type of trial. The experts identified the well-studied biomarker prostate-specific antigen (PSA) as the most promising marker to pursue for this application. The new study design uses PSA to show the presence of semen in the vagina, which should be a more reliable indicator of clinical condom failure than is the incidence of pregnancy or a sexually transmitted infection. A report of the workshop and the details of the study design are published in the journal Contraception. (Excerpt)
Language: English
Keywords:
UNITED STATES OF AMERICA | SUMMARY REPORT | STUDY DESIGN | WORKSHOPS | FEMALE CONDOMS | CONTRACEPTIVE EFFECTIVENESS | CONTRACEPTION RESEARCH | CONDOM FAILURE | SEMEN | ANTIGENS | VAGINA | Developed Countries | North America | Americas | Research Methodology | Education | Vaginal Barrier Methods | Barrier Methods | Contraceptive Methods | Contraception | Family Planning | Condoms | Seminal Vesicles | Genitalia, Male | Genitalia | Urogenital System | Physiology | Biology | Immunologic Factors | Immunity | Immune System | Genitalia, Female
Document Number: 331704

10.

Title: Use of and unmet need for injectable contraception.
Author: Family Health International [FHI]
Source: [Unpublished] 2009 Jun 8. 12 p.
Abstract: Understanding trends in contraceptive use and unmet need for family planning is critical to creating policies which respond to current gaps in service delivery and address future needs for services to meet existing and unmet demand. Creating non clinic-based mechanisms to deliver services has the potential to expand access to underserved populations and reduce pressure on weak health systems. This document examines patterns of the current use of and unmet demand for injectable services. Trends in use of clinic and non clinic-based services for injectables, differentials in injectable use by place of residence, and potential negative consequences of increased use of injectables are explored. Information described in this paper is intended to inform the Technical Consultation on Expanding Access to Injectable Contraception. (Excerpt)
Language: English
Keywords:
DEVELOPING COUNTRIES | TECHNICAL REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | INJECTABLES | CONTRACEPTIVE USAGE | NEEDS | COMMUNITY-BASED DISTRIBUTION | CLINICAL DISTRIBUTION | PHARMACIES | CONTRACEPTIVE DISTRIBUTION | GEOGRAPHIC FACTORS | CONTRACEPTION CONTINUATION | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Economic Factors | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Health Facilities | Delivery of Health Care | Health
Document Number: 331836

11.

Title: Community-based distribution of injectable contraceptives. Approaches that work.
Author: Futures Group International. Health Policy Initiative
Source: Washington, D.C., Futures Group International, Health Policy Initiative, 2009 Apr. [1] p.
Abstract: Contraceptive prevalence rates in many sub-Saharan African countries surged in the mid-1990s. Much of this increase can be attributed to additional resources devoted to family planning (FP) programs and the uptake of specific methods, including injectable contraceptives. For example, use of injectables in Malawi grew from 2 percent in 1992 to 18 percent in 2004. Surveys in many African countries have found that women prefer injectable contraceptives; in some cases, preference for injectables is 2-1 over oral contraceptives and other methods. In recent years, however, these same countries have experienced a stagnation or decline in overall contraceptive prevalence. Particularly in rural areas, modern contraceptives are often scarce, and few trained professionals are available to provide FP services. One way to increase access to and use of family planning is to promote community-based distribution (CBD) of injectables. Countries struggling with stagnating contraceptive prevalence can begin to alterthis trend by training and empowering community-based workers to provide injectable contraceptives.
Language: English
Keywords:
DEVELOPING COUNTRIES | SUMMARY REPORT | CONTRACEPTIVE PREVALENCE | INJECTABLES | ORAL CONTRACEPTIVES | COMMUNITY-BASED DISTRIBUTION | PRIVATE SECTOR | HEALTH SERVICES | Contraceptive Usage | Contraception | Family Planning | Contraceptive Methods | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Macroeconomic Factors | Economic Factors | Delivery of Health Care | Health
Document Number: 331532

12.

