Systematic review of experiences and effects of integrating post-abortion family planning services into existing health system worldwide

Objective To systematic review and analyze the practices and effects of integrating post-abortion family planning （PAFP） services into existing health system worldwide in order to inform the future interventions to deliver PAFP in China. Methods A systematic search for relevant published and unpublished literature was conducted. Based on a set of criteria, citation and full text were screened, related data were extracted. Findings of included studies were reviewed and analyzed using a textual narrative approach to synthesis. Results A total of 28 studies were included in the synthesis. The studies were published between 1995 and 2008 and covered 20 countries. Some countries were in the stage of piloting post-abortion care （PAC）/PAFP intervention, while others were either from piloting to scaling up or examined how well a pilot PAC/PAFP intervention and resulting improvements were able to be maintained over the long term in the same intervention site. Most studies examined initiatives that were implemented at public sectors from tertiary, secondary to primary health facilities, while a few were imple- mented at private sectors. Efforts of integrating PAFP into existing health system from health system perspectives such as funding the programs, training of trainer （TOT） training or on the job training of physicians and mid-level service provider, expan- sion the range of contraceptive methods available including a few free distribution of contraceptives, improving data collection including cost analysis in a few countries,service guidelines provided to health professionals, supportive supervision at program sites to ensure quality of care, and leadership from government to strengthen PAC/ PAFP service by revising or developing a new national policy. Effects of those intervention programs included that 2 studies decreased abortion rates, 7 studies improved modern contraceptive use, 1 study improved women＇s knowledge on sexual ＆ reproductive health, and 5 studies reported women＇s high satisfaction rate with receiving PAC/PAFP services. Conclusion Each study was conducted within a cultural legal social and religious framework. There might be no single set of best practices that can be put forward as a model to integrate PAFP into existing health system in China. These areas should be taken into account in our future intervention including government＇s optimization and complement to the regulations related to abortion, contraception and PAFP, capacity building for service provider, continuous efforts to improve the quality of PAFP service, and accessibility of multiple contraceptive methods for married as well as unmarried youth.

Induced abortion in China and the advances of post abortion family planning service

This is a review of current situation of induced abortion and post abortion family planning service in China. Induced abortion is an important issue in reproductive health. This article reviewed the distribution of induced abortion in various time, areas, and population in China, and explored the character, reason, and harm to reproductive health of induced abortion.Furthermore, this article introduces the concept of Quality of Care Program in Family Planning,and discusses how important and necessary it is to introduce Quality of Care Program in Family Planning to China.

Assessment of Clients Satisfaction in Family Planning Service Delivery in Port Harcourt, Nigeria

Background: Client satisfaction is considered as one of the desired outcomes of health care service delivery and it is directly related to the utilization of any health services. The family planning clinic remains one of the important health care delivery outlets where client satisfaction guarantees continuation of usage, hence this study. Objective: The objective of this study is to assess the determinants of client satisfaction with the family planning (FP) services provided in Port Harcourt. Materials and methods: This was a descriptive prospective cross-sectional study conducted between 18th of June 2018 and 18th of July 2018. The target population is women of reproductive age group (15 - 49) who visited 11 randomly selected family planning health facilities in Port Harcourt during the study period. A set of exit interviewer-administered questionnaire (pretested for reliability and validity) was used for data collection from a sample size of 195 respondents;and analyzed using SPSS 22.0. Standard deviation was used for continuous variable while categorical variables were presented in simple percentages and frequencies. The P value was set at <0.05 and confidence interval was 95%. Results: Age range 30 - 39 years constituted the largest proportion of 51.3%. A large proportion of the women (87.2%) expressed satisfaction with FP services provided. All respondents said the facilities were easily accessible, clean and were treated respectfully. However, only about half of the clients (51.3%) received their chosen contraceptive product after 1 hour. Conclusion: A huge proportion of family planning clients expressed satisfaction with family planning service delivery in Port Harcourt;not minding the longer waiting time. Implication of this is continued use and by implication improved contraceptive prevalence.

Improving Access to Quality Care in Family Planning:WHO’s Four Cornerstones of Evidence-based Guidance

The four cornerstones of guidance in technique service of family planning are established by WHO based on high quality evidences. They have been updated according to the appearing new evidences, and the consensuses were reached by the international experts in this field. The four documents include Medical Eligibility Criteria for Contraceptive Use, Selected Practice Recommendations for Contraceptive Use, Decision-making Tool for Family Planning Clients and Providers and The Global Handbook for Family Planning Providers. The first two documents mainly face to the policymakers and programme managers and were treated as the important references for creating the local guideline. The other two documents were developed for the front-line health-care and family planning providers at different levels, which include plenty of essential technical information to help providers improve their ability in service delivery and counselling. China paid great attention to the introduction and application of WHO guidelines. As soon as the newer editions of these documents were available, the Chinese version would be followed. WHO guidelines have been primarily adapted with the newly issued national guideline, The Clinical Practical Skill Guidelines-Family Planning Part, which was established by China Medical Association. At the same time, the WHO guidelines have been introduced to some of the clinicians and family planning providers at different levels. In the future, more special training courses will be introduced to the township level based on the needs of grass-root providers.

