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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Source: [Unpublished] [2009]. 12 p.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: 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

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

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

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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

Peer Reviewed

Title: Pharmacy worker practices related to use of misoprostol for abortion in one Mexican state.
Author: Billings DL; Walker D; Mainero del Paso G; Clark KA; Dayananda I
Source: Contraception. 2009 Jun;79(6):445-51.
Abstract: BACKGROUND: Pharmacies are important sites for access to health information and medications in Mexico. Most workers are not trained in health issues and may provide inaccurate information to consumers. Misoprostol is used by women throughout Mexico for early abortion and often is purchased from pharmacies. This study aims to understand the practices of pharmacy workers when asked for advice about and medications for abortion, in particular misoprostol. STUDY DESIGN: A random sample of pharmacies in both urban and rural areas of one state of Mexico included both chain and independent pharmacies (n=169). Two mystery clients (MCs) visited the pharmacies, requesting medication for "bringing down the period" and then asking for misoprostol. MCs recorded information about the interactions following each visit in standardized formats. Bivariate comparisons were made between spontaneous and prompted discussions of misoprostol. Associations were considered statistically significant at alpha<.05. RESULTS: Ninety percent of pharmacy workers attending to the MCs discussed misoprostol as an abortifacient, either spontaneously or after being prompted by the MCs. Misoprostol was for sale in most (61%) of these pharmacies. The majority of pharmacy workers (75%) did not request a prescription. Over 75% of all pharmacy workers provided the MCs referral to trained medical providers with whom they could seek a follow-up visit. Sixteen percent of pharmacy workers suggested a regimen consistent with evidence and recommendations for using misoprostol for early abortion. Regimens that were underdosages were common, and few workers recommended a potentially harmful overdosage. Instructions about side effects and risks were rare. The price of misoprostol ranged from 900 to 1800 pesos (US$83-167) for a bottle of 28 tablets (200 mcg each) or US$4.07 per tablet, on average. CONCLUSIONS: Pharmacy workers in both urban and rural areas of Mexico are increasingly becoming aware of misoprostol as an effective abortifacient and are willing to provide the information to consumers. However, their information is limited and often inaccurate. Strategies need to be developed so that they receive timely and correct information, consistent with evidence-based recommendations. The legal context of abortion in Mexico (with restrictions in every state, except Mexico City), the restricted registration of misoprostol as a therapeutic agent only for gastric ulcers and the fact that the majority of pharmacy workers are not considered to be health workers are among the most important barriers to advances in training pharmacy workers in the correct application of misoprostol.
Language: English
Keywords:
MEXICO | RESEARCH REPORT | CLIENTS | PHARMACY DISTRIBUTION | MISOPROSTOL | ABORTION | INFORMED CHOICE | INFORMATION | North America | Americas | Developing Countries | Program Activities | Programs | Organization and Administration | Nonclinical Distribution | Distributional Activities | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Fertility Control, Postconception | Family Planning | Contraceptive Usage | Contraception
Document Number: 342599 Notification

Peer Reviewed

Title: Involving pharmacists in sexual health research: experience from an emergency contraception study.
Author: Black K; Anderson C; Kubba A; Wellings K
Source: Journal of Family Planning and Reproductive Health Care. 2009 Jan;35(1):41-3.
Abstract: BACKGROUND: Community pharmacists are expanding their sphere of activity within primary health care, increasing their role not only in health care but also research. METHODS AND RESULTS: We describe the challenges encountered in carrying out a pilot study of women obtaining emergency hormonal contraception through different providers, including pharmacies, highlighting deficiencies in understanding and experience of the research process, which impacted on the study in substantial ways. CONCLUSIONS: As pharmacists expand their role, training and professional development will need to be enhanced to support them in their contribution to health care and research.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | EMERGENCY CONTRACEPTION | PHARMACISTS | EDUCATION | HOME CARE | PHARMACY DISTRIBUTION | SEX EDUCATION | HEALTH | RESEARCH AND DEVELOPMENT | Developed Countries | Europe, Western | Europe | Contraception | Family Planning | Health Personnel | Delivery of Health Care | Care and Support | Health Services | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Technology | Economic Factors
Document Number: 329636

10.

11.

Peer Reviewed

Title: Delivery of chlamydia screening to young women requesting emergency hormonal contraception at pharmacies in Manchester, UK : a prospective study.
Author: Brabin L; Thomas G; Hopkins M; O'Brien K; Roberts SA
Source: BMC Women's Health. 2009 Mar 26;9(1):7.
Abstract: ABSTRACT: BACKGROUND: More women are requesting Emergency Hormonal Contraception (EHC) at pharmacies where screening for Chlamydia trachomatis is not routinely offered. The objective of this study was to assess the uptake of free postal chlamydia screening by women under 25 years who requested EHC at pharmacies in Manchester, UK. METHODS: Six Primary Care Trusts (PCTs) that had contracted with pharmacies to provide free EHC, requested the largest EHC providers ([greater than or equal to] 40 doses annually) to also offer these clients a coded chlamydia home testing kit. Pharmacies kept records of the ages and numbers of women who accepted or refused chlamydia kits. Women sent urine samples directly to the laboratory for testing and positive cases were notified. Audit data on EHC coverage was obtained from PCTs to assess the proportion of clients eligible for screening and to verify the uptake rate. RESULTS: 33 pharmacies participated. Audit data for 131 pharmacy months indicated that only 24.8% (675/2718) of women provided EHC were also offered chlamydia screening. Based on tracking forms provided by pharmacies for the whole of the study, 1348 /2904 EHC clients (46.4%) who had been offered screening accepted a screening kit. 264 (17.6%) of those who accepted a kit returned a sample, of whom 24 (9.1%) were chlamydia-positive. There was an increase in chlamydia positivity with age (OR: 1.2 per year; 1.04 to 1.44; p = 0.015). CONCLUSIONS: Chlamydia screening for EHC pharmacy clients is warranted but failure of pharmacists to target all EHC clients represented a missed opportunity for treating a well defined high-risk group.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | PROSPECTIVE STUDIES | WOMEN | YOUTH | SCREENING | EMERGENCY CONTRACEPTION | CHLAMYDIA | PHARMACY DISTRIBUTION | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Demographic Factors | Population | Age Factors | Population Characteristics | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraception | Family Planning | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration
Document Number: 330849

12.