Title: RAPID Mali: Population, development, and quality of life.
Author: Futures Group International. Health Policy Initiative; Mali. Minist�re de la Sant�
Source: [Bamako], Mali, Futures Group International, Health Policy Initiative, 2009 May. [56] p.
Abstract: Mali's population has tripled since it achieved independence in 1960. The country's fertility rate has remained stagnant for the past two decades and contraceptive prevalence rates remain much lower than in many other African countries. At the current rate of growth, the population would double in size in about 24 years. The purpose of this presentation is to examine some of the implications of this rapid growth for Mali's social and economic development. It is divided into six sections: Mali's Vision; Population Situation; Relationship Between Population and Economic Development; Population and Socioeconomic Development; Contraceptive Use, Unmet FP Need, and Effects of High Fertility on Maternal and Child Health; and Policy Response. This powerpoint presentation draws on analysis conducted using the RAPID model.
Language: English
Keywords:
MALI | SUMMARY REPORT | YOUTH | CONTRACEPTIVE USAGE | FERTILITY | FAMILY PLANNING | MATERNAL HEALTH | CHILD HEALTH | POLICY | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Age Factors | Population Characteristics | Demographic Factors | Population | Contraception | Population Dynamics | Health | Political Factors | Sociocultural Factors
Document Number: 331558

13.

Title: The logistics handbook: A practical guide for supply chain managers in family planning and health programs.
Author: John Snow [JSI]. DELIVER
Source: Arlington, Virginia, JSI, DELIVER, 2009 Jul. 182 p. (USAID Contract No. GPO-I-01-06-00007-00) Oringinally published in 2004.
Abstract: The Logistics Handbook includes the major aspects of logistics management with an emphasis on contraceptive supplies. The text should be helpful to managers who work with supplies every day as well as managers who assess and design logistics systems for entire programs. Policymakers may find the text useful in exploring the inputs needed to create an effective logistics system. Key terms and concepts are clearly defined and explained, and the design and implementation of management information systems and inventory control are discussed in detail. Storage and quality control practices are also discussed, and overviews of forecasting and procurement processes are included.
Language: English
Keywords:
DEVELOPING COUNTRIES | MANUAL | USAID | FAMILY PLANNING PROGRAMS | LOGISTICS | CONTRACEPTIVE METHODS | DRUGS | INFORMATION RETRIEVAL SYSTEMS | RECORDS | QUALITY CONTROL | MONITORING | STORAGE AND WAREHOUSES | IMPLEMENTATION | PLANNING | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Family Planning | Management | Organization and Administration | Contraception | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Data Storage and Retrieval | Information Processing | Information | Evaluation | Programs
Document Number: 331681

14.

