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OUTLOOK. 1990 Jun; 8(2):7-9.This article summarizes the most recent data on WHO's multicenter clinical trial test of the low dose progestin-releasing vaginal ring as an effective contraceptive for women. The study involved 1005 women aged 19-34 and was carried out from 1980-86 at 19 centers in 13 countries, including 9 developing countries. The overall findings on vaginal ring use included: the ring's effectiveness was comparable to oral contraceptive (OC) effectiveness, pregnancy rates increased with increasing body weight, about 1/2 of the users had discontinued the ring by 1 year, the ring disrupted menstrual bleeding patterns in about 1/2 of all users, and about 1/4 of all users expelled the ring at least once but most continued to use it. The irregular bleeding pattern was the main reason for discontinuation. Part of the reason for having different ring contraceptive effectiveness in different countries could be due to differing average weights of the women. Increasing risk of expulsion was directly related to increasing age by approximately 3% with each year of age. For effective use of 90-day low-dose levonorgestrel-releasing vaginal ring, appropriate clients should have the following: a dislike for inserting and removing vaginal devices, low weight, counselling on potentially irregular bleeding, and counseling on how to deal with an expulsion. (author's modified)
Seminar Paper, Bombay, India, International Institute for Population Studies, June 1978. 9 pIn the 1971 census in India, data on current fertility were collected for the 1st time. Various factors affecting fertility (fertility differentials) were revealed after studying the data: 1) Rural and urban residence data show higher fertility in rural areas, with total marital fertility rate estimated to be 4.56 and 4.09 in rural and urban populations, respectively. The difference was mainly due to lower fertility among the currently married women of urban areas in the age group of 18 years and above. 2) Educational attainment of women data indicate that fertility among the illiterate group was lower as compared to those women who have read up to the graduate level in rural areas, whereas urban fertility was lower in all categories except graduate level or above. 3) Age at marriage data indicate that in Karnataka the total marital fertility rates declined sharply as age at marriage increased in both urban and rural areas. 4) Religion data show that total marital fertility by religion and place of residence was lowest among Hindu women. Christians exhibited highest fertility in rural areas, and Muslims had the highest urban fertility. 5) Differentials in scheduled caste, tribe, and nonscheduled population show lower fertility rates among nonscheduled as compared to scheduled population. Among the scheduled castes and tribes, the latter show higher fertility.