Peer Reviewed

Title: The "seeded" focus group: a strategy to recruit HIV+ community members into treatment research.
Author: Busza J; Zaba B; Urassa M
Source: Sexually Transmitted Infections. 2009 Jun;85(3):212-5.
Abstract: OBJECTIVE(S): We piloted an innovative community-based recruitment approach to contact known HIV+ individuals for referral to treatment without endangering their confidentiality. METHODS: Nested within an HIV cohort study, operations research to monitor and improve rural uptake of antiretroviral therapy (ART) was conducted alongside the introduction of Tanzania's national treatment programme. We confronted the challenge of recruiting participants without inadvertently disclosing their HIV status to family or other community members. During post-test counselling, nurses compiled a list of HIV+ persons who expressed interest in being contacted when ART became available. Study numbers, but not names, of 12 "seeds" were added to a randomly generated list of residents, matched by age group and sex, and all were invited to participate in focus-group discussions on community perceptions of treatment. After the discussion, the original counsellors met each participant in private, inviting the "seed" for ART referral and offering VCT to others. RESULTS: Ten "seeds" were successfully located and attended the local focus-group discussion; all subsequently volunteered to undergo clinical tests in advance of receiving antiretroviral therapy. They also agreed to participate in a study of barriers to ART access. The other focus-group members contributed useful information on levels of understanding and support for treatment, and several came forward for HIV testing. CONCLUSIONS: The "seeded" focus group is a very straightforward and easily arranged method of recruiting HIV+ people for research or service delivery within a wider context of engaging with local community perceptions.
Language: English
Keywords:
TANZANIA | RESEARCH REPORT | PILOT PROJECTS | COHORT ANALYSIS | OPERATIONS RESEARCH | PERSONS LIVING WITH HIV/AIDS | RECRUITMENT ACTIVITIES | ANTIRETROVIRAL THERAPY | PERCEPTION | COMMUNITY-BASED DISTRIBUTION | HIV TESTING | TREATMENT | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Program Evaluation | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Program Activities | HIV | Psychological Factors | Behavior | Nonclinical Distribution | Distributional Activities | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 342673

13.

Title: Preventing student pregnancy in Guinea�s Forest Region.
Author: Castle S
Source: Washington, D.C., CORE Group, [2009]. 8 p.
Abstract: Plan International implemented the Forest Region Sustainable Community-Based Reproductive and Sexual Health Project, a 3.5-year intervention to increase knowledge and use of family planning in five prefectures of Guinea's forest region. In partnership with the Association Guinenne pour le Bien-Etre Familiale (AGBEF), Plan International used a community-based approach that included recruiting and training nearly 800 community-based services agents to offer information, some modern methods, and referrals to women, men, and couples in the project zone. From the outset, the Forest Region Project also took a strong interest in the sexual health and FP needs of young people, knowing that early sexual activity combined with low FP use commonly led to unwanted pregnancy and school abandonment and/or unsafe abortion.
Language: English
Keywords:
GUINEA | SUMMARY REPORT | PILOT PROJECTS | STUDENTS | SUGAR DADDIES | PEER EDUCATORS | TEACHERS | FAMILY PLANNING PROGRAMS | SCHOOL-BASED SERVICES | ADOLESCENT PREGNANCY | EDUCATION | COMMUNITY-BASED DISTRIBUTION | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Sex Behavior | Behavior | Family Planning | Programs | Organization and Administration | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population | Nonclinical Distribution | Distributional Activities | Program Activities
Document Number: 330603

14.