Title: Success story: Bangladesh averts a stock crisis with help from the USAID | DELIVER PROJECT.
Author: John Snow [JSI]. DELIVER
Source: Arlington, Virginia, JSI, DELIVER, 2009 Apr. [2] p. (USAID Deliver Project, Task Order 1)
Abstract: In the fall of 2007, the Ministry of Health in Bangladesh faced a severe shortage of condoms in the public sector; countrywide stockouts were very likely. A shipment was underway, but despite negotiated contracts, the supplier made some last minute changes that were unacceptable to the Government of Bangladesh (GoB). While the GoB and the supplier continued to negotiate, the condom supply dwindled. December 2007 approached, and the condom stocks continued to go down. It soon became clear that negotiations with the supplier were not going to be resolved in time to head off a countrywide stockout of public sector condoms. As always, the Directorate General of Family Planning (DGFP) and the USAID | DELIVER PROJECT jointly monitored the consumption and pipeline for public sector products; the project kept the U.S. Agency for International Development (USAID) and other partners informed of the potential stock issues. The USAID | DELIVER PROJECT, in discussions with DGFP and local stakeholders, pursued various options for alleviating this short-term problem, including moving up other procurement ship dates and borrowing supplies. These solutions, however, would not be enough to fill the gap in time. At this point, after the project alerted USAID to the potential stockout, they agreed to airlift 6 million condoms to Bangladesh-in time to prevent a stockout. The project worked closely with the DGFP, with USAID in Washington and in Dhaka, as well as with the Bangladesh Social Marketing Company (SMC) to get the condoms into the country and through the various tiers of the supply chain. SMC, a recipient of USAID-donated condoms, agreed to receive and clear the emergency condom donation-the shipment came into the country quickly, without any disruption. In just one month, Bangladesh had received the USAID-donated condoms in-country, and the condoms were on their way through the supply chain to the end user. This action successfully averted a full blown stockout and gave the government time to sort out issues with the supplier. The contract negotiation was eventually completed and the first shipment arrived in-country in March 2008. At the time of delivery, condoms were still available because fewer condoms than usual were distributed during the shortages.
Language: English
Keywords:
BANGLADESH | SUMMARY REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | CONDOMS | CONTRACEPTIVE SECURITY | CONTRACEPTIVE IMPORTATION | Developing Countries | Asia, Southern | Asia | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Barrier Methods | Contraceptive Methods | Contraception | Family Planning | Contraceptive Availability | Family Planning Program Administration | Family Planning Programs
Document Number: 339992

15.

16.

17.

Title: Expanding access to injectable contraceptives.
Author: United States. Agency for International Development [USAID]
Source: [Washington, D.C.], USAID, [2009]. [2] p.
Abstract: A technical consultation, co-sponsored by the World Health Organization (WHO), USAID, and Family Health International (FHI), was held June 15-17, 2009, at the WHO in Geneva to review the evidence and programmatic experience for community-based provision of injectable contraceptives. Thirty technical and program experts from countries and organizations reviewed the scientific evidence and experiences from programs that provided injectable contraceptives through community-based health workers (CHWs). This evidence and programmatic experience came from Africa, Asia, and Latin America and focused on depotmedroxyprogesterone acetate (DMPA). The evidence consistently showed that given appropriate training, CHWs can screen clients effectively, provide DMPA injections safely, and counsel on side effects appropriately, demonstrating competence equivalent to higher level facility-based providers of DMPA. Continuation of use of DMPA by clients of CHWs was as long as those of clients receiving injections at clinics. In addition, the vast majority of clients expressed satisfaction with CHW provision of DMPA. The Consultation concluded that sufficient evidence existed for national policies to support the introduction, continuation, and scale-up of community-based provision of progestin-only injectable contraceptives, especially DMPA. Provision of DMPA by CHWs will expand choice for underserved populations and contribute to reducing the unmet need for family planning. Operational guidelines for family planning should therefore reflect that appropriately trained CHWs can safely initiate use of DMPA and provide reinjection. (Excerpt)
Language: English
Keywords:
GLOBAL | SUMMARY REPORT | CONFERENCES AND CONGRESSES | COMMUNITY WORKERS | WHO | INJECTABLES | DEPO-PROVERA | SAFETY | CONTRACEPTION CONTINUATION | TRAINING ACTIVITIES | COUNSELING | FAMILY PLANNING POLICY | Health Personnel | Delivery of Health Care | Health | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Contraceptive Methods | Contraception | Family Planning | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Public Health | Contraceptive Usage | Training Programs | Education | Clinic Activities | Program Activities | Programs | Organization and Administration | Population Policy | Social Policy | Policy
Document Number: 331839

18.

19.

