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CONTRACEPTIVE TECHNOLOGY UPDATE. 2001 Jan; 22(1):8-9.More than 2 million women around the world are expected to become unintentionally pregnant in the year 2001, due to improper use of OCs. Effective counseling on missed pills and revised package information are needed. Guidance can be structured around the “7-day rule,” which states that women should not go more than seven days without taking the hormonal pill. In the context of the revised OC package, the Food and Drug Administration is reviewing revisions that include simpler language for enhanced reading comprehension.
International Quarterly of Community Health Education. 2006; 24(3):215-229.In July 2003, a consortium of three USAID partners launched a project to promote the correct use of color-coded, age-specific, prepackaged drugs (PPDs) to treat malaria promptly in preschool-aged children in Aba, Abia State, Nigeria. A 3-pronged promotional approach included training of patent medicine vendors (PMVs), home visits by community health promoters, and mass media. Five hundred seventy respondents were interviewed in February-March 2004. People heard about the PPDs from medicine sellers (33.4%), health workers (24.3%), the electronic mass media (18.4%), and friends or relatives (13.5%). Most children (81.1%) took Robaquine (chloroquine--CQ), while 108 (18.9%) took Fansidar (sulphadoxine-pyrimethamine--SP). The median amount paid for Robaquine was N50 ($0.36) and for Fansidar, N80 ($0.57). Respondents rated the effectiveness of the PPD treatment as very effective (86.8%). Most respondents had something positive to say about the drug (94.9%) and the packaging (93.8%). Only 19.5%) had a complaint about either the drug or the packaging. Overall, 454 (83.9%) received the correct age-appropriate packet. Continuing education is needed for the PMVs to ensure that they obtain accurate age information about the child and sell the age-specific packet. Underdosing is just as serious a concern as overdosing in Nigeria where parasite resistance is rapidly developing for both drugs. (author's)
Rational Drug Bulletin. 2000 Oct; 10(4):1.Injection is the most frequently used means for delivering drugs into the body despite the pain and the health hazards inherent in the procedure. A survey conducted by the WHO reveals that 12 billion injections are used annually throughout the world, 90% of them for therapeutic purposes. Injections are also be used for preventive health care and, unfortunately, for recreational drug use. Deviations from the established guidelines in packaging, handling and disposal of injections may expose the recipient, health worker, or community to infection. Effective and safer alternatives have been produced to replace injections in primary care. However, in many countries, there have been reports on their overuse and misuse. Unsafe injection practices may be due to lack of knowledge, shortage of sterile supplies, or absence of disposal facilities. The irresponsible use of injections must be curtailed. Interventions to reduce injection hazards include adequate awareness, supportive health infrastructure, adequate supply of sterile accessories, effective system for disposal, and strict control of over narcotic traffic and controlled substances. In relation, the UN developed a Safe Injection Global Network strategy to work towards implementation of safe injection practices globally.
Reproductive Health Matters. 2006 Nov; 14(28):63-67.DKT International is a non-profit social marketing enterprise whose mission is to provide safe, affordable options for family planning and STI/HIV prevention. In Brazil, DKT sells male and female condoms to mostly lower-income couples nationwide. This paper is about the introduction of a ribbed, lubricated, latex condom called Affair to the Brazilian market in 2000. Sales were initially very low, but based on reports that Affair was well liked by some men who have sex with men, we took the opportunity to give Affair that positioning. We worked with our advertising agency, a local research company and Dignidade, a Brazilian NGO working for the rights of men who have sex with men. Two new products - a baggy condom called Affair Sensation and a complimentary lubricating gel called Affair Personal Lubricant - with new packaging and a promotional campaign were launched in February 2006. The billboard advertisement generated controversy in Sao Paulo, where the Advertising Council required it to be taken down due to complaints. However, the controversy helped promotion and at the same time generated public debate on sexuality and human rights. Our overall experience has been positive, sales are up and we have received messages of support for the products and their promotion from consumers. (author's)