Peer Reviewed

Title: Adherence to first-line antiretroviral therapy affects non-virologic outcomes among patients on treatment for more than 12 months in Lusaka, Zambia.
Author: Chi BH; Cantrell RA; Zulu I; Mulenga LB; Levy JW; Tambatamba BC; Reid S; Mwango A; Mwinga A; Bulterys M; Saag MS; Stringer JS
Source: International Journal of Epidemiology. 2009 Jun;38(3):746-56.
Abstract: BACKGROUND: High-level adherence to antiretroviral therapy (ART) is associated with favourable patient outcomes. In resource-constrained settings, however, there are few validated measures. We examined the correlation between clinical outcomes and the medication possession ratio (MPR), a pharmacy-based measure of adherence. METHODS: We analysed data from a large programmatic cohort across 18 primary care centres providing ART in Lusaka, Zambia. Patients were stratified into three categories based on MPR-calculated adherence over the first 12 months: optimal (> or =95%), suboptimal (80-94%) and poor (<80%). RESULTS: Overall, 27 115 treatment-naive adults initiated and continued ART for > or =12 months: 17 060 (62.9%) demonstrated optimal adherence, 7682 (28.3%) had suboptimal adherence and 2373 (8.8%) had poor adherence. When compared with those with optimal adherence, post-12-month mortality risk was similar among patients with sub-optimal adherence [adjusted hazard ratio (AHR) = 1.0; 95% CI: 0.9-1.2] but higher in patients with poor adherence (AHR = 1.7; 95% CI: 1.4-2.2). Those <80% MPR also appeared to have an attenuated CD4 response at 18 months (185 cells/microl vs 217 cells/microl; P < 0.001), 24 months (213 cells/microl vs 246 cells/microl; P < 0.001), 30 months (226 cells/microl vs 261 cells/microl; P < 0.001) and 36 months (245 cells/microl vs 275 cells/microl; P < 0.01) when compared with those above this threshold. CONCLUSIONS: MPR was predictive of clinical outcomes and immunologic response in this large public sector antiretroviral treatment program. This marker may have a role in guiding programmatic monitoring and clinical care in resource-constrained settings.
Language: English
Keywords:
ZAMBIA | RESEARCH REPORT | CLINICAL RESEARCH | COHORT ANALYSIS | PERSONS LIVING WITH HIV/AIDS | CLIENTS | ANTIRETROVIRAL THERAPY | USER COMPLIANCE | IMMUNOLOGICAL EFFECTS | PHARMACY DISTRIBUTION | MORTALITY | HEMOGLOBIN LEVEL | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | HIV Infections | Viral Diseases | Diseases | Program Activities | Programs | Organization and Administration | HIV | Behavior | Immunity | Immune System | Physiology | Biology | Nonclinical Distribution | Distributional Activities | Population Dynamics | Demographic Factors | Population | Hemic System
Document Number: 342460

15.

Peer Reviewed

Title: Contraception in historical and global perspective.
Author: Cleland J
Source: Best Practice and Research. Clinical Obstetrics and Gynaecology. 2009 Apr;23(2):165-176.
Abstract: This chapter describes the rise in contraceptive practice and fall in fertility from around 1880 to the present day. Two main phases are identified: the first confined to European populations and involving methods of low efficacy, and the second embracing the whole planet involving modern methods. Today, sub-Saharan Africa is the only region where low levels of contraceptive use and high fertility persist. Nevertheless, nearly half of pregnancies worldwide are still unintended, and much scope remains for improvement in contraceptive protection. The main international priority is Africa, where demographic factors jeopardize the goals of reducing poverty and hunger.
Language: English
Keywords:
AFRICA | RESEARCH REPORT | CONTRACEPTIVE PREVALENCE | SOCIAL MARKETING | POPULATION GROWTH | CONTRACEPTIVE METHODS CHOSEN | PREGNANCY, UNPLANNED | COMMUNITY-BASED DISTRIBUTION | CONTRACEPTION | FAMILY PLANNING PROGRAMS | Developing Countries | Contraceptive Usage | Family Planning | Marketing | Economic Factors | Population Dynamics | Demographic Factors | Population | Reproductive Behavior | Fertility | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration
Document Number: 329659

16.

Title: Self-reported sexually transmitted disease symptoms and treatment-seeking behaviors in China.
Author: Guan J; Wu Z; Li L; Lin C; Rotheram-Borus MJ; Detels R; Hsieh J
Author: NIMH Collaborative HIV/STD Prevention Trial Group
Source: AIDS Patient Care and STDs. 2009 Jun;23(6):443-8.
Abstract: In recent decades, sexually transmitted diseases (STDs) have reemerged and spread as a major public health problem in China. However, little effort has been made on promoting appropriate health-seeking behaviors among people living with STDs. A randomly selected sample of market vendors in Fuzhou (N = 4510) was recruited and assessed from 2003 to 2004 to examine their choice of pharmacy versus hospital, and folk remedy versus Western medicine when having STD symptoms. Approximately 11.3% of the sample (4.0% of men and 17.8% of women) reported having had abnormal genital discharge or genital ulcer during the past 6 months. More (over 60%) people chose Chinese folk remedy to treat symptoms or prevent transmission when they had genital discharge and/or genital ulcer. Approximately 30% of study participants with reported STD symptoms visited pharmacies only to seek treatment, and 17% visited neither hospital nor pharmacies. Visiting a pharmacy only for STD treatment was marginally significantly associated with being female (prevalence ratio [PR] = 1.665, confidence interval [CI] = 0.980, 2.831) and never married (PR = 1.984, CI = 1.098, 3.594) after controlling for other potential confounders. Education about appropriate health-seeking behaviors to obtain effective treatment of STD must be a top priority to control the rapid spread of STDs in China.
Language: English
Keywords:
CHINA | RESEARCH REPORT | COMPARATIVE STUDIES | CLIENTS | SEXUALLY TRANSMITTED DISEASES | TREATMENT | TRADITIONAL HEALTH PRACTICES | UTILIZATION OF HEALTH CARE | HEALTH SERVICES | PHARMACY DISTRIBUTION | Asia, Eastern | Asia | Developing Countries | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Reproductive Tract Infections | Infections | Diseases | Medical Procedures | Medicine | Delivery of Health Care | Health | Culture | Sociocultural Factors | Nonclinical Distribution | Distributional Activities
Document Number: 342431

