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    Acceptability of contraceptive methods and services: a cross-cultural perspective.

    Shain RN

    In: Shain RN, Pauerstein CJ, eds. Fertility control: biologic and behavioral aspects. Hagerstown, Maryland, Harper and Row, 1980. 299-312.

    The results of recent cross-cultural contraceptive acceptability studies conducted by WHO and by other investigators were briefly reviewed. The studies demonstrate that contraceptive acceptability is influenced by cultural and personal beliefs and attitudes. WHO multinational studies undertaken to examine the acceptability of hypothetical contraceptives revealed 1) males are willing to use contraceptives but would prefer using a form of oral contraceptive which could be self-administered, which would not reduce sexual desire, and which would be reversible; 2) females in many countries would be unreceptive to a contraceptive which produced amenorrhea; and 3) women in a number of countries indicated that the route of administration was not a major determinant of contraceptive acceptability. In conection with clinical trials, WHO conducted acceptability studies of daily pills and monthly injectables for males and of depot-medroxyprogesterone acetate or norethisterone oenanthate injectables and prostaglandin vaginal suppositories for women. WHO conducted contraceptive preferences studies in free choice situations among women in India, Korea, Philippines, and Turkey. Results indicated that preferences varied by clinics within countries and that education was highly correlated with choice. WHO also conducted discontinuation studies in Bangkok, Santiago, and Mexico City and studies of the acceptability of indigenous antifertility agents in Egypt and Malaysia. Other investigators have assessed the acceptability of specific attributes and side effects, such as the gender of the user, routes of administration, duration of effectiveness, color, reversitility and found that acceptabilty varied cross-culturally. Several investigators examined the acceptability of a number of service delivery attributes such as waiting time, privacy during clinics visits, and convenience.
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