Geneva, Switzerland, WHO, 2006.  p. (WHO/FCH/CAH/06.1)This document is updating an earlier document (WHO/CDD/SER/85.8), and provides information on the manufacture of the new ORS that, since 2003, is recommended by WHO and UNICEF. It has been prepared to assist national authorities in establishing the local manufacture of a product of pharmaceutical quality, in order that they may become self-reliant in meeting the needs of their national diarrhoeal diseases control activities. It is emphasized that the methods recommended in the document are meant to serve as guidelines, and that they need to be adapted to meet local requirements and conditions, provided they follow the principles of Good Manufacturing Practices for pharmaceutical products (WHO Technical Report Series, No 908, 2003) that can be found in the annexes of this document. Specific information on "Quality Management", "Personnel", "Validation" and "Qualification" can be found in this annex. (excerpt)
Revista de Saude Publica / Journal of Public Health. 2006 Jun; 40(3):513-520.The objective was to assess the advances in the Brazilian norm for commercialization of infant foods from 1988 to 2002, comparing the different texts with each other and with the International Code of Marketing of Breast-Milk Substitutes. This was a descriptive study based on data collected from documents, reports, ordinances and resolutions from the Brazilian Ministry of Health. The versions utilized in the comparison were from 1992 and 2002. Comparative analysis made it possible to identify important advances in the legislation. In 1992, liquid and powdered milk were included in the scope, along with teats and dummies (pacifiers), and also warning phrases in advertising and on product labeling. In 2002, regulations for products were published by the National Agency for Sanitary Surveillance, thereby strengthening supervisory actions and including regulations for baby foods, nutrient formulae for high-risk newborns, and nipple protectors. The phrases used in commercial advertising and on product labeling, including dummies, teats and bottles, became Ministry of Health warnings. The labeling was defined according to product types, on the basis of more restrictive rules. Significant modifications in the control over the marketing of products aimed at mothers during the lactation period. However, there are still some legislative questions that would make it possible to improve the Brazilian norm, in order to protect breastfeeding. There is also a need for the government to implement systematic monitoring routines to supervise this legislation. (author's)
In: 1st Pacific Regional HIV / AIDS and STD Conference, Nadi, Fiji, 23-25 February 1999. Conference proceedings, [compiled by] Pacific Community. Secretariat. Noumea, New Caledonia, Pacific Community, Secretariat, 2000. 172-6.This paper covers social marketing in general, answers frequently asked questions and addresses the potential for condom social marketing in the Pacific. Social marketing is becoming increasingly important in efforts to assure developing countries have access to the health products and services they need. The key to successful social marketing is effective communications. Oceania is a vast space with small populations; however, commercial wholesale and retail networks and mass media communications are well developed. Social marketing may be the best means to promote healthy sexual behavior and to ensure access to condoms. (author's)
Sourcing guide. The nevirapine infant-dose pouch for use in prevention of mother-to-child transmission of HIV / AIDS programs. Version 1.
Seattle, Washington, PATH, 2006 Aug. 23 p. (USAID Cooperative Agreement No. GHA-A-00-01-00005-00; USAID Development Experience Clearinghouse DocID / Order No. PN-ADI-175)As part of a public-private partnership with the US Agency for International Development (USAID) and Boehringer Ingelheim (BI; manufacturer of Viramune®1 brand nevirapine), PATH developed a simple solution, the nevirapine (NVP) infant-dose pouch. This pouch can help prevention of mother-to-child transmission of HIV/AIDS (PMTCT) programs overcome the packaging challenges to increased coverage of at-risk newborns with the infant dose of NVP. The purpose of the Sourcing Guide is to provide PMTCT programs with the information they would need to independently procure NVP infant-dose pouches for use in PMTCT services. While PATH developed the NVP infant-dose pouch and validated its use in the field, PATH is not a manufacturer or supplier of the pouch. PATH's design for the pouch uses readily available packaging materials and processes which may be locally available in many countries. This guide will help programs either: Procure pouches from a current manufacturer(s) identified by PATH; or Engage a local or regional packaging manufacturer to produce pouches of similar function and quality. (excerpt)
Training manual. Training providers on packaging nevirapine oral suspension using the nevirapine infant-dose pouch.