17.
Peer Reviewed

Title: Development of a framework for evaluating the sustainability of community-based dengue control projects.
Author: Hanh TT; Hill PS; Kay BH; Quy TM
Source: American Journal of Tropical Medicine and Hygiene. 2009 Feb;80(2):312-8.
Abstract: There are currently no frameworks developed specifically for assessing community-based dengue control project sustainability. We first review the literature for frameworks for assessing project sustainability and second validate the framework criteria against the oldest community-based intervention using Mesocyclops in Xuan Phong commune, Nam Dinh province, north Vietnam, the subject of an intervention in 1998-2000. The framework used 13 criteria, clustered into three categories: 1) maintenance of health benefits from the original project, 2) continued delivery of community activities, and 3) human resource development. To provide consistency between criteria and to allow comparison both over time and with non-intervention communes, a five-point scale for each criterion was used, with the overall sustainability score calculated as the mean of all criteria. The framework offers a practical tool for assessing sustainability, and is amenable to adaptation for specific interventions without compromising the framework as a whole.
Language: English
Keywords:
VIETNAM | RESEARCH REPORT | LITERATURE REVIEW | EVALUATION | DENGUE | COMMUNITY-BASED DISTRIBUTION | PROGRAM SUSTAINABILITY | PREVENTION AND CONTROL | Asia, Southeastern | Asia | Developing Countries | Viral Diseases | Diseases | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration
Document Number: 330140

18.
Title: [Providing emergency contraceptive pills in pharmacies]
Author: Heidarsdottir ML; Almarsdottir AB; Geirsson RT
Source: Laeknabladid. 2009 May;95(5):343-347.
Abstract: Objective: Use of the levonorgestrel emergency contraception (EC) pill has become more common after being made formally available in pharmacies without prescription. It was investigated how pharmacists in the capital area of Reykjavik supply EC to clients. Material and methods: A total of 46 pharmacists of all working ages and both genders were asked to answer a questionnaire concerning how they sold the emergency contraception pill over the counter (84.8% reply rate). Results: Four of five used <5 minutes to discuss emergency contraception with the client, but almost all enquired about time from intercourse. While only 20% asked about the woman s health, most considered concomitant drug use and potential interaction with levonorgestrel. Only about 50% pointed out that EC did not protect against sexually transmitted disease, (3/4) pointed out the need for permanent contraceptive use, 95% asked about previous EC use, but only 30% would provide EC again in the same menstrual cycle. One half of the pharmacists sold EC to men/teenage boys and wished to assist them with taking responsibility, while the others only sold the drug to the woman. Of those prepared to give the drug to the men, 55% asked to speak over the telephone with the woman to ensure correct prescription and information. Nearly a third would never or rarely provide consultation in private. Conclusions: Pharmacists agree mostly about main points in supplying EC, but not as regards provision to women through their male partners. Provisons for consultation can be improved. Key words: Key contraception, emergency contraception, pregnancy. Correspondence: Reynir Tomas Geirsson, reynirg@landspitali.is.
Language: Icelandic
Keywords:
RUSSIA | RESEARCH REPORT | QUESTIONNAIRES | WOMEN | SEXUAL PARTNERS | EMERGENCY CONTRACEPTION | PREGNANCY | PHARMACY DISTRIBUTION | Developing Countries | Asia, Northern | Asia | Demographic Factors | Population | Sex Behavior | Behavior | Contraception | Family Planning | Reproduction | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration
Document Number: 341070

19.
Title: Knowledge of emergency contraception among women of childbearing age at a teaching hospital of Karachi.
Author: Irfan F; Karim SI; Hashmi S; Ali S; Ali SA
Source: JPMA. Journal of the Pakistan Medical Association. 2009 Apr;59(4):235-40.
Abstract: OBJECTIVES: To assess knowledge and attitudes about Emergency Contraception among women of childbearing age in Karachi, Pakistan. METHODS: A questionnaire based survey was conducted on 400 married women, attending the family practice clinics at a teaching hospital in Karachi, Pakistan from July to December 2006. Questionnaire was administered to women at the family practice clinic-seeking level of knowledge of emergency contraception (EC) and attitudes towards its use, Ethical requirements of informed consent and confidentiality were ensured Data was entered into Epi data and analyzed in SPSS. RESULTS: Eighty-eight percent of women were not aware of EC. 83% were housewives. Only a small number (11.5%) ever used EC to prevent pregnancy, out of those, the correct timing of effectiveness of post-coital pill was known to only 40% of women while none of these women were aware of the existence of Intra Uteriune Contraceptive Device (IUCD) insertion as an option for EC About 50% of women identified general practitioners or family medicine clinics as their main sources of knowledge about EC. Increased advertising was considered desirable by 72% while 37% considered over the counter availability of EC pill desirable and only 36% of women were uncomfortable to use EC because of religious reasons. CONCLUSION: EC has a potential to offer women an important option for fertility control. Lack of women's knowledge about EC use and availability may account in part for its limited use. There is a need to improve women's education about EC. The primary health care providers can play a major role in informing their patients about emergency contraception.
Language: English
Keywords:
PAKISTAN | RESEARCH REPORT | KAP SURVEYS | WOMEN IN DEVELOPMENT | KNOWLEDGE | EMERGENCY CONTRACEPTION | ATTITUDES | TIME FACTORS | CONTRACEPTIVE USAGE | IUD | ADVERTISING | PHARMACY DISTRIBUTION | CONTRACEPTIVE AVAILABILITY | RELIGION | Developing Countries | Asia, Southern | Asia | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Sociocultural Factors | Contraception | Family Planning | Psychological Factors | Behavior | Population Dynamics | Demographic Factors | Population | Contraceptive Methods | Promotion | Marketing | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration
Document Number: 331281

20.