Community-based educational intervention on necklace method as a natural family planning amongst reproductive age group women in India

Objective:To assess the effectiveness of a community-based educational intervention on necklace method as a natural family planning amongst reproductive age group women.This approach helps women decide on their reproductive health choices and avoid ill health,impact and long-term consequences of unwanted pregnancy that lead to unsafe abortion.Methods:A total of 120 women were selected using non-probability purposive sampling technique.The knowledge and practice of participants were assessed using the structured knowledge questionnaire and practice checklist followed by a community-based educational intervention to participants,which covered aspects such as meaning,purposes and criteria;steps of the procedure;and advantages and disadvantages of the necklace method.The methods of teaching were lecture cum discussion and demonstration.The collected data were analysed using SPSS version 21.Results:The levels of knowledge (t-14.571,P=0.023) and practice (t =14.571,P=0.026) significantly improved after administering the community-based educational intervention.Knowledge and practice positively correlated with each other (P < 0.05).Conclusions:Nurses play a vital role in educating women and creating awareness regarding modern and safe family planning methods.These methods are effective and essential to avoid unwanted pregnancy and thus greatly impact the health of women.

China’s Experience of Quality Care in Family Planning

Objective To evaluate and overview the experience of quality care of family planning of China.Methods The framework of quality care of China was summarized and analyzed, that was clients, technology and management triangle program system.Results The 8fundamental elements of quality care in China were presented： 1） policy environment of QoC, 2） comprehensive services, 3） choice of method, 4） IEC to policy-makers and providers, 5） technical competence, 6） interpersonal communications, 7） institutional guideline and regulation, 8） appropriate constella- tion of service.Conclusion FP sectors should prepare different constellations of service to meet their individual reproductive health need for different clients and develop institutional guide- line and regulation for FP service to follow up in practice. QoC should be a kind of standardized service process.

Attitudes of Family Planning Workers toward Setting Up Special Counseling Stations for Unmarried Young Adults

ve To understand attitudes of family planning workers to setting up special counseling stations for unmarried young adults and to identify the acceptable and feasible ways to provide the services for unmarried young adults in eight provinces/cities in China

Healthcare Providers' Perceptions of the Sexual and Reproductive Health Needs (Including Family Planning) of Elderly Women from Selected Sites in Botswana

Much of the sexual and reproductive health services and service delivery including family planning target women of child bearing ages (15 - 49 years) and sometimes men. Hardly are there programmes/interventions that specifically target the needs of the elderly women (50 years and above), yet this group has serious sexual and reproductive health needs as many of them are still sexually active. This cross-sectional study obtained the views of a stratified random sample of 169 healthcare providers (doctors, nurses and pharmacists) from four selected sites, Gaborone, Selibe Phikwe, Barolong and Kweneng East health districts in Botswana on how the healthcare system in the selected sites is meeting the SRH/FP needs of the elderly women. The study found out that while overwhelming majority of the healthcare providers feltthat the healthcare system has no programme that specifically target the SRH/FP needs of this significant others and their SRH/FP needs are not being met ,less than 15% indicated that Pap smear screening as well as screening of cervical cancer were on-going. Although there are SRH/FP services available in the healthcare system, the elderly women are minimally accessing these services. Only condom, combined oral contraceptives, progestogen-only pills, treatment of STIs, screening for HIV/AIDS and screening for cervical cancer are accessed and information is also limited to these services. Reasons given by the healthcare providers for the non-accessibility of these services were cultural diversity (80%), people's sexual behavior and perceptions about sex (79%), lack of knowledge about the desired SRH/FP services (76%), religion (73%) and gender issues (62%). The study, advocates as part of policy options to mitigate the obstacles to accessing SRH/FP services, the expansion of counseling programmes, screening and treatment for breast cancer, public awareness campaigns, production and circulation of appropriate educational materials, effective training of healthcare providers and the establishment of separate clinic days for the elderly women' SRH/FP services.

