Determinants of Modern Contraceptive Uptake among the Youth in Akuse Township in the Lower Manya Krobo Municipality, Ghana

Background: Access to safe and effective contraception is crucial for sexual and reproductive health to be at its best. This allows improved pregnancy results and the avoidance of unintended births. Teenagers’ views on using contraceptives are influenced by the information available at their disposal. The study assessed the influential factors affecting the utilization of modern contraceptives among the youth in Akuse in the Eastern Region of Ghana. Methods: The data for the study were gathered from 378 consented youth aged 15 - 24 years using a quantitative cross-sectional study design and a well-structured questionnaire. Person’s Chi-Square test was adopted to measure the association between the outcome variable and selected independent variables. Logistic regression models were utilized to measure the odds of the factors influencing modern contraceptive use among the respondents. Results: The results of the study suggested a high knowledge level of contraceptives;however, the prevalence of utilization was low. The level of education and age were factors found to influence the uptake of contraceptives. A bivariate analysis to examine the association between selected socio-demographic variables revealed that educational level (p = 0.044), religious affiliation (p = 0.002), and ethnicity (p = 0.016) were statistically associated with modern contraceptive use among the respondents. All other tested demographic variables including the age groups, gender, marital status, and residential status proved otherwise at the observed p-values greater than the 0.05 threshold. Respondents who indicated staying with partners were 6.79 times more likely to use contraceptives compared to their counterparts staying with a parent, after controlling for all other covariates. Conclusions: Based on the findings of this study, it was concluded that high contraceptive knowledge influences the choice of contraceptive preferred by the youth, and contraceptive use is also influenced by the advancement in age and educational level of the youth. It is however recommended that parents, guidance, and teachers be entreated to offer relevant and timely sexual information or education as these will most likely improve the uptake of modern contraceptives among the targeted population.

An Investigation on the Utilization of Intra Uterine Contraceptive Device among Women in Kabwe, Central Province

Introduction: Intrauterine contraceptive device (IUCD) is an effective long acting reversible contraceptive but its use is low. This study examined factors contributing to the utilization of intrauterine contraceptive devices (IUCDs) among women in Kabwe Central Province. Methodology: This was an analytical cross sectional study. Primary data was collected from 150 respondents in using simple random sampling method. Data was analysed using the statistical package of social sciences (SPSS) version 22. Chi-square test was used to test associations among the dependent and independent variables. Logistic regression analysis was conducted. The confidence interval was set at 95% and significant level was at 0.05%. Findings: The study found that 44% of the respondents had high level of knowledge about IUCD. About 28% of the respondents, said that they used IUCD because it maintains menstrual bleeding, 26% said that they used because IUCD it does not cause infections, and 19% said that they used IUCD because it does not migrate to other body parts. Majority (81%) of the respondents agreed with a statement that age contributes to underutilization of IUCD. About 77% of the respondents agreed with a statement that marital status contributes to underutilization of IUCD and 75% agreed with a statement that, education level contributes to underutilization of IUCD and was significant. Furthermore, 91% of the respondents agreed with a statement that lack of knowledge about IUCD contributes to underutilization of IUCD and 74% agreed with a statement that religion contributes to underutilization of IUCD. Age (p = 0.003), marital status (p = 0.002), education level (p = 0.003), and employment status (p = 0.02), were found to have a significant relationship with the utilization of IUCD. About 36% of the respondents said that knowledge or education affects the utilization of IUCD at a large extent. The study showed a positive relationship between the utilization of IUCD and all explanatory variables such as age, education/knowledge, marital status, religion, family size and income and acceptability which had a positive correlation ranging from 0.543 to 0.815. Older women with higher education levels were more inclined to use IUCDs compared to younger individuals and those with only a primary education. Religious affiliation influenced IUCD use with Muslim women being less likely to opt for IUCDs. Moreover, being married was associated with lower IUCD utilization. Conclusion: Based on these findings, the study identified age, education/knowledge, marital status, religion, family size and income, and acceptability as the primary drivers of IUCD usage. The study recommends that, there should be a conduct of educational workshops, there should be community awareness programs and there should be comprehensive family Planning Services.