Title: Task sharing in family planning.
Author: Janowitz B; Stanback J
Source: [Unpublished] 2009. [4] p.
Abstract: Many developing countries face strains in meeting the demands for provision of health services because of limited medical personnel. This situation has been exacerbated by the continued "brain drain" of highly trained medical professionals, and, more recently, by the increased demand for HIV services, especially in countries with a generalized epidemic. This has led to renewed interest in task sharing, also known as task shifting. A key feature of task sharing is that those with less medical or paramedical training can provide some of the same services with the same quality as those with more training. While the term �task sharing� is new, the concept has been applied for many years in family planning programs as various tasks became shared between doctors and nurses or between nurses and community health workers. The consensus reported in a recent WHO document, �Task Shifting to Tackle Health Worker Shortages�, was that task sharing �will positively affect health outcome. In family planning, perhaps the most important reason for task shifting is to bring services to women with poor access. Since it is not always cost effective to build clinics in sparsely populated rural areas, women will either be forced to travel long distances for services or non-clinic-based services must be provided in local communities. (Excerpts)
Language: English
Keywords:
GLOBAL | CRITIQUE | HEALTH PERSONNEL | FAMILY PLANNING PROGRAMS | PROGRAM ACCESSIBILITY | NEEDS | QUALITY OF HEALTH CARE | COMMUNITY-BASED DISTRIBUTION | TRAINING ACTIVITIES | SUPERVISION | CONTRACEPTIVE USAGE | Delivery of Health Care | Health | Family Planning | Program Evaluation | Programs | Organization and Administration | Economic Factors | Health Services Evaluation | Nonclinical Distribution | Distributional Activities | Program Activities | Training Programs | Education | Management | Contraception
Document Number: 331837

21.

Peer Reviewed

Title: HIV infection, stressful life events, and intimate relationship power: the moderating role of community resources for black South African women.
Author: Ketchen B; Armistead L; Cook S
Source: Women and Health. 2009 Mar-May;49(2-3):197-214.
Abstract: BACKGROUND: Black women in South Africa are vulnerable with limited power in intimate relationships. This study explored whether stressful life events and/or HIV infection were associated with relationship power and whether the impact was moderated by community resources. METHOD: One hundred four women living with HIV and 152 women not living with HIV participated in individual interviews. RESULTS: Undesirable life changes were negatively associated with relationship control. HIV infection and women's knowledge of community resources were associated with mutual decision-making, while frequency of family use of community resources was negatively related to female dominated decisions. Women living with HIV perceived their male partners as less dominant when they perceived their community resources to be more helpful. CONCLUSIONS: Power in intimate relationships may enhance the quality and length of life for black South African women living with HIV. Knowledge of and perceived helpfulness of community resources are avenues for promoting relationship power.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | BLACKS | WOMEN | PERSONS LIVING WITH HIV/AIDS | POWER | COMMUNITY-BASED DISTRIBUTION | SOCIAL WELFARE | STRESS | COUNSELING | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Political Factors | Sociocultural Factors | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Economic Factors | Psychological Factors | Behavior | Clinic Activities
Document Number: 342428

22.

Title: Pharmacist interest in and attitudes toward direct pharmacy access to hormonal contraception in the United States.
Author: Landau S; Besinque K; Chung F; Dries-Daffner I; Maderas NM; McGhee BT; Foster DG
Source: Journal of the American Pharmacists Association. 2009 Jan-Feb;49(1):43-50.
Abstract: OBJECTIVES: To assess pharmacist interest, comfort level, and perceived barriers regarding providing pharmacist-initiated access to hormonal contraceptives (i.e., tablets, patches, rings, injectables, emergency contraception [EC]). DESIGN: Descriptive, nonexperimental, cross-sectional study. SETTING: United States between November 2004 and January 2005. PARTICIPANTS: 2,725 pharmacists working in community chain pharmacies (64%), community independent pharmacy (31%), and other practice settings, including hospitals and home care facilities (5%). INTERVENTION: Survey sent electronically by the American Pharmacists Association to a random sample of 14,142 of its 50,000 pharmacist members nationally. MAIN OUTCOME MEASURES: Pharmacist interest and comfort level in providing pharmacy access to hormonal contraception (HC), perceived barriers and training needs, and familiarity with and provision of EC. RESULTS: 2,725 survey responses (19% response rate) were received. Pharmacists reported being very familiar with HC. The majority of respondents were comfortable and interested in providing direct access to HC in the pharmacy. Perceived barriers to providing HC in the pharmacy included lack of time, no mechanism of reimbursement for the service, and possible resistance from physicians. CONCLUSION: Strong interest, comfort level, and capability from pharmacists, combined with a documented demand for direct pharmacy access from patients, indicate that pharmacy access to HC has the potential to meet patient needs and increase access to HC. Education about current clinical practice recommendations-which no longer require pelvic examinations and Papanicolaou (Pap) smears before hormonal contraception is initiated-may increase pharmacist support for providing hormonal methods directly.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | KAP SURVEYS | CROSS SECTIONAL ANALYSIS | PHARMACISTS | HORMONES | CONTRACEPTIVE AGENTS | ATTITUDES | PERCEPTION | CONTRACEPTIVE DISTRIBUTION | PHARMACY DISTRIBUTION | ON-THE-JOB TRAINING | NEEDS ASSESSMENT | TIME FACTORS | ECONOMIC FACTORS | Developed Countries | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Health Personnel | Delivery of Health Care | Health | Endocrine System | Physiology | Biology | Contraception | Family Planning | Psychological Factors | Behavior | Distributional Activities | Program Activities | Programs | Organization and Administration | Nonclinical Distribution | Training Programs | Education | Evaluation | Population Dynamics | Demographic Factors | Population
Document Number: 330051

23.