Title: Voluntary population planning activities -- supplemental requirements (January 2009) [letter]
Author: United States. Agency for International Development [USAID]. Bureau for Management. Office of Acquisition and Assistance
Source: Washington, D.C., USAID, Bureau for Management, Office of Acquisition and Assistance, 2009 Jan 26. [5] p.
Abstract: The purpose of this letter is to amend the Standard provisions of all grants and cooperative agreements involving any aspect of voluntary population planning activities and which contain the provision VOLUNTARY POPULATION PLANNING ACTIVITIES - SUPPLEMENTAL REQUIREMENTS (May 2006). This provision is deleted and replaced by the new provision VOLUNTARY POPULATION PLANNING ACTIVITIES - SUPPLEMENTAL REQUIREMENTS (January 2009) which removes the conditions relating to the Mexico City Policy that were set forth in the May 2006 version of the provision. (Excerpt)
Language: English
Keywords:
DEVELOPING COUNTRIES | GOVERNMENT PUBLICATION | RECOMMENDATIONS | EVALUATION | POLICYMAKERS | USAID | STANDARDIZATION | GRANTS | POPULATION POLICY | FAMILY PLANNING PROGRAM EVALUATION | INCENTIVES | FAMILY PLANNING POLICY | CONTRACEPTIVE AGENTS | ABORTION LAW | STERILIZATION, SEXUAL | Administrative Personnel | Organization and Administration | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Data Adjustment | Research Methodology | Financial Activities | Economic Factors | Social Policy | Policy | Family Planning Programs | Family Planning | Contraception | Fertility Control, Postconception
Document Number: 331346 Notification

20.

Title: Community-based health workers can safely and effectively administer injectable contraceptives: Conclusions from a technical consultation.
Author: World Health Organization [WHO]; United States. Agency for International Development [USAID]; Family Health International [FHI]
Source: Research Triangle Park, North Carolina, FHI, 2009. 4 p.
Abstract: In June 2009, a technical consultation held at the World Health Organization (WHO) in Geneva concluded that evidence supports the introduction, continuation, and scale-up of community-based provision of progestin-only injectable contraceptives. The group of 30 technical and programme experts reviewed scientific and programmatic experience, which largely focused on the progestin-only injectable, depot-medroxyprogesterone acetate (DMPA). The experts found that community-based provision of progestin-only injectable contraceptives by appropriately trained community health workers (CHWs) is safe, effective, and acceptable. Such services should be part of a family planning programme offering a range of contraceptive methods. (Excerpt)
Language: English
Keywords:
GLOBAL | CONFERENCES AND CONGRESSES | COMMUNITY WORKERS | WHO | INJECTABLES | DEPO-PROVERA | NEEDS | SAFETY | CONTRACEPTION CONTINUATION | TRAINING ACTIVITIES | MONITORING | FAMILY PLANNING POLICY | Health Personnel | Delivery of Health Care | Health | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Contraceptive Methods | Contraception | Family Planning | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Economic Factors | Public Health | Contraceptive Usage | Training Programs | Education | Evaluation | Population Policy | Social Policy | Policy
Document Number: 331834

21.

Title: WHO / USAID / FHI Technical Consultation: Expanding Access to Injectable Contraception, 15-17 June 2009, Room M405, WHO, Geneva.
Author: World Health Organization [WHO]; United States. Agency for International Development [USAID]; Family Health International [FHI]
Source: [Unpublished] 2009. 5 p.
Abstract: The agenda for the consultation is presented. The objectives of the consultation were: To review systematically the evidence and programmatic experience on interventions designed to expand access to / provision of contraceptive injectables, focusing on non clinic-based services and programs; To reach conclusions on issues: (a) for which evidence is consistent and strong; (b) for which evidence is mixed; and (c) for which evidence is marginal or entirely lacking and, thus requires additional research; To document discussions and conclusions of the Consultation, including policy and program implications, and to disseminate these widely.
Language: English
Keywords:
GLOBAL | TABLES AND CHARTS | CONFERENCES AND CONGRESSES | WHO | USAID | INJECTABLES | CONTRACEPTIVE AVAILABILITY | INTERVENTIONS | NEEDS | COMMUNITY-BASED DISTRIBUTION | CONTRACEPTION CONTINUATION | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Government Agencies | Contraceptive Methods | Contraception | Family Planning | Programs | Organization and Administration | Economic Factors | Nonclinical Distribution | Distributional Activities | Program Activities | Contraceptive Usage
Document Number: 331853