Successful Laparoscopic Management of a Migrated Intrauterine Contraceptive Device in the Pelvic Cavity: A Case Report

Background: An Intrauterine device (IUD) is a long-acting reversible contraceptive commonly used in clinical practice. Its insertion in the uterus is simple and safe. But sometimes, complications can occur. Case Report: Herein, we report a case of successful laparoscopic removal of a missing IUD Copper-T, mis-inserted in a 32-year-old woman, 4 months after she delivered by caesarian section, and presented persistent lower abdominal pain lasting 6 months. Uterine ultrasound was unremarkable, but a plain abdominopelvic X-ray confirmed the presence of the Copper-T inside the abdominal cavity. Conclusion: Insertion of IUD is simple and safe. When the diagnosis of uterine perforation following its insertion is clinically suspected and radiologically confirmed, laparoscopy, when available, remains one of the best options for removal.

Trends in the Use of Reversible Modern Contraceptives in Burkina Faso between 2010 and 2015

Background: In Burkina Faso, efforts have been made between 2010 and 2015 to address the low levels of contraceptive utilization. However, the socio-cultural context in the country still reinforces traditional gender roles, low status for women, and a strong desire for larger families. The objectives of this study are twofold: 1) to analyze the trends in reversible modern contraceptive prevalence, and 2) to identify the factors influencing the use of reversible modern contraceptives, comparing the urban and rural areas. Data and Methods: We conducted an analysis using data from Burkina Faso sourced from the 2010 Demographic and Health Survey (DHS) and the 2015 Demographic and Health Module (DHM). The 2010 DHS received responses from 17,087 women aged 15 - 49 years, achieving a response rate of 98.4%. Similarly, the 2015 DHM garnered responses from 11,504 women aged 15 - 49 years, with a response rate of 96.6%. Results: Our findings revealed that while advancements were observed in urban areas, the majority of underprivileged women still faced limited access to modern contraception. Moreover, we did not observe any significant interaction effects between age and parity with the year of the survey. However, there was a slight decrease in the impact of marital status, although the difference between married and non-married women remained significant in 2015. It is noteworthy that family planning discussions and approval continued to play crucial roles. Conclusion: The initiatives to subsidize contraceptive costs and establish mobile clinics have proven inadequate in facilitating rural, impoverished, and young women’s access to modern contraception. Additional endeavors are required to enhance geographical accessibility to modern contraceptives by expanding the availability of supply sources, particularly in rural areas. Furthermore, providing psychosocial support has the potential to empower women in making informed contraceptive decisions and exercising greater control over their reproductive choices.

Factors Influencing the Choice between IUD and Implant among Long-Acting Reversible Contraceptive (LARCs) Users in Burkina Faso

Background: Long-acting and reversible contraceptive methods hold great potential as solutions to address the unmet need for contraception and the significant discontinuation rates, especially in sub-Saharan Africa. Among these methods, the Implant has gained popularity in sub-Saharan Africa, whereas the utilization of Intrauterine Devices (IUDs) has remained comparatively low, particularly in Burkina Faso. This study aims to evaluate the shifts in IUD and Implant usage from 2010 to 2020 and to pinpoint the factors influencing the choice of IUDs among LARCs users in Burkina Faso. Data and Methods: We conducted an analysis using data from Burkina Faso, drawn from the 2010 Demographic and Health Survey (DHS) and the 2020 PMA Phase 1 data. The 2010 DHS garnered responses from 17,087 women aged 15 - 49, achieving a response rate of 98.4%. The 2020 PMA data collected responses from 6590 women aged 15 - 49, with a response rate of 95.8%. The final sample of Long-Acting Reversible Contraceptives (LARCs) users consisted of 1502 women, including 576 women from the 2010 survey and 926 women from the 2020 survey. Results: The study demonstrates an expansion of IUD usage to include socioeconomically disadvantaged segments among LARC users. However, higher levels of education, older age, and decisions influenced by healthcare providers are correlated with the preference for IUDs over Implants. The choice of IUDs is also connected to a comprehensive understanding of contraceptive methods, suggesting potential biases in the counseling process. Conclusion: Facilitating the broader adoption of IUDs among disadvantaged groups could be achieved by improving the accessibility of IUD products and services in rural areas. Nevertheless, there should be focused initiatives to enhance access to removal services, as this factor could dissuade specific users. Further efforts are required to train healthcare providers, aiming to mitigate biases in delivering Long-Acting Reversible Contraceptives (LARCs). Providers should provide impartial counseling, irrespective of the selected type of LARC.