Peer Reviewed

Title: The effect of the community-directed treatment approach versus the school-based treatment approach on the prevalence and intensity of schistosomiasis and soil-transmitted helminthiasis among schoolchildren in Tanzania.
Author: Massa K; Magnussen P; Sheshe A; Ntakamulenga R; Ndawi B; Olsen A
Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2009 Jan;103(1):31-7.
Abstract: This study compared the effect of the community-directed treatment (ComDT) approach and the school-based treatment approach on the prevalence and intensity of schistosomiasis and soil-transmitted helminthiasis (STH) among schoolchildren. Following a parasitological survey in a randomly selected sample of 1140 schoolchildren, school-age children in 10 study villages received one dose of praziquantel (40 mg/kg body weight) against schistosomiasis and one dose of albendazole (400mg) against STH. Five of these villages implemented the ComDT approach and received treatment by community drug distributors, while school teachers administered treatment in five other villages using the school-based approach. At 12 months follow-up, the prevalence of Schistosoma mansoni and Trichuris trichiura infections were similar between the ComDT and the school-based approaches when examined in randomly selected schoolchildren (10.1 vs. 9.4%, P=0.66 and 0.8 vs. 1.4%, P=0.37). However, the prevalence of S. haematobium and hookworm infections were significantly lower in the ComDT approach villages compared to the school-based approach villages (10.6 vs. 16.3%, P=0.005 and 2.9 vs. 5.8%, P=0.01, respectively). The results showed that the ComDT approach is at least as effective as the school-based approach in reducing prevalence and intensity of schistosomiasis and STH among schoolchildren.
Language: English
Keywords:
TANZANIA | RESEARCH REPORT | PREVALENCE | COMPARATIVE STUDIES | CHILDREN | STUDENTS | PRIMARY SCHOOLS | SCHOOL-BASED SERVICES | COMMUNITY-BASED DISTRIBUTION | SCHISTOSOMIASIS | TREATMENT | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Measurement | Research Methodology | Studies | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Education | Schools | Programs | Organization and Administration | Nonclinical Distribution | Distributional Activities | Program Activities | Parasitic Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 330843

24.

Peer Reviewed

Title: Emergency contraceptive use among 5677 women seeking abortion in Shanghai, China.
Author: Meng CX; Gemzell-Danielsson K; Stephansson O; Kang JZ; Chen QF; Cheng LN
Source: Human Reproduction. 2009 Apr 9;1(1):1-7.
Abstract: BACKGROUND The increasing use of emergency contraceptive pills (ECPs) does not seem to reduce the number of induced abortions as would be expected, indicating that women use ECPs might also be a strong factor affecting their final efficacy. The study aimed to understand the attitude towards, and use of, ECPs among women seeking an abortion. METHODS A cohort study was conducted via face-to-face questionnaire interview among women seeking abortion in Shanghai, China. Logistic regression analysis and chi(2) test were performed for statistical analysis. RESULTS The response rate was 99.3%. Among all 5677 respondents aged 15-48 years, 48.8% were ECP ever-users. Compared with ever-users, ECP never-users were less likely to have used contraception during the present cycle of conception (P < 0.001). In response to the question on the main reason for non-use of contraception, ECP never-users were less likely to realize the risk of pregnancy and had less contraceptive knowledge (P < 0.001). Among 2773 ECP ever-users, 72.7% did not use ECPs to prevent the current pregnancy, mainly due to lack of awareness of pregnancy risk. Out of 757 women, 437 (57.7%) repeated unprotected sex after taking ECPs during the current pregnant cycle. A pharmacy was the preferred source to access ECPs, for the reason of convenience. CONCLUSIONS Non-use of ECPs was correlated to less knowledge on fertility and a lower rate of contraceptive use among abortion-seeking women. Women of reproductive age should have access to ECPs and receive sufficient information on their use. Health care providers and pharmacists should also be trained in contraceptive counselling, including ECPs.
Language: English
Keywords:
CHINA | RESEARCH REPORT | COHORT ANALYSIS | KAP SURVEYS | CONTRACEPTIVE PREVALENCE SURVEYS | WOMEN IN DEVELOPMENT | ABORTION | EMERGENCY CONTRACEPTION | ATTITUDES | CONTRACEPTIVE PREVALENCE | RISK ASSESSMENT | PERCEPTION | CONDOM USE | PHARMACY DISTRIBUTION | Asia, Eastern | Asia | Developing Countries | Research Methodology | Surveys | Sampling Studies | Studies | Family Planning Surveys | Family Planning | Economic Development | Economic Factors | Fertility Control, Postconception | Contraception | Psychological Factors | Behavior | Contraceptive Usage | Evaluation | Risk Reduction Behavior | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration
Document Number: 331002 Notification

25.