计生协参与应对“少子老龄化”研究

“少子老龄化”是当前中国人口发展的主要特征,积极应对“少子老龄化”是中国式现代化建设面临的一个重大任务。在人口发展新形势下,要成功应对“少子老龄化”问题,必须加强政府和社会协同治理,充分发挥群团组织等社会力量的作用。计划生育协会作为人口领域最大的群团组织,在参与应对“少子老龄化”方面具有得天独厚的政治优势、群团优势、组织网络优势、人才和专业优势、工作方法优势以及资源优势,可通过开展宣传教育、建设新型婚育文化,加强优生优育指导、积极参与托育服务,强化家庭健康指导服务、积极参与养老服务等途径,在应对“少子老龄化”问题中发挥重要作用。

Family planning technical services in China

Family planning is a basic state policy in China.Its aim is to control population growth and to enhance population quality.Technical services are the key measures for implementing the family planning policy.In order to ensure that people use safe,effective,and appropriate contraceptive methods based on the government’s commitment,China has established countrywide family planning service networks down to the township level.The people can access various and convenient contraceptive services.In urban areas,all contraceptive services are free.The contraceptive prevalence rate in 2007 was 84.6%,the percentage of intrauterine device(IUD)was 52.3%,that of female sterilization was 32.3%,and that of vasectomy was 6.1%.This means that more than 90% of married childbearing couples were using long-term contraceptives.At the same time,the government gives priority to supporting research on contraceptive technology.Studies’results have provided scientific evidence for development,introduction,and expansion of contraceptive methods,and also for establishment and revision of the technical guidelines.Great efforts have been made in promoting“human-oriented and client-centered”services during the recent ten years.Remarkable success has been achieved in improving the quality of technical services.

计划生育服务在人工流产术患者中的应用效果分析

目的:分析计划生育服务在人工流产术患者中的应用效果。方法:选取2018年1月-2022年12月于福泉市马场坪社区卫生服务中心行人工流产的80例患者作为研究对象,随机分为对照组和观察组,各40例。对照实施常规干预,观察组实施计划生育服务。比较两组干预效果。结果:观察组避孕知识掌握总优良率高于对照组,差异有统计学意义(P=0.006)。观察组避孕总依从性高于对照组,差异有统计学意义(P=0.004)。两组近期意外妊娠率比较,差异无统计学意义(P>0.05);观察组近期再次流产率、远期意外妊娠率及再次流产率低于对照组,差异有统计学意义(P<0.05)。干预后,两组躯体、社会、角色、情绪评分高于干预前,且观察组高于对照组,差异有统计学意义(P<0.05)。观察组服务总满意度高于对照组,差异有统计学意义(P<0.001)。结论:计划生育服务在人工流产术患者中的应用效果显著,可提高患者避孕知识掌握情况、避孕依从性、服务满意度,改善避孕效果、生活质量。

接受人工流产术的未婚女性及其男伴参与互动式健康教育的效果

目的:探讨接受人工流产术的未婚女性及其男伴参与互动式健康教育的效果。方法:选取2022年2月-4月在郑州市某三级甲等医疗机构门诊接受人工流产手术的未婚女性病人作为研究对象,根据参与者意愿分为干预组62例和对照组64例。对照组女性接受流产后关爱(PAC)标准化流程健康教育服务,干预组女性及其男伴共同接受互动式健康教育服务,从有效避孕知识水平、人工流产术准备程度、术后随访行为落实情况进行评价。结果:两组未婚女性术后留观有效避孕知识得分比较差异有统计学意义(P<0.05),术后1个月、3个月的有效避孕知识得分比较差异有显著统计学意义(P<0.01)。干预组未婚女性术后留观、术后1个月、术后3个月的有效避孕知识得分比较差异无统计学意义(P>0.05),对照组未婚女性术后留观、术后1个月、术后3个月的有效避孕知识得分比较差异有显著统计学意义(P<0.01)。两组未婚女性人工流产术准备程度比较差异有统计学意义(P<0.05),两组未婚女性术后1个月、3个月随访形式比较差异有显著统计学意义(P<0.01)。结论:有效避孕知识需大力在未婚女性群体中普及,男伴参与互动式健康教育对接受人工流产术的未婚女性有效避孕知识水平改变及人工流产术后随访行为落实影响显著。