Seattle, Washington, PATH, 2006 Aug.  p. (USAID Cooperative Agreement No. GPH-A-00-01-00005-00; USAID Development Experience Clearinghouse DocID / Order No. PN-ADI-174)This training manual was developed to assist programs planning to introduce the nevirapine infant-dose pouch into prevention of mother-to-child transmission of HIV/AIDS (PMTCT) programs. This brief manual is intended for adaptation by programs and can be implemented by itself or integrated into ongoing training. (excerpt)
[Blitz of the male and female condom: carrying, packaging and use] Blitz do preservativo masculino e feminino: porte, acondicionamento e uso.
DST -- Jornal Brasileiro de Doenças Sexualmente Transmissíveis. 2002; 14(6):22-32.Introduction: The Diseases Sexually Transmissible, healthy as old as the humanity, and that its expansion in the word happened not only with the human being migration, as well as with the increase of the population, precarious conditions of health, sanity, diagnosis, treatment and sexual promiscuity, if constituting like this in a public, allied serious problem of health the epidemic of the Syndrome of Acquired Immunodeficiency - Aids. One in the ways of controlling its increase makes an appointment the use of the preservative, the in spite of the entire controversial history, it is still constituted in an of the most effective ways of prevention. This way, it just is not enough to distribute the population, but above all also to know to condition and to use appropriately. This way, for its accomplishment, settled as general objective: to make the blitz of the masculine and feminine preservative: carry, keeps and use, in drivers and passengers of automobiles and walk motorcycles, circulating in public roads of Rio Branco - Acre - Brazil. Methodology: It is an exploratory-descriptive study, developed 1011 subjects close to, being 792(78.3%) drivers of automobiles and 219(21.7%) of motorcycles of Rio Branco - Acre - Brazil. For the collection of data, made use of a form with shut subjects, whose processing and analysis was made in the EPI INFO-6, with frequency presentation and percentile. Under the ethical point of view of the research, it was requested its spontaneous participation, besides guaranteeing the anonymity. Results: The population of the study varied of 18 to 69 year, being 61.7% masculine and 38.3% feminine. 44.9% were single and 44.9% married and joined, and 38.9% possessed the second complete degree. 52.5% didn't take I get preservative in the week sexual activity and 41,5% accomplished it. 94,5% had already used the masculine preservative with 85.2% of acceptance and 94.7% for the partner. The data also showed that 49.6% bought the preservative, against 45.2% that had received from the government. With relationship to the guard's of the masculine preservative place, 36.4% placed it in it carries it glove of the car, proceeded by 19.5% in the wallet of money of the back pocked of the pants, while for the feminine, 33.3% also placed it in it carries it glove of the car and 66.7% in the bag to shoulder belt. Conclusion: Research highly important, where the subjects have been making use of the preservative, with great acceptance besides for the partner. Stand out the ones that not and they sometimes took preservative in the weekend with risk for its health, in spite of possessing them inside of the period of validity and they be with the entire packing. It is still pointed out not the adapted guard of the preservatives, with excessive exhibition to the heat and damage, with in a certain way they exponse sexually to the risk of not wanted pregnancy and the infection for the diseases transmissibles. As the evaluation of the campaign of the incentive of the use of the masculine preservative for the great and good item reached 85.8% against 32.2 of the feminine, and that 97.1% evaluated this as great and good. (author's)
AIDS and Behavior. 2008 May; 12(3):452-458.The aim of this article is to examine the impact of the FDA's proposed condom package labeling on HIV-related beliefs about condom effectiveness, on intentions to recommend condoms for friends to use, and intentions to use condoms. Using a nationally representative survey we randomized 1,194 adults ages 18-65 years into one of three condom label conditions: the current label on condom packaging; a label with the proposed FDA language; and a label with CDC language on condom effectiveness. In short, there are no significant differences between the proposed FDA label and the current label on HIV-related beliefs and intentions. In contrast, from an HIV prevention perspective, the CDC condom language appears to offer a better alternative to the current condom label for unmarried populations. (author's)