Peer Reviewed

Title: Community-based distribution of sulfadoxine-pyrimethamine for intermittent preventive treatment of malaria during pregnancy improved coverage but reduced antenatal attendance in southern Malawi.
Author: Msyamboza KP; Savage EJ; Kazembe PN; Gies S; Kalanda G; D'Alessandro U; Brabin BJ
Source: Tropical Medicine and International Health. 2009 Feb;14(2):183-9.
Abstract: OBJECTIVE: To evaluate the impact of a 2-year programme for community-based delivery of sulfadoxine-pyrimethamine (SP) on intermittent preventive treatment during pregnancy coverage, antenatal clinic attendance and pregnancy outcome. METHODS: Fourteen intervention and 12 control villages in the catchment areas of Chikwawa and Ngabu Government Hospitals, southern Malawi, were selected. Village-based community health workers were trained in information, education and counselling on malaria control in pregnancy and the importance of attending antenatal clinics and promoted these messages to pregnant women. In the intervention group community health workers also distributed SP to pregnant women. RESULTS: In the control area, coverage of intermittent preventive treatment during pregnancy (>2 doses) was low before (44.1%) and during the intervention (46.1%). In the intervention area, coverage increased from 41.5% to 82.9% (P < 0.01). Antenatal clinic attendance (>2 visits) was maintained in control villages at above 90%, but fell in intervention villages from 87.3% to 51.5% (P < 0.01). Post-natal malaria parasitaemia prevalence fell in women from both study areas during the intervention phase (P < 0.05). Increasing the coverage of intermittent preventive treatment during pregnancy to >40% did not significantly improve maternal haemoglobin or reduce low birthweight prevalence. CONCLUSIONS: Better coverage of community-based intermittent preventive treatment during pregnancy can lower attendance at antenatal clinics; thus its effect on pregnancy outcome and antenatal attendance need to be monitored.
Language: English
Keywords:
MALAWI | RESEARCH REPORT | PREGNANT WOMEN | PREGNANCY | BIRTH WEIGHT | ANEMIA | ANTENATAL CARE | MALARIA PREVENTION | PREGNANCY OUTCOMES | COMMUNITY-BASED DISTRIBUTION | BAREFOOT DOCTORS | INTERVENTIONS | PROGRAM EVALUATION | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Population Characteristics | Demographic Factors | Population | Reproduction | Body Weight | Physiology | Biology | Diseases | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Malaria | Parasitic Diseases | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Health Personnel
Document Number: 341028

26.

Peer Reviewed

Title: Feasibility, acceptability and cost of home-based HIV testing in rural Kenya.
Author: Negin J; Wariero J; Mutuo P; Jan S; Pronyk P
Source: Tropical Medicine and International Health. 2009 Aug;14(8):849-55.
Abstract: OBJECTIVE: To demonstrate the feasibility, acceptability and cost of home-based HIV testing and to examine the applicability of the model to high HIV prevalence settings. METHODS: Quantitative, qualitative and cost data were collected during a home-based HIV testing program in a high-prevalence rural area of Kenya; data on age, gender and marital status along with HIV test results were collected. This was complemented with qualitative research including key informant interviews with counselors and program managers to highlight experiences and challenges. Direct costs of the interventions were estimated through the review of budgets and monthly expenditure sheets. RESULTS: Of 3180 15-49-year olds exposed to a community awareness campaign, 2033 (63.9%) agreed to be visited by counselors, of whom 1984 (97.6%) agreed to be tested and receive the results. Adult HIV prevalence was 8.2% and married women were 4.8 times more likely to be HIV-positive than those never married. Counselors reported feeling welcomed and noted the enthusiasm of the community towards testing. The total cost of the exercise was $17,569. The program cost was $2.60 for each of the 6750 community members, $5.88 for each person tested, and $84 per positive case detected. CONCLUSION: This study suggests that home-based HIV testing is feasible with high uptake, and has the potential to substantially expand access to HIV testing services. There is a strong economic case for the extension of such a screening program to other communities.
Language: English
Keywords:
KENYA | RESEARCH REPORT | DATA ANALYSIS | HIV TESTING | HOME CARE | FEES | COMMUNITY-BASED DISTRIBUTION | PROGRAM ACCEPTABILITY | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Care and Support | Financial Activities | Economic Factors | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Program Evaluation
Document Number: 342977

27.

Peer Reviewed

Title: Accuracy of information given by Los Angeles County pharmacies about emergency contraceptives to sham patient in need.
Author: Nelson AL; Jaime CM
Source: Contraception. 2009 Mar;79(3):206-10.
Abstract: BACKGROUND: As emergency contraception (EC) becomes increasingly available without prescription, it is important that women in need be provided accurate information about its use. STUDY DESIGN: A telephone survey of all retail pharmacies in Los Angeles County was conducted by women posing as a 23-year-old who wanted to prevent pregnancy after an unprotected act of intercourse. RESULTS: One thousand four hundred sixty unduplicated pharmacies listed in the Yellow Pages 2007 were called between October 2007 and April 2008. Sixty-nine percent had EC available on site; 19% referred the caller elsewhere. The remainder said nothing could be done or hung up. Multiple calls and multiple recitations of the situation were needed in over one third of calls. Isolated incidents of inappropriate comments occurred. CONCLUSION: While most pharmacies provided information about EC that was consistent with labeling, barriers still exist to both accurate information and timely access to that product.
Language: English
Keywords:
CALIFORNIA | RESEARCH REPORT | SURVEYS | WOMEN | PHARMACISTS | PHARMACY DISTRIBUTION | FAMILY PLANNING EDUCATION | EMERGENCY CONTRACEPTION | TELECOMMUNICATIONS | United States of America | North America | Americas | Developed Countries | Sampling Studies | Studies | Research Methodology | Demographic Factors | Population | Health Personnel | Delivery of Health Care | Health | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Education | Contraception | Family Planning | Broadcast Media | Mass Media | Communication
Document Number: 330057

28.

