Postpartum Family Planning at the Timbuktu Hospital in Mali

Introduction: Postpartum family planning is the prevention of pregnancies during the 12 months following childbirth. Few studies have been devoted to postpartum family planning in Mali. Our work will contribute to reducing unmet need for family planning. Objective: To study the use of contraceptive methods in the postpartum period in the obstetrics and gynecology unit of Timbuktu hospital. Materials and Methods: This was a descriptive and analytical cross-sectional study with prospective collection of data from January 1, 2022 to December 31, 2023. All women who gave birth having chosen and benefited from a contraceptive method were included. The statistical test used was the Fisher test with a significance threshold fixed at 5%. Results: The frequency of contraception in the postpartum period was 17.03%. The average age of clients was 26.14% with extremes of 14 and 45 years. They were paupiparous at 56.4% with an inter-birth interval of less than 12 months at 12.3%. More than half of the counseling (58.5%) was done during postnatal visits. The methods chosen were implants at 48.1%, injectable progestins at 21.3%, intrauterine device at 14.7%, miro-progestin pills at 13.5%, tubal ligation at 1 .4% and condoms at 1%. The regular follow-up rate was 51.1% of cases and 25.6% had no follow-up. Conclusion: The overall rate of postpartum family planning of 17.08% remains low. Improving FP staff skills will reduce unmet needs and contribute to increasing contraceptive prevalence in Timbuktu.

Comparison of Contraceptive Methods Chosen by Breastfeeding, and Non-Breastfeeding, Women at a Family Planning Clinic in Northern Nigeria

Introduction: Breast feeding may pose a further challenge to uptake of contraception by possibly restricting use of certain methods for real or perceived risks of side effects. Methodology: A retrospective study was done at the Barau Dikko Teaching Hospital, Kaduna. Available family planning clinic client cards from January 1st, 2000 to March 31st, 2014 were retrieved and information collected on demographics, reproductive and menstrual history, contraceptive choices and breast feeding status. Data were analyzed using the statistical package for social sciences (SPSS) version 15. Missing responses were stated and excluded from analysis. Chi square was used as a test of association with significance level established at p value, 0.05. Results: A total number of 5992 client cards were retrieved. All clients were female and married, and majority of clients aged between 25 - 34 years (53.1%), had either completed their secondary education or gone further (56%) and were Muslims (52.3%). Only 2924 women stated that they were currently breastfeeding (48.8%), 1828 women were not breastfeeding (30.5%) and 1240 women (20.7%) did not state their breastfeeding status. Younger and more educated women were more likely to be breastfeeding than older women and less educated ones (p < 0.05). Only 4636 cards (77%) had correctly filled data on the choice of contraceptives chosen by breastfeeding status with 2854 women breast feeding and 1302 (45.6%) chose injectable hormonal contraception, 888 (31.1%) chose intrauterine contraceptive devices, 484 (17%) chose oral contraceptive pills and 180 (6.3%) chose contraceptive implants. There was no record of condom use or use of permanent methods of contraception. Conclusion: Breastfeeding rates were high among women seeking contraception. The pattern of contraception is similar among both breastfeeding and non-breastfeeding women, with injectable contraception being the preferred choice. Awareness should be raised on the safety of a wider variety of contraception available for breastfeeding women.

Women’s Attitudes and Knowledge towards the Use of Contraceptive Methods

Background: Contraceptive use reduces the need for abortion by preventing unwanted pregnancies, and the causes of maternal death worldwide. Contraceptive use helps women to plan their pregnancies and contributes for population growth. This study aims to analyze the attitudes and knowledge of the women attending Van Norma Clinic for the use of contraceptive methods. Methods: A cross-sectional study was used to analyze the information. A convenience sampling method has been used to select the 100 women who attended Van Norman Clinic in Family planning service in the period of the study of four months (April to July, 2020). A self-administered questionnaire with four parameters addressing importance of using contraceptive methods, the factors affecting the women’s attitudes for not using contraceptive methods, types of contraceptive methods currently used, advantages and disadvantages of using contraceptive methods was used to collect data. Results: Research findings show that the majority of respondents knew the importance of using contraceptive methods like preventing unwanted pregnancies (97%), spacing pregnancies (96%), planning pregnancies (92%), and getting well (70%). Two factors affecting women for not using contraceptive methods had been identified such as religion (73%) and fear (70%). In addition, the women attending Van Norman Clinic prefer using implants (99%) and injectable (99%). It is clear that women do not know the consequences related to the nonuse of contraceptive methods. Some recommendations have been made to the health care facilities, parents, women themselves, churches’ leaders and government in general. Conclusion: Factors which influence women’s attitudes for not using contraceptive methods were notified in our study such as religion (73.0%) and fear (70.0%) which was explained by the fact that in Burundi most people are catholic which is the most religion prohibiting the use of contraceptive methods. However, the participants’ knowledge was significantly good as their score was more than 50% for all variables.