22.
Peer Reviewed

Title: Emergency contraception: knowledge and attitudes of family physicians of a teaching hospital, Karachi, Pakistan.
Author: Abdulghani HM; Karim SI; Irfan F
Source: Journal of Health, Population, and Nutrition. 2009 Jun;27(3):339-44.
Abstract: This study was conducted to assess the knowledge of family medicine providers and their attitudes towards emergency contraception in a teaching hospital in Karachi, Pakistan. A 21-item questionnaire containing the demographic profile of respondents and questions concerning knowledge of and attitudes towards emergency contraception was distributed among participants. In total, 45 interviews were conducted, with a response rate of 100%, with faculty physicians (33%), residents (27%), medical officers (40%), 36% male and 64% female physicians; of them, the majority (64%) were married. Although the large majority (71%) of the respondents reported considerable familiarity with emergency contraception, objective assessment revealed deficiencies in their knowledge. About 38% of the participants incorrectly chose menstrual irregularity as the most common side-effect of progestin-only emergency contraception pills, and only 33% answered that emergency contraception was not an abortifacient while 42% were unsure. Forty percent of the physicians prescribed emergency contraception in the past. The large majority (71%) of the physicians were familiar with emergency contraception, yet deficiencies in knowledge inaccuracies were identified. Barriers to its use were identified as 'it will promote promiscuity' (31%), religious/ethical reasons (27%), liability (40%), teratogenicity (44%), and inexperience (40%). Overall attitudes regarding emergency contraception were positive; however, most (82%) physicians were unsatisfied with their current knowledge of emergency contraception, and there was a discrepancy between perceptions of physicians and actual knowledge. Interventions providing education to family physicians regarding emergency contraception is strongly recommended.
Language: English
Keywords:
PAKISTAN | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PHYSICIANS | EMERGENCY CONTRACEPTION | ATTITUDES | KNOWLEDGE | PERCEPTION | FAMILY PLANNING | Developing Countries | Asia, Southern | Asia | Research Methodology | Health Personnel | Delivery of Health Care | Health | Contraception | Psychological Factors | Behavior | Sociocultural Factors
Document Number: 341579

23.

Title: The morning-after pill [letter]
Author: Abell S
Source: Clinical Pediatrics. 2009 Apr;48(3):341-2; discussion 342.
Abstract: This is a question from a reader to the journal's Medical Doctor about the morning-after pill. The Dr. clearly confirms that the morning-after pill is not causing abortion. Her description helps us better understand how this pill (usually levonorgestrel), a progestin, works in preventing a pregnancy. This approach, which is now known as Plan B�, has received strong support in the prevention of unplanned pregnancies from both the American College of Obstetrics and Gynecology and the American Academy of Pediatrics in also circumventing the need for abortions in women of all ages, especially in adolescent girls. Some pharmacists have resisted filling these Plan B prescriptions, so it will be important for pediatricians to know which pharmacies in your community will accept your Plan B� prescriptions. Sadly, teenage pregnancies continue to have a major impact on disadvantaged teenagers. This group of individuals also may have limited access to Plan B prescriptions, which requires that they should be taken within 5 days of unprotected intercourse in order for them to be effective in preventing unwanted pregnancies.
Language: English
Keywords:
UNITED STATES OF AMERICA | CRITIQUE | EVALUATION | WOMEN | EMERGENCY CONTRACEPTION | CONTRACEPTIVE MODE OF ACTION | ABORTION | CONTRACEPTIVE SAFETY | CONTRACEPTIVE AVAILABILITY | PHARMACY DISTRIBUTION | ORAL CONTRACEPTIVES, SIDE EFFECTS | NAUSEA | VOMITING | Developed Countries | North America | Americas | Demographic Factors | Population | Contraception | Family Planning | Fertility Control, Postconception | Safety | Public Health | Health | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Signs and Symptoms | Diseases
Document Number: 331244 Notification

24.