Contraception. 2008 Nov; 78(5):370-6.OBJECTIVE: In November of 2004, the US Food and Drug Administration (FDA) issued a black box warning regarding skeletal health concerns with depot medroxyprogesterone acetate (DMPA) contraception. This FDA labeling change has the potential to impact how this contraceptive is used. Our goal was to assess the impact of the FDA decision on how Florida obstetrician-gynecologists prescribe DMPA. METHODS: A survey was conducted with questions and case scenarios regarding the use of DMPA before and after the black box warning. The survey was sent to all members of the Florida Obstetric and Gynecologic Society. RESULTS: Four hundred twenty-five surveys were mailed and 149 were returned - a 35% return rate. Forty-six percent of physicians surveyed indicated that they place a time limit on DMPA use, and 66% stated that this limit was based on the FDA black box warning. Sixty-five percent of respondents ordered bone mineral density (BMD) testing solely due to the use of DMPA, with 58% indicating that this decision was based on the black box warning. Eight (5.4%) of the respondents indicated they selectively prescribe bisphosphonates for patients based solely on the use of DMPA, while 33% of respondents state that they use estrogen supplementation. There was a trend towards fewer DMPA injections per week after the black box warning as compared to before; however, this trend was not statistically significant (p<.125). CONCLUSION: Respondents may be writing fewer prescriptions for DMPA, are likely to institute a time limit on said prescription and are likely to order BMD testing, using the black box warning as justification. Continued education is necessary to prevent inappropriate restrictions on DMPA use and the performance and/or prescription of inappropriate tests and medications.
One versus multiple packs for women starting oral contraceptive pills: a comparison of two distribution regimens.
Contraception. 2009 May; 79(5):369-74.BACKGROUND: Despite World Health Organization and International Planned Parenthood Federation recommendations to provide multiple pill cycles to new users, many programs in developing countries still give only one pill cycle to new acceptors. STUDY DESIGN: To compare provision of a single versus multiple packs of pills, new pill users in 20 matched public sector clinics in Jamaica were assigned to one of two pill regimens in which they received either one (then subsequently three) or four pill cycles at method initiation. The primary outcome was the proportion of women who used pills beyond 4 months. RESULTS: Among 655 women, those receiving one cycle of pills at initiation, followed by counseling and a three-pack resupply, were no more likely to be using pills after 4 months than women who received four packs at initiation (odds ratio=1.33; 95% confidence interval=0.88-2.0). In both pill regimen groups, returning late to the clinic for resupply was a problem. However, more women in the 1+3-pack regimen group returned late to study clinics to obtain their fifth cycle of pills than their counterparts in the 4-pack regimen group (53% vs. 28%). CONCLUSION: Our findings support the recommendation that pill users should be given more than one cycle to start, because an extra visit for resupply contributes to clinic and provider costs. Moreover, providing more pill cycles at initiation would decrease the likelihood that women experience a gap in pill use between cycles.
Arlington, Virginia, JSI, DELIVER, 2009.  p. (USAID Contract No. GPO-I-01-06-00007-00)USAID's Public Health Product Catalog 2010 is a catalog of condoms and contraceptives provided by USAID.
Longitudinal antiretroviral adherence in HIV+ Ugandan parents and their children initiating HAART in the MTCT-plus family treatment model: role of depression in declining adherence over time.
AIDS and Behavior. 2009 Jun; 13(Suppl 1):S82-S91.The authors conducted a study to assess the effect of family-based treatment on adherence amongst HIV-infected parents and their HIV-infected children attending the Mother-To-Child-Transmission Plus program in Kampala, Uganda. Adherence was assessed using home-based pill counts and self-report. Mean adherence was over 94%. Depression was associated with incomplete adherence on multivariable analysis. Adherence declined over time. Qualitative interviews revealed lack of transportation money, stigma, clinical response to therapy, drug packaging, and cost of therapy may impact adherence. Our results indicate that providing ART to all eligible HIV-infected members in a household is associated with excellent adherence in both parents and children. Adherence to ART among new parents declines over time, even when patients receive treatment at no cost. Depression should be addressed as a potential barrier to adherence. Further study is necessary to assess the long-term impact of this family treatment model on adherence to ART in resource-limited settings.