Trends of Inequalities in the Use of Long-Term Reversible Contraceptives in Burkina Faso between 2010 and 2015

Background: Efforts have been made in Burkina Faso, a French-speaking country, since 2010 to improve healthcare access and provide affordable contraceptive methods to women. With the increasing prevalence of modern contraceptives in Burkina Faso, it is important to examine the socio-demographic factors that contribute to this new pattern of contraceptive use. This study aims to analyze the changes in socio-demographic factors associated with long-term contraceptive use and provide scientific evidence to guide policy development and action planning in family planning. Data and Methods: We utilized data from the 2010 Demographic and Health Survey, which included 17,087 women aged 15 - 49 years, and the 2015 Demographic and Health Module, which included 11,504 women in the same age group. For the analysis of contraceptive use, we focused on women who were in need of contraception (either met or unmet), of reproductive age, non-pregnant, and either married or sexually active but not married. We included users of modern reversible methods and excluded non-users, as well as users of traditional or permanent methods. Results: Our findings revealed a high prevalence of long-term contraceptive use across all categories;however, certain challenges were identified, such as lower levels of information about contraceptive methods among users and the persistence of inequalities. Family planning discussions and partner approval did not influence long-term contraceptive choice. Additionally, some providers selectively offered specific methods based on women’s life course characteristics, such as parity and marital status, despite evidence suggesting that young and nulliparous women can effectively use long-term methods. Conclusion: Given the high effectiveness of long-term contraceptive methods, it is crucial to address barriers that hinder their utilization among young and nulliparous women, as well as those who desire to delay pregnancy. Efforts should focus on improving knowledge and dispelling misconceptions surrounding long-term methods. Providers play a pivotal role in this process by adopting counseling strategies that enhance users’ understanding and facilitate informed decision-making regarding contraceptive options.

Contraceptive Experiences of Women of Procreation Age Who Attended Two HealthCenters in the City of Abidjan (Cote d’Ivoire)

Introduction: Maternal mortality, which is estimated at 614 deaths per 100,000 births in Côte d’Ivoire, is associated with a low national contraceptive prevalence rate of 13.9%. In this study, we are interested in the contraceptive experiences of women who attend health centers to estimate their rate of contraceptive use and to assess the factors involved in the use of modern contraceptive methods among women of childbearing age who are exposed to the risk of pregnancy. Method: A descriptive cross-sectional study was conducted from December 2018 to September 2019 among 423 women, who attended two health centers in Abidjan. A bivariate analysis identified factors associated with contraceptive use by these women. A descriptive analysis determined the means for the quantitative variables and the frequencies and percentages of qualitative variables. Interpretation of results was based on significance (α = 5%, 95% CI). Results: Contraceptive prevalence was 37%. There was a significant relationship between contraceptive use and the socio-demographic and reproductive characteristics of women (p Conclusion: Women who were over 35 years age, uneducated, primary school graduates, housewives, unemployed, in the informal sector, Muslims, nulliparous, and lacking information and decision-making power were less likely to use modern contraceptive methods. They are the target population for strategic interventions to improve contraceptive prevalence.

Family Planning: Choosing Contraceptive Methods in Kongo Central Province, the Democratic Republic of the Congo

Background: In developing countries, access to modern contraceptive methods remains a concern, particularly in Sub-Saharan Africa (SSA). Although satisfactory progress in increasing family planning use has been observed worldwide, demand and unmet need continue to grow. This study describes the different reasons that push women in rural and urban areas of Kongo Central province in the Democratic Republic of Congo (DRC) to choose one of the modern contraceptive methods. Methods: A cross-sectional, analytical study on the 705 clients recruited during the family planning mini-campaigns organized from January to March 2021 in 8 health zones of the Kongo Central Province in DRC. Community Contraceptive Methods Distributors (CCMD) collected the data, community health workers (CHW) trained in clinical providers’ community family planning service. The Pearson’s Chi2 test was used to compare the proportions of the methods chosen in the different study variables categories, and logistic regression was done to analyze the strength of association between the uses of long-acting reversible contraceptives (LARC) with the study variables. Results: The mean age (SD) of the clients was 25.7 years. The median number of living children was 2 children and that of pregnancies carried per client was 3. Three (3) clients under the age of 20 out of 126 (2.4%) have 3 to 4 living children and one a up to 6 living children. Out of a total of 705 clients, 11.1% aged under 20 and 39.1% of clients aged 20 to 24 requested LARC. Divorced and unmarried women chose SAC and married and common-law women chose LARC more, compared to other categories of women. Unemployed women prefer SACs more than other professional categories, and women farmers prefer LARC. The level of education has no influence on the choice of method. The use of LARC increased with the number of pregnancies carried, children alive, and children who died. The age and number of children who died did not influence the association between LARC and alive children. Conclusion: The choice of modern contraceptive methods is guided by the age of the mother and the number of children living in her life. Younger women are more likely to choose short-acting contraceptive methods in the eight health zones of Kongo Central province. The high number of living children influences the choice of LARC regardless of age.