Title: Awareness and views of the law on termination of pregnancy and reasons for resorting to an abortion among a group of women attending a clinic in Colombo, Sri Lanka.
Author: Abeyasinghe NL; Weerasundera BJ; Jayawardene PA; Somarathna SD
Source: Journal of Forensic and Legal Medicine. 2009 Apr;16(3):134-7.
Abstract: In Sri Lanka, induced abortion is a criminal offence except to save the life of the mother. This study determined the awareness and views of the law on abortion among women seeking an abortion. Three hundred and thirteen women were interviewed. The characteristics of the study group are discussed. 65.8% of the respondents stated they knew the current law, 25.6% stated they did not and 8.3% were unsure. On detailed analysis of each respondent's knowledge regarding the situations where abortion is legalized including those who stated that they did not know the law, only 11.2% had an accurate knowledge. More than 75% stated that abortion should be legalized when the mother's life was in danger, where there was pregnancy after rape or incest, when there was psychiatric illness in the mother and when there were fetal anomalies. Reasons for resorting to an abortion are discussed. Although 11.2% were aware of the law, there was no difference in the reasons for resorting to an abortion when compared with those who were unaware of the law. This study highlights the fact that availability of abortion services to women depend not only on the law and its awareness, but on how it is interpreted and enforced.
Language: English
Keywords:
SRI LANKA | RESEARCH REPORT | ABORTION | ABORTION LAW | AWARENESS | INTERVIEWS | ABORTION RATE | ATTITUDES | CONTRACEPTIVE USAGE | Developing Countries | Asia, Southern | Asia | Fertility Control, Postconception | Family Planning | Knowledge | Sociocultural Factors | Data Collection | Research Methodology | Psychological Factors | Behavior | Contraception
Document Number: 342188 Notification

25.

Peer Reviewed

Title: Sexual activity and contraceptive use among young female students of tertiary educational institutions in Ilorin, Nigeria.
Author: Abiodun OM; Balogun OR
Source: Contraception. 2009 Feb;79(2):146-9.
Abstract: BACKGROUND: A survey was conducted to evaluate the pattern of sexual behavior and contraceptive use among female students aged 15 to 24 years attending tertiary institutions in Ilorin, Nigeria. STUDY DESIGN: A valid and reliable semistructured questionnaire was self-administered to a sampled population of 600 students aged 15 to 24 years. RESULTS: Of the 600 students, 562 (93.7%) completed the questionnaire. Most (98.6%) of the respondents were unmarried, 77.6% have had sexual intercourse, 67.8% have had an unwanted pregnancy while 63.5% have had induced abortion. All the respondents were aware of contraceptives, but only 25.4% have ever used any contraceptive method. The most common sources of information about contraception among the respondents were friends/relatives (73.7%), while the fear of side effects of modern contraceptives was the most common reason (77.5%) for nonuse. CONCLUSION: The fear of side effects is the main reason for low contraceptive prevalence among young female students of tertiary institutions in Ilorin. Reproductive health services should focus more on delivery of adequate and accurate information about contraceptives to improve use among young women.
Language: English
Keywords:
NIGERIA | RESEARCH REPORT | QUESTIONNAIRES | ADOLESCENTS, FEMALE | YOUTH | CONTRACEPTIVE USAGE | SEXUALITY | SEX BEHAVIOR | CONTRACEPTIVE PREVALENCE | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Adolescents | Age Factors | Population Characteristics | Demographic Factors | Population | Contraception | Family Planning | Personality | Psychological Factors | Behavior
Document Number: 329609

26.