The Clinical and Experimental Research on Billings Ovulation Method During Breastfeeding

Objective The effectiveness and acceptability of Billings Ovulation Method (BOM) during breastfeeding were studied. At the same time, the monitoring indexes of fertility return were studied.Methods It was a clinical comparative study of BOM and IUD containing copper (200mm 2). The annual rate of pregnancy, discontinuation rate and continuation rate in the two groups was determined. The serum prolactin and estradiol in 90 breastfeeding mothers and urine estrogen and pregnanediol in different feeding mothers were measured.Results There were 219 subjects in the BOM group and 200 in the IUD group. The pregnancy rate in this two groups was 1. 43% and 1. 54% respectively. The rates of discontinuation and continuation in the IUD group were:8. 87% and 91. 35% as well as in the BOM group were 8. 53% and 90. 17% respectively. Neither result was statistically significant (P>0. 05). The experimtal research showed that menses return was well estimated by 0. 35 ratio of serum prolactin vs. estrodiol. Sensitivity and specificity was 94. 61% and 84. 61% respectively. It also indicated that (1) the levels of urine hormone were closely related to the patterns of cervical mucus and (2) the incidence of ovulating before the second return of menses in partially breastfeeding mothers was much lower than that of bottle-feeding mothers (47. 05% vs. 94. 20%). Conclusion BOM is a simple, reliable and well accepted contraceptive method of during breastfeeding. If it can be combined with the measurement of serum prolactin/ estradiol, the date of menses return will be determined more easily. Encouraging mothers to breast-feed will be beneficial to the health of both babies and mothers and delay the fertility return of mothers.

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 C&#244;te 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.

Women’s Perceptions and Attitudes Related to Family Planning Use among Poor Population in Rural Rwanda

INTRODUCTION: In 2012, Rwandan Government has declared family planning (FP) a national priority for poverty reduction and socioeconomic development. However, rural areas still contribute to higher fertility rates. OBJECTIVE: To explore factors to influence FP uptake in rural families. METHODS: This study used mixed (quantitative and qualitative) methods consisted of two separate surveys. The first survey (quantitative-based cross-sectional design) determined FP use in households while the second survey (qualitative-based design) identified socio-cultural factors which hindered FP uptake in households. In total, 119 households with women in reproductive age (15 - 45) were targeted in rural areas in Western province, Karongi District. The data collected during door-to-door visits using paper-based-questionnaires and administered through interviews. A database mask was designed under OnaCollect, then processed in SPSS software. The results were presented in tables of frequencies, the difference between proportions assessed using Chi-Square-test, the difference between means assessed using t-tests, significance at p = or <0.05, confidence level at 0.95, and a margin error of 0.09. RESULTS: Socio-cultural norms influenced no use of contraception (32.8%) or only promoted natural methods (12.6%). Social norms were religious in origin (38.5%) where Christianity (91.8%) discouraged modern methods (viewed as killing children) but encouraged using natural methods, preferably abstinence (73.3%). Cultural norms (17.9%) influenced families to have many children as resources of wealth, evidence of productivity, and a way to decrease parents’ workloads including assisting mothers in home-based activities such as cooking, and assisting fathers in farming activities such as keeping cows, goats and pigs. Other attitudes included gender-based issues (2.5%) mainly due to spousal disapproval (men dominated in taking FP decisions in families), whereas other non-users of modern methods (28.2%) feared side-effects. This study was registered with IRB: CMHS/IRB/097/2019. CONCLUSION: Religious, social, and cultural norms affect FP in rural areas. In order to accelerate FP uptake, men and religious leaders should be targeted as key partners who influence women’s choices.

Chinese Expert Consensus on Clinical Application of Female Contraceptive Methods

Unintended pregnancy is a global issue, with approximately 85,000,000 women around the world having unintended pregnancy annually. The contents of clinical application of women’s contraceptive methods are very wide, involving multiple areas. This consensus deeply discusses the specific contraceptive needs at different statuses, combined with gynecological diseases, postabortion contraception, and postpartum family planning, ensuring the correct use of contraceptive methods under the corresponding status. The top priority of the consensus is the specific contraception consensus section for women combined with gynecological diseases because medical treatment effect as well as side effects should be weighed carefully. The consensus is to make high-efficiency and individual contraceptive strategy for different groups based on multidisciplinary(gynecology, obstetrics, and family planning) and multidimensional aspects, which can provide uniform guidance for medical and health organizations under the condition as relevant global guidance or consensus is still lacking.

Profile of Implanon~ acceptors and pattern of side effects

Objective To determine the social and biological characteristics of Implanon acceptors at Ibadan Nigeria, and also to describe reasons why they opt for this choice and their concerns. Methods This was a descriptive study that retrospectively reviewed all records of the Implanon acceptors from January 2006 to December 2009 at University College Hospital Ibadan, Nigeria. Results One hundred and twenty-eight women accepted Implanon as a modern contraception accounting 4.3% of the total number of clients seen （2 972） during the period. The age range of the client that accepted Implanon was 26-43 years with a mean of 33.6 ±2.4 years. Of the 128 Implanon acceptors, 101 （78.9%） had used other contraceptive methods before. The commonest reason for switching to Implanon by clients was failure of the contraceptive method that was previously used （32.7%）. Within the first year follow-up of insertion, none of the Implanon acceptors had expressed desire for removal due to any of the side effects, and none contraceptive failure was observed during their follow-up evaluation. Conclusion The findings suggest that Implanon could safely be used by all women of reproductive age group including those who desire future fertility.

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.