Peer Reviewed

Title: Does readily available emergency contraception increase women's awareness and use?
Author: Novikova N; Weisberg E; Fraser IS
Source: European Journal of Contraception and Reproductive Health Care. 2009 Feb;14(1):39-45.
Abstract: BACKGROUND: In Australia just over half of all women of reproductive age have experienced an unplanned pregnancy, many of which could have been avoided by use of emergency contraception. A dedicated emergency contraceptive pill (ECP) pack became available on prescription in Australia in 2002, and over the counter in 2004. OBJECTIVES: To determine if availability of a dedicated over the counter ECP pack in Australia increased knowledge and use of emergency contraception (EC). MATERIAL AND METHODS: Women attending three free-standing abortion clinics in Sydney answered an anonymous questionnaire on their knowledge and use of the ECP. Group 1 (208 women) was recruited prior to a dedicated ECP pack being available, group 2 (308) after it was available on prescription, and group 3 (202) after it became available over the counter. RESULTS: Women who had heard about EC were significantly younger (p < 0.005). The mean age of women who had never heard about EC was 29.8 years compared to 26.3 for women who had heard about EC. More women expressed awareness of the ECP after it became available over the counter. Women in group 2 attained a higher educational level than women in the other groups (p < 0.005). There was a significant trend to increased use of the ECP in women of higher educational level (p < 0.005). The use of EC did not increase significantly with improved availability and access. CONCLUSIONS: Among women seeking termination of pregnancy wider availability of the ECP has increased women's awareness of EC but not use.
Language: English
Keywords:
AUSTRALIA | RESEARCH REPORT | KAP SURVEYS | WOMEN | CONTRACEPTIVE USAGE | EMERGENCY CONTRACEPTION | CONTRACEPTIVE AVAILABILITY | PHARMACY DISTRIBUTION | CONTRACEPTIVE DISTRIBUTION | KNOWLEDGE | CONTRACEPTIVE PREVALENCE | AGE FACTORS | EDUCATIONAL STATUS | Developed Countries | Oceania | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Factors | Population | Contraception | Family Planning | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Sociocultural Factors | Population Characteristics | Socioeconomic Status | Socioeconomic Factors | Economic Factors
Document Number: 330346

29.

Peer Reviewed

Title: Comprehension of a prototype emergency contraception package label by female adolescents.
Author: Raymond EG; L'Engle KL; Tolley EE; Ricciotti N; Arnold MV; Park S
Source: Contraception. 2009 Mar;79(3):199-205.
Abstract: BACKGROUND: We evaluated female adolescents' comprehension of a prototype over-the-counter package label for an emergency contraceptive pill product. STUDY DESIGN: Volunteers aged 12-17 years who could read English were recruited at malls and clinics in six United States metropolitan areas. After completing a literacy assessment, subjects examined the prototype package and answered 20 questions that assessed understanding of six key concepts related to appropriate use of the product. RESULTS: The analysis population included 335 subjects, 54 to 59 of each year of age between 12 and 17 years. When asked what the product is used for, 264 respondents (79%) specifically indicated contraception. The six key concepts were each understood by 83-96% of subjects. In all 24 population subgroups examined, each key concept was understood by at least 72% of subjects. CONCLUSION: Female adolescents aged 17 years and younger understand the prototype package label well enough to enable safe and effective use without assistance from a clinician.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | KAP SURVEYS | ADOLESCENTS, FEMALE | EMERGENCY CONTRACEPTION | READING | LANGUAGE | KNOWLEDGE | FAMILY PLANNING EDUCATION | CONTRACEPTIVE MODE OF ACTION | AGE FACTORS | PHARMACY DISTRIBUTION | Developed Countries | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Adolescents | Youth | Population Characteristics | Demographic Factors | Population | Contraception | Family Planning | Literacy | Educational Status | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Communication | Sociocultural Factors | Education | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration
Document Number: 330058

30.
Peer Reviewed

Title: The free condom initiative: promoting condom availability and use in New York City.
Author: Renaud TC; Bocour A; Irvine MK; Bernstein KT; Begier EM; Sepkowitz KA; Kellerman SE; Weglein D
Source: Public Health Reports. 2009 Jul-Aug;124(4):481-9.
Abstract: In 2005, the New York City Department of Health and Mental Hygiene (DOHMH) made free condoms available to organizations through a Web-based ordering system. In 2006, we interviewed managers and patrons about free condom availability, acquisition, and use in venues where people at high risk for human immunodeficiency virus congregate. DOHMH condom distribution increased from 5.8 million in 2004 to 17.3 million in 2006. Overall, managers reported making condoms available at 76% (309/409) of high-priority venues, but only at 40% of gay bars. Among patrons who saw free condoms, 80% (280/351) reported taking them; 73% (205/280) of those who reported taking them also reported using them. A simple, Web-based ordering system dramatically increased condom distribution. In the venues we sampled, the majority of patrons acquired and used free condoms when available and visible, suggesting that increasing free condom availability may increase use. Special efforts are needed to ensure availability at gay bars.
Language: English
Keywords:
UNITED STATES OF AMERICA | NEW YORK | RESEARCH REPORT | URBAN POPULATION | CONDOMS | PROMOTION | PROGRAM EVALUATION | DISTRIBUTIONAL ACTIVITIES | CLINICAL DISTRIBUTION | COMMUNITY-BASED DISTRIBUTION | INTERNET | CONDOM USE | INTERVIEWS | Developed Countries | North America | Americas | Population Characteristics | Demographic Factors | Population | Barrier Methods | Contraceptive Methods | Contraception | Family Planning | Marketing | Economic Factors | Programs | Organization and Administration | Program Activities | Nonclinical Distribution | Information Networks | Communication | Risk Reduction Behavior | Behavior | Data Collection | Research Methodology
Document Number: 342144


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