27.

Peer Reviewed

Title: Intended postpartum contraceptive use among pregnant and puerperal women at a university teaching hospital.
Author: Adegbola O; Okunowo A
Source: Archives of Gynecology and Obstetrics. 2009 Mar 26;
Abstract: OBJECTIVE: To assess the intention to use postpartum contraceptives and factors influencing use. METHOD: A total of 423 consecutive consenting women attending the pregnancy and puerperal clinics at a university teaching hospital were interviewed using structured questionnaire. RESULTS: The prevalence of previous contraceptive use was 35.5%. Fifty-four percent of the respondents intended to use contraceptives after delivery, though 3% were yet to decide. Condoms (38.3%) followed by intrauterine contraceptive device (IUCD) 11.5%, were the most preferred choice of postpartum contraceptives. However, spermicide (0.4%) was the least preferred. Advanced age and high parity significantly predicted intention to use postpartum contraceptives (P = 0.02 and 0.01, respectively). Also high level of respondent's education and family planning counseling by doctors and nurses increased the intention to use postpartum contraceptives (P = 0.03 and 0.01, respectively). CONCLUSION: Family planning counseling and education play a vital role in increasing the use of contraceptives in the postpartum period.
Language: English
Keywords:
GLOBAL | RESEARCH REPORT | PREVALENCE | POSTPARTUM WOMEN | PREGNANT WOMEN | CONTRACEPTIVE USAGE | FAMILY PLANNING | ATTITUDES | Measurement | Research Methodology | Puerperium | Reproduction | Population Characteristics | Demographic Factors | Population | Contraception | Psychological Factors | Behavior
Document Number: 330850

28.

Peer Reviewed

Title: Factors affecting awareness of emergency contraception among college students in Kathmandu, Nepal.
Author: Adhikari R
Source: BMC Women's Health. 2009 Sep 17;9(1):27.
Abstract: ABSTRACT: BACKGROUND: In Nepal, Emergency Contraception (EC) could play a critical role in reducing unintended pregnancies, but very few people aware about it. This paper aims to investigate the level of awareness and factors influencing awareness of EC among college students. METHODS: A cross-sectional study was carried out in April-May 2006. Structured self-administered questionnaires were administered to 1,137 college students (573 males and 564 females) in Kathmandu district. The association between awareness of EC and the explanatory variables were first assessed in bivariate analysis using the Chi-square test. The associations were further explored using a multivariate logistic analysis. RESULTS: Only about two-thirds of college students (68%) had ever heard about EC. Bivariate analysis shows that males were more aware (72%) of EC than were females (64%). Similarly, the awareness level was significantly higher among younger, unmarried youth who were from outside Kathmandu Valley, who lived with friends, and who had received reproductive health (RH) education in school/college. The study also found that students' sex, permanent place of residence (district), and RH education are significant predictors of awareness of EC. Males are 1.5 times more likely to be aware of EC compared to females. Furthermore, students who lived in Kathmandu Valley were 41% less likely to be aware of EC than were students from outside Kathmandu Valley. On the other hand, those students who received RH education in school/college were almost nine times more likely to be aware of EC compared to those who did not receive such education. CONCLUSIONS: Awareness of the EC is low among college students in Nepal. Health education initiatives should target students as they are more likely to be sexually active. There is a need to further educate students about EC which can help to reduce unintended pregnancies, many of which result in unsafe abortion and take a large toll on women's health.
Language: English
Keywords:
NEPAL | RESEARCH REPORT | STUDENTS | EMERGENCY CONTRACEPTION | AWARENESS | QUESTIONNAIRES | LIVING ARRANGEMENTS | SEX FACTORS | AGE FACTORS | SEX EDUCATION | PREGNANCY, UNPLANNED | Developing Countries | Asia, Southern | Asia | Education | Contraception | Family Planning | Knowledge | Sociocultural Factors | Residence Characteristics | Population Distribution | Geographic Factors | Population | Population Characteristics | Demographic Factors | Reproductive Behavior | Fertility | Population Dynamics
Document Number: 342836

29.