Knowledge, Attitude and Practice of Contraceptive Use among Women of Reproductive Age in Port Harcourt, Nigeria

Background: Low contraceptive use among all other factors have been implicated in rapid population growth seen in low and lower middle-income countries (LLMICs). This can be attributed to poor knowledge and attitude of the populace towards use of modern contraceptives. Aim: To determine the knowledge, attitude and practice of contraception among pregnant women attending ANC at the University of Port Harcourt Teaching Hospital (UPTH) in Port Harcourt, Rivers State, Nigeria from July 1 to August 31, 2021. Methods: This quantitative study was designed as a descriptive cross-sectional study that recruited 529 women. They were administered with a semi-structured questionnaire which was used to collect their data and responses. The data was analysed using Statistical Product and Service Solutions (SPSS) version 25. Results: According to the findings, 57.3% and 47.1% of the women had poor knowledge and negative attitude towards contraception respectively. About a tenth of the women (9.8%) utilised contraceptives of which 44.2% and 42.3% used the natural method and male condoms respectively. The study also revealed the major reason behind the low use as desire for more children (36.3%). Conclusion: The study showed that the women had poor knowledge and negative attitude towards contraceptives and this translated to poor contraceptive use. Hence, awareness campaigns should be intensified by health workers towards enlightening the populace on the different types, uses and benefits of modern contraceptives.

Perception of Condoms and Emergency Contraceptive Pill Use among Students in the University of Bamenda

Background: Globally, university students fall in the youth group prone to unattended sexual risks which may lead to unwanted pregnancy and STI/HIV. In Cameroon, more than a third of maternal deaths occur among adolescent girls and young mothers. Unwanted pregnancies results from the infrequent use of modern contraceptive methods and is one of the main causes of death in this population. Condoms are barrier contraceptive that have a beauty of dual protection-against pregnancy and transmission of STI/HIV, meanwhile emergency contraceptives has just one function which is protection against unwanted pregnancy. Aim: To assess the perception of condoms and emergency contraceptive pill use among students in the university of Bamenda, Cameroon. Materials and Methods: A university-based cross-sectional study was conducted among students in the University of Bamenda, North West Region of Cameroon, a cosmopolitan area approximately about 19 km from Bamenda main town (Commercial Avenue). The study was carried out over a period of three months. Data were collected using a structured interviewer questionnaire administered through Google form. Data collected were extracted into excel sheet and analysed with SPSSv23. Results: The study included 719 students (318 males and 401 females). The rate of male and female condom use was 28.5% and 8.1% respectively. The mean age of our study populations was 24.5 ± 4.97 years with 52.7% of population between 20 to 24 years of age. Knowledge about condoms was high at 98.3%, however, 91.9% of participants have never used the female condoms before. Highest factor recorded for non-utilisation of the male and females condoms were reduction in sexual pleasure (47.4%) and lack of knowledge on usage (44.1%) respectively. 95% of students have knowledge on Emergency Contraceptive Pills (ECPs) but just an average (52.4%) have used it before. Fear of side effects (47.4%) was the main reason for not using ECPs. Conclusion: There is a very high knowledge about condom and emergency contraceptive pill among students. However, the rate of usage recorded was very low with highest source of information being the media/internet and lowest among relatives/family.