中国流动人口卫生健康与计划生育动态调查数据:2009-2018年多波大规模全国性横断面调查

这篇数据论文介绍了2009~2018年中国流动人口动态调查(Chinese Migrants Dynamic Survey,CMDS)的数据。CMDS是原国家卫生和计划生育委员会组织开展的全国流动人口的多年度大规模全国性横断面调查。调查对象为15岁以上的国内流动人口,样本取自中国流动人口信息系统,采用多阶段分层抽样方法和概率比例-大小(probability proportional-to-size,PPS)聚类抽样策略进行抽样。2009年至2018年,共有来自23个省、5个自治区和4个直辖市的1,527,650名流动人口参与了该调查。调查工具是由原国家卫生和计划生育委员会组织设计的一系列具有高度继承性和一致性的调查问卷,问卷内容主要包括被调查者及其家庭成员的基本情况、流动状况、医疗保健或健康行为、公共卫生服务利用情况、社会保险情况、社会融合情况、计划生育情况等。该数据集是目前使用最广泛的关于中国流动人口的调查数据,提供了有关流动人口的流动模式、医疗卫生和健康行为、公共卫生服务、社会保障、社会融合和计划生育的信息,对医疗卫生规划、卫生决策和卫生公平研究具有重要价值。

计划生育服务对人工流产术后避孕效果的近期及远期影响

目的探讨人工流产后计划生育服务对避孕效果的近期及远期影响。方法选取2021年3月至2022年3月济南市妇幼保健院98例人工流产患者,采用随机数字表法分为参考组、调查组,每组各49例。参考组采用常规干预,调查组采用计划生育服务,评估两组避孕知晓情况,统计两组避孕依从性,比较两组近远期效果。结果调查组避孕知晓优良率高于参考组,差异有统计学意义(P<0.05)。调查组避孕总依从率高于参考组,差异有统计学意义(P<0.05)。调查组在随访3个月、1年时的意外妊娠率及再次流产率均低于参考组,差异有统计学意义(P<0.05)。结论计划生育服务的近远期效果较好,能提高避孕知识知晓率和依从性,减少意外妊娠、再流产事件。

河北省母婴保健计划生育技术服务监管现状与管理策略

目的:对河北省近5年母婴保健计划生育技术服务监管现状进行调查分析,找出存在的问题,提出对策与建议。方法:通过河北省卫生健康监督信息报告系统平台获取有关数据,采用SPSS 23.0软件进行描述性统计分析。结果:2017年—2021年河北省母婴保健计划生育卫生监督覆盖率依次为11.20%、48.67%、82.09%、77.80%和77.61%,基本呈上升趋势;母婴保健计划生育卫生行政处罚案件232起,在各类医疗机构受到的行政处罚占比中,医院、卫生院占比较高,分别为55.60%、11.64%。结论:5年间,河北省母婴保健计划生育技术服务卫生监督管理工作得到全面提升,但仍面临基层卫生监督员业务能力不够、被监管单位自我约束力欠佳、法律法规惩戒力不足等问题。因此,应加快法律、法规修订与完善工作,加强监管队伍建设,提升监管能力,创新监管模式,提高监管效力,加强行业自律,建立健全依法行政、综合监管的长效机制等相应的对策与建议。

计划生育服务对人工流产后患者避孕节育知识与避孕措施正确使用情况的影响

目的分析为人工流产后患者提供计划生育服务的临床价值。方法选取300例人工流产患者,将其按照随机数字表形式1:1分为对照组与干预组,各150例。对照组实施常规护理服务,干预组实施计划生育服务。比较两组避孕节育知识知晓情况、避孕节育依从性、避孕措施正确使用情况及避孕效果。结果护理前,两组避孕节育知识知晓评分比较,差异无统计学意义(P>0.05);护理后,干预组避孕节育知识知晓评分高于对照组(P<0.05)。干预组避孕节育依从性95.33%高于对照组的72.67%(P<0.05)。干预组避孕节育措施正确使用率高于对照组(P<0.05)。干预组非意愿妊娠率、再次人工流产率均低于对照组(P<0.05)。结论为人工流产后患者提供计划生育服务可提高患者避孕节育知识知晓程度,提升患者避孕节育依从性,帮助其更好地掌握避孕节育措施,降低非意愿妊娠率、再次人工流产率,可推广。

计划生育工作人员咨询服务状况调查

目的:了解计划生育工作人员的咨询服务状况及可能的影响因素,为下一步在该人群中开展咨询培训提供依据。方法:通过结构式问卷,调查了来自于全国31个省、市、自治区和直辖市的271名计划生育工作人员,对他们的咨询服务状况及可能的影响因素进行分析。结果:271名调查对象中,255人曾为服务对象提供过咨询服务。咨询服务相关知识得分最高为100.0分,中位数为76.9分;咨询服务知识得分单因素分析显示,不同年龄组、不同文化程度对象之间的差别有统计学意义(P<0.05);多分类反应变量多元Logistic回归分析显示,文化程度越高,研究对象的咨询服务知识得分越高。结论:计划生育工作人员咨询服务的总体状况良好,但研究对象的年龄,文化程度等因素可能对他们的咨询服务产生影响。建议加强咨询培训的针对性,提高计划生育工作人员的整体素质。