[Research Triangle Park, North Carolina], FHI, .  p. (Research Brief on Hormonal Contraception)Over-the-counter provision of oral contraceptives by pharmacists is a safe, effective, and practical way to distribute this popular contraceptive method in Jamaica, according to research published in the journal Studies in Family Planning.
Journal of Family Planning and Reproductive Health Care. 2009 Oct; 35(4):217-8.This report provides information on EllaOne®, a new, single-dose oral preparation to help prevent pregnancy after unprotected sexual intercourse or when contraception fails. It describes EllaOne and what is new about it, its mode of action, its effectiveness, side effects, menstrual changes, who can take EllaOne, drug interactions, effects on pregnancy, and effects on breastfeeding.
American Journal of Public Health. 2009 Oct 15; 99(12)We assessed awareness and experience with the NYC Condom via surveys at 7 public events targeting priority condom distribution populations during 2007. Most respondents (76%) were aware of NYC Condoms. Of those that had obtained them, 69% had used them. Most (80%) wanted alternative condoms offered for free: 22% wanted ultra-thin, 18% extra-strength, and 14% larger-size. Six months after the NYC Condom launch, we found high levels of awareness and use. Because many wanted alternative condoms, the Department of Health and Mental Hygiene began distributing the 3 most-requested alternatives.
Contraception. 2009 Dec; 80(6):495-6.This editorial addresses the issue of increased prices for IUDs over the last several years as demand has grown. It also discusses the problem of web sites offering low prices on IUDs that are not FDA approved.
Global Health. 2010 Fall;  p.Improving the health outcomes for the world’s children is a priority in global health. The recent launch of the Decade of Vaccines by the Bill & Melinda Gates Foundation, strongly supported by the WHO Director General, Margaret Chan, in her recent speech to the World Health Assembly, has renewed the world’s attention and commitment to combating vaccine-preventable diseases. It is good news that many countries now have the chance to add new vaccines to their programs, but we need to ensure that the systems tasked with delivering them are able to cope. Innovative solutions exist -- and they have been shown to significantly improve vaccine performance and delivery. Yet, there is work to be done. Without fully adequate or reliable vaccine delivery systems, the backbone of immunization, lifesaving interventions will not reach the very people who need them most. (Excerpt)
[Washington, D.C., PSI], 2010 May.  p.FoQus on Traders is a pilot methodology intended to better understand retailers’ decision-making about stocking and selling PSI products. To streamline the distribution and sales of PSI condoms, PSI / Zimbabwe investigated why retailers did not consistently stock Protector Plus condoms. Bottle shops were included in this study, which helped PSI / Zimbabwe shift its sales and distribution emphasis towards wholesalers.
[The consideration and several suggestions on the national standard GB 7544 natural latex rubber condoms--requirements and test methods]
Zhongguo Yi Liao Qi Xie Za Zhi. 2010 Nov; 34(6):448-9.It was found that several problems exist in the implementation of GB 7544-2004 in the aspects of requirements of natural latex materials and safety of rubber condom products, microorganisms to be controlled and the packaging and label. As a result, the suggestions were put forward.
[Seattle, Washington], PATH, 2011 Jun.  p.Facilitated by project Optimize and conducted by a multidisciplinary group of partners, these landscape analyses highlight ongoing work related to five priority areas that comprise the vision for immunization supply systems in 2020. The analyses also highlight critical gaps that need to be addressed to achieve the vision. The five priority areas are vaccine and related products, supply system design, environmental impact, information systems, and human resources.
Contraception. 2011 Sep; 84(3):212-3.This commentary explains why the Food and Drug Administration (FDA) should remove the black box warning regarding skeletal health on the package labeling for the injectable contraceptive depot medroxyprogesterone acetate (DMPA). It states that by depriving women of long-term use of this safe, effective product, this black box warning hurts the public health. Copyright © 2011 Elsevier Inc. All rights reserved.
Journal of Adolescent Health. 2004; 35:399-401.We studied the relationship between reading nutrition labels and percent calorie intake from fat. In adolescent boys, reading nutrition labels was associated with higher fat intake. In girls, fat intake did not differ by frequency of nutrition label reading. Nutrition label reading does not translate into healthier diet in adolescents. (author's)