Contraceptive Method Choice Among Newly Married Couples and Influential Factors in Shanghai Municipality

A follow-up study with 7,826 representative newly married couples for fifteen months after their weddings in Shanghai Municipality showed that among the 3, 412 couples who actually adopted contraceptive method, rhythm was the main choice; the proportion for couples taking the contraceptive pill was much higher among sexually active couples before their weddings. The proportions of adopting rhythm or condom or the both, however, increased afterwards.About 86% of couples who had ever planned adopting the rhythm at registration actually used it. In fact, 16% of those who had ever planned to take pills eventually made this choice, because of their worry about any adverse side effects on mother's and fetus' health. Their knowledge about contraception,especially the pills, was incomprehensiue. APProximately 62% of condom users had not been given any instruction regarding its use when they got this contracoptive device one year later. Half of the pill and spermicide users learnt these respective methods from their friends or relatives. The proportion of delivering contraceptiues alter marriage by;F.P.P. was rather low. By fitting the multinomial logistic regression model, it is indicated that couple's evaluation on contraceptiue methods and contraceptiue goal were the main factors determining newlyweds' method of choice. Wife's knowledge on contraception and the accessibility of contraceptives and devices also influenced the method choice to some extent.

Complications Related to the Insertion Technique of Jadelle® Contraceptive Implants

Introduction: Contraceptive implants are one of the most effective methods of birth spacing. Jadelle® implants consist of two strands that are easy to insert and remove. Although their effectiveness is no longer in question, their use (insertion) requires a surgical procedure with the corollary possibility of complications. These are mainly insertions that are too deep (in the arm muscle), vascular and nerve damage. Material and Methods: Our study focused on complications related to implant insertion. It was a descriptive and retrospective study over thirty-four months, from October 2016 to July 2019, and concerned all patients seen in consultation and who presented a complication related to the insertion of contraceptive implants in the Department of Gynecology and Obstetrics of the National Hospital of Pikine. Results: We collected nine complications managed at the Gynecology and Obstetrics Department of the Centre Hospitalier National de Pikine from 2016 to 2019. These were insertions that were too deep with sometimes nerve damage, infection or incident during anesthesia. The operative procedures were based on the type of complication. Conclusion: Although Jadelle® has the advantage of having only 2 rods compared to its predecessor Norplant®, its use is also conditioned by insertion and removal procedures which may experience complications.

Spousal communication, fertility preference and other factors affecting contraceptive use among married couples in Ekiti State, Nigeria

Objective:To assess and compare the relationship between spousal communication,fertility preference,and other factors with contraceptive use among married couples in Ekiti State,Nigeria.Methods:This cross-sectional study was carried out in AdoEkiti Local Government Area of Ekiti State,Nigeria between the 12th of August 2017 and the 15th of February 2018.A pre-tested,semi-structured interviewer-administered questionnaire was used to collect data from 976 respondents by a multi-stage sampling technique.Data were analyzed(univariate,bivariate,and binary logistic regression analysis)using SPSS version 24.0.Factors that showed statistical significance(P<0.05)were included in a binary logistic regression to determine significant predictors of contraceptive use.Results:The proportion of respondents currently using contraceptives was 56.9%.The education status of the respondents revealed that those with primary education were more likely to use contraceptives than those without formal education[adjusted odds ratio(aOR)8.4,95%confidence interval(CI)1.97-36.2,P<0.001].Respondents with fair spousal communication were more likely to use contraceptive than those with poor communication(aOR 4.9,95%CI 2.80-8.71,P<0.001).In addition,fertility preference of 4 or less children was found to be significantly associated with contraceptive use(aOR 3.0,95%CI 1.67-5.50,P<0.001)compared to a preference of more than 4 children.Finally,the urban respondents were more likely to use contraceptives than those in the rural setting(aOR 1.7,95%CI 1.16-2.41,P=0.047).Conclusions:Educational status,residential site,spousal communication,and fertility preference significantly influence the level of contraceptive use among married couples.Couples should endeavor to discuss more on issues bordering on their fertility preference and contraceptive issue.Government should formulate policies to improve the rural uptake of contraceptives using identified target interventions.

Characteristics of Contraceptive Use in So Paulo State,Brazil

Objective To know the characteristics of contraceptive use in Sao Paulo State collected by the Demographic and Health Survey （DHS） conducted in 1996. Methods Data of Sao Paulo in 1996 were analyzed compared with the previous DHS carried on in 1986focusing on Sao Paulo State. Contraceptive use among married or cohabiting women by age, number of children and schooling was closely examined. Age and timing of female sterilization were also analyzed. Results The results showed that unlike Brazil there was a stability of female sterilization in Sao Paulo State during 1986 and 1996. There was a pattern in Sao Paulo： up to 30 years old the pill was the most used contraceptive, after 30 there was a predominance of female sterilization, which increased with the number of children and decreased with schooling. The use of male methods had also increased in the 1986 and 1996 period, being greater in Sao Paulo than in Brazil. Sao Paulo also presented more diversity in the use of reversible contraceptives. Conclusions The predominant two contraceptive methods in Brazil and Sao Paulo changed from 1986 to 1996, i.e..from pill to female sterilization.