Peer Reviewed

Title: Evaluation of mifepristone as a once a month contraceptive pill.
Author: Agarwal M; Das V; Agarwal A; Pandey A; Srivastava D
Source: American Journal of Obstetrics and Gynecology. 2009 May;200(5):e27-9.
Abstract: OBJECTIVE: The purpose of this study was to assess the efficacy and safety of mifepristone as a contraceptive pill. STUDY DESIGN: A prospective case-control study was conducted in a tertiary care center of North India. The study group (n = 86) was given 200-mg mifepristone tablets on the 16th day of the menstrual cycle. The control group (n = 92) received combined oral contraceptive (COC) as per protocol. Subjects were followed for drug compliance, satisfaction, side effects, and failure. RESULTS: Acceptability of mifepristone was significantly higher in educated population (P < .001), with fewer side effects (P = .001), good satisfaction (P < .001), and higher compliance rate (P = .05). The oral contraceptive pill group had higher adverse biochemical parameters. CONCLUSION: Mifepristone can be used as a monthly contraceptive pill effectively.
Language: English
Keywords:
INDIA | RESEARCH REPORT | ORAL CONTRACEPTIVES | RU-486 | TIME FACTORS | ADMINISTRATION AND DOSAGE | Asia, Southern | Asia | Developing Countries | Contraceptive Methods | Contraception | Family Planning | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Population Dynamics | Demographic Factors | Population | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 341243

30.

Peer Reviewed

Title: Enhanced immunogenicity of an oral inactivated cholera vaccine in infants in Bangladesh obtained by zinc supplementation and by temporary withholding breast-feeding.
Author: Ahmed T; Svennerholm AM; Al Tarique A; Sultana GN; Qadri F
Source: Vaccine. 2009 Feb 25;27(9):1433-9.
Abstract: The killed oral cholera vaccine Dukoral is recommended for adults and only children over 2 years of age, although cholera is seen frequently in younger children and there is an urgent need for a vaccine for them. Since decreased immunogenicity of oral vaccines in children in developing countries is a critical problem, we tested interventions to enhance responses to Dukoral. We evaluated the effect on the immune responses by temporarily withholding breast-feeding or by giving zinc supplementation. Two doses of Dukoral consisting of killed cholera vibrios and cholera B subunit were given to 6-18 months old Bangladeshi children (n=340) and safety and immunogenicity studied. Our results showed that two doses of the vaccine were safe and induced antibacterial (vibriocidal) antibody responses in 57% and antitoxin responses in 85% of the children. Immune responses were comparable after intake of one and two doses. Temporary withholding breast-feeding for 3 h before immunization or supplementation with 20 mg of zinc per day for 42 days resulted in increased magnitude of vibriocidal antibodies (77% and 79% responders, respectively). Administration of vaccines without buffer or in water did not result in reduction of vibriocidal responses. This study demonstrates that the vaccine is safe and immunogenic in children under 2 years of age and that simple interventions can enhance immune responses in young children.
Language: English
Keywords:
BANGLADESH | RESEARCH REPORT | INFANT | CHOLERA | ZINC | HUMAN MILK | VACCINES | ADMINISTRATION AND DOSAGE | CONTRACEPTIVE USE-EFFECTIVENESS | AUTOIMMUNE RESPONSE | SAFETY | Developing Countries | Asia, Southern | Asia | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Bacterial and Fungal Diseases | Infections | Diseases | Metals | Vitamins and Minerals | Physiology | Biology | Lactation | Maternal Physiology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Drugs | Treatment | Contraceptive Effectiveness | Contraception | Family Planning | Antibodies | Immunologic Factors | Immunity | Immune System | Public Health
Document Number: 341051


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