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  1. 1
    071359

    Switching tracks: a tracer study of clinic discontinuity in Mauritius.

    Oodit G; Johnston T

    In: African research studies in population information, education and communication, compiled and edited by Tony Johnston, Aart de Zeeuw, and Waithira Gikonyo. Nairobi, Kenya, United Nations Population Fund [UNFPA], 1991. 54-72.

    Researchers arranged for interviews with 300 female discontinuing clients at 2 maternal and child health/family planning (MCH/FP) clinics in Mauritius and followed 230 of them to explain what happens to women who discontinue coming to the MCH/FP clinic. 26% of all women in the sample stopped using MCH/FP clinic services for fertility related reasons. The 2 leading reasons were desire for pregnancy (15.2% of all women) followed by husband absent or sexually inactive (5.2%). Further 30.1% switched to a competing contraceptive provider, especially a factory based provider (11.3%). They tended to switch providers because the new provider was more accessible or they were either dissatisfied with the quality of services at the MCH/FP clinic or the new clinic had an advantage over the MCH/FP clinic. 43.9% switched from scientific family planning methods to either natural or traditional family planning methods. These women tended no to wander out of the house and to be poorly educated, of an ethnic minority group, and >35 years old. In fact, 26.1% used natural family planning because of dissatisfaction with either the contraceptive methods themselves or the quality of services provided. Much attendance discontinuity was determined by misperceptions about ongoing or long term contraceptive use. This indicated that clinic counselors should become more sensitive to and fully address the problems and side effects of contraceptive method use. In conclusion, the MCH/FP clinics should focus their information, education, and communication efforts on the women who switched to unscientific or natural methods.
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  2. 2
    050704
    Peer Reviewed

    Assessing changes in vaginal bleeding patterns in contracepting women.

    Machin D; Farley TM; Busca B; Campbell MJ; d'Arcangues C

    CONTRACEPTION. 1988 Aug; 38(2):165-79.

    Researchers recruited 1216 females to study changes in amenorrhea patterns with successive injections of the long acting injectable contraceptive depot-medroxyprogesterone acetate (DMPA). The women received an injection of either 100 mg or 150 mg DMPA on the day of randomization and 3 additional injections at 90 day intervals. 1151 (94.7%) women completed a menstrual diary that could be used, but only diaries of at least 60 days were considered in each reference period (90 days). Of the 99 who received only 1 100mg injection, 23 had amenorrhea. Of the 361 receiving 4 injections, 142 experienced no amenorrhea in any of the injection intervals and 30 had amenorrhea in all 4 intervals. Overall 281 women out of 576 who received 1-4 injections of 100 mg DMPA did not experience amenorrhea at all. For those in the 150 mg sample receiving 1-4 injections, 237 out of 575 women did not have amenorrhea. Analysis of change over time suggested an increase incidence of amenorrhea following the 2nd injection. In terms of the probability of a woman accepting a injection, women who experienced amenorrhea with the 1st injection were less likely to accept a 2nd, especially in the 150 mg DMPA group. Additionally, the trend in amenorrhea pattern demonstrated that a 3rd injection was adversely affected by amenorrhea in the 2nd injection interval in the 150 mg group but not the 100 mg group. Nevertheless, the decision to have a 4th injection appeared adversely affected by amenorrhea in the 3rd injection interval in both groups. The conditional probabilities used in this research can also be applied to examine continuation or survival rates in a follow-up study based on any prognostic factors.
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