CONTRACEPTIVE PREVALENCE AND USE－EFFECTIVENESS OF MARRIED WOMEN OF REPRODUCTIVE AGE IN THE RURAL AREAS OF SHAANXI PROVINCE

In order to study women's fertility and behavior in shaanxi Province, we used PPS method to sample Weinan, Nanzheng and Yan'an counties which represent the centre, south and north of Shaanxi respectively from February to March in 1990. 3253 qualified married women of reproductive age were available. Because contraception is one of the most imPOrtant proximate determinants in inhibiting fertility, we just measured contraceptive prevalence and use-effectiveness among different subgroups in this dissertation. The results indicated that the prevalence rate of contraception was 75. 9 %, prevalence of different contraceptive methods varied widely: it was 43. 5% in IUD, 27. 7% in women'sterilization, 2. 0% in pill, 1.9% in men's sterilization, 0. 2% in condom and 0. 7 % in other methods, The average use-effectiveness of three methods was 0. 9965 for sterilization,0. 8792 for IUD and 0. 8520 for other methods and total average use-effectiveness was 0. 9251.

Choice and Changes of Contraceptive Methods after Primiparous Delivery in Shanghai

Totally, 3 701 prim iparousw om en in Shanghaiw ere follow ed up for 15 m onths after delivery to assess their initialand subsequent changes in choice of contraceptive m ethods. Results show ed that 15 m onths after delivery, 95.46of w om en had al- ready used a contraceptive m ethod. The leading firstchoice of contraceptive m ethods am ong urban w om en w asthe condom (50.72) or IUD(29.09), w hile the leading firstchoice am ong ruralw om en w asIUD(56.65) or the condom (30.60). Within 15 m onths after delivery, w om en w hose first choice had been the condom tended to sw itch usually to an IUD. Butfew er w om en w hosefirstm ethod w asan IUD sw itched to other m ethods. Atthe 15th m onth follow -up, 94.54of w om en w ere all using a m ethod, w ith 60.76of urban w om en and 71.07of rural w om en using IUDs. Multinom inal logistic regression analysis suggests that w om en's characteristics influ- ence the choice of m ethods. Urban, w ell-educated w om en w ere m ore likely to choose condom and rhythm , and lesslikely to chooseOC. Older w om en tended to use condom and rhythm m ore often than younger w om en. Breastfeeding w om en w ere lesslikely to use OC. Wom en w ho received recom m endations regarding postpartum contraception from fam ily planning w orkers w ere m ore likely to use IUD. It w as concluded that fam ily planning w orkers should increase w om en's aw areness of the advantages and disadvantagesof differentm ethods, dispelmythsand rum orsaboutsom em ethodsand improve w om en'sknow ledge of inform ed choice.

Attributable Causes of Breast Cancer and Ovarian Cancer in China:Reproductive Factors,Oral Contraceptives and Hormone Replacement Therapy

Objective： To provide an evidence-based, consistent assessment of the burden of breast cancer attributable to reproductive factors （RFs, including nulliparity, mean number of children, age at first birth and breastfeeding）, use of oral contraceptives （OCs, restricted to the age group of 15-49 years）, and hormone replacement therapy （HRT）, as well as of the burden of ovarian cancer attributable to the mean number of children in China in 2005. Methods： We derived the prevalence of these risk factors and the relative risk of breast and ovarian cancer from national surveys or large-scale studies conducted in China. In the case of RFs, we compared the exposure distributions in 2001 and counterfactual exposure. Results： Exposure of RFs in 2002 was found to account for 6.74% of breast cancer, corresponding to 9,617 cases and 2,769 deaths, and for 2.78% of ovarian cancer （712 cases, 294 deaths）. The decrease in mean number of children alone was responsible for 1.47% of breast cancer and 2.78% of ovarian cancer. The prevalence of OC use was 1.74% and the population attributable fraction （PAF） of breast cancer was 0.71%, corresponding to 310 cases and 90 deaths. The PAF of breast cancer due to HRT was 0.31%, resulting in 297 cases and 85 deaths. Conclusion： RFs changes in China contributed to a sizable fraction of breast and ovarian cancer incidence and mortality, whereas HRT and OCs accounted for relatively low incidence of breast cancer in China.

Constraints in the development of contraceptives for men

Considerable efforts have been made to develop a male contraceptive and the studies have provided very useful infor-mation in this field. At least five different strategies to develop a male contraceptive have been pursued, namely: inhi-bition of sperm production, interference with sperm function, interruption of sperm transport, prevention of sperm de-position, and prevention of sperm-egg interaction. Of all these approaches, inhibition of sperm production by using an-drogens either alone or in combination with progestins have given the most encouraging results. A nmnber of clinicaltrials substantiate that it is indeed possible to have a reversible, effective and safe hormonal method of contraception. Apostmeiotic and epididymal approach to interfere with sperm function or the secretory and metabolic processes of theepididymis is another attractive option of male contraceptive development. A number of chemical compounds have beenidentified which interfere with sperm function in the epididymis without affecting sperm production, however, the com-pounds evaluated so far were found to be toxic. Interruption of sperm transport through the vas either by vasectomy orpercutaneous intmvasal injection of liquids which form cure-in-place plugs is also an attractive option. However, re-versibility of the methods is of concern in their wide scale use. The major constraint in developing a long-acting male contraceptive seems to be the need for greater investment forproduct development. The clinical trials for evaluating the efficacy and safety of the new products and formulationsstretch over several years and require enormous financial commitment. Nevertheless, the long-term gain of having along-acting reversible contraceptive for men is far greater than the financial commitments over few years. Male attitudetowards using methods of family planning is much more favourable than originally believed. The pharmaceutical indus-try as well as the health care providers therefore have a greater responsibility. For early development of a contraceptivefor men, it is essential to increase investment and simplify the drug regulatory procedures. The advent of newer tech-nologies coupled with the convergent efforts of scientists will certainly make it possible to have an effective, safe andreversible male contraceptive in the near future.

Relationship between Contraceptive Knowledge,Cognition and Behaviors among Vocational High School Students

Objective To study the relationship between contraceptive knowledge, cognition and behaviors among vocational high school students. Methods A cross-sectional survey was anonymously self-administrated by way of computer to all the 1st graders＇ among three vocational high schools in a district of Shanghai. Four cognition indicators, including perceived benefits, perceived barriers, perceived risks and self eJficacy were applied according to Health Belief Model. Results The percentage of respondents who reported ever sexual practices and contraceptives use at first sex was 7.01% and 56.64% respectively. Condom （58. 70%） and oral contraceptive pills （27.78%） were used by the majority. Main reasons for non-use were ＂shy to buy it＂ （26.53%） and ＂partner don＇t want to use any＂ （18.37%）. Proportion of respondents who ever had sex regarded withdrawal and rhythm as effective were 68.35% and 68.42% respectively. Proportion of respondents having sex knew ＂If a person was infected with STDs, he/she might not have noticeable symptoms＂ were 22.86%. Proportion of respondents who reported non-use of contraceptives at first sex considered that ＂infrequent intercourse could not cause a girl pregnant even she had experienced her menstruation＂ were 40.63%. Proportion of respondents who had ever used condom got full score of knowledge on ＂how to correctly use condom＂ were 23,26%. Perceived risks were poorest among four cognition indicators. High level of contraceptive knowledge was connected with high rate of contraceptives use at first sex, whereas high level contraceptive cognition was connected with high rate of contraceptive use both at first and recent sex. Conclusions It is important to provide youth-friendly services as well as message on contraceptives among vocational school students.

Pulmonary Embolism and Deep Vein Thrombosis in a Woman Taking Contraceptives and with Unhealthy Life Habit:a Case Report

QRAL contraceptives are widely used to prevent pregnancy. A number of studies have dem- onstrated the increased risk of venous throm- boembolism in women taking oral contracep-tives.1, 2 Pulmonary embolism （PE） and deep vein throm- bosis （DVT） are two clinical presentations of venous thromboembolism which share the same predisposing factors.3 This article described a female patient who taked oral contraceptives and had an unhealthy life habit de- veloped PE and DVT. CASE DESCRIPTION