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Ottawa, Canada, International Development Research Centre, 1973. 30 p. (IDRC-009e)This paper evaluates the progress of a Latin American population through stages in family planning adoption. The focus is on changes in knowledge of contraception, attitudes, and practices which occurred over 5 years (1964-69) of widespread public discussion concerning family planning and of program activity in Bogota, Colombia. Data from 2 surveys, 1 in 1964 and the other in 1969, permit the 1st temporal analysis of family planning adoption for a major metropolitan city in Latin America. Additional data on rural and small urban areas of Colombia from the 2nd survey permit a limited assessment of diffusion of family planning from the city to the nation as a whole. The 1st survey in Bogota revealed moderate to high levels of knowledge of contraceptive methods and generally favorable attitudes to birth limitation. However, at this time many women had never spoken to their husbands about the number of children they wanted, nor tried a contraceptive method at any time. The 2nd survey showed substantial changes in this picture. The proportion of currently mated women who had spoken to their husbands about family size preference changed from 43 to 62% for an increase of 71%. Fertility fell appreciably over this period, especially among younger women. Family planning program services had a significant direct contribution to the adoption process, since 36% of mated women had been to a clinic by 1969. The most modern methods of birth control -- the anovulatory pill and the intrauterine device -- which were scarcely known in 1964 were widely known in 1969, and contributed most to the observed increase in current contraceptive practice. However, among the previously known methods, the simplest method of all, withdrawal (coitus interruptus), showed the greatest increase in current practice and remained the most commonly used method. These findings suggest that favorable attitudes and knowledge tend to become rather widespread before levels of husband-wife discussion of family size preferences and levels of contraceptive trial increase appreciably. The results also indicate that contraceptive knowledge and favorable family planning attitudes are spreading rapidly outward from the cities into the rural areas, but that contraceptive practice is still predominantly restricted to urban populations. (author's)
Journal of the Royal College of General Practitioners. 1984 Nov; 34(268):600-2.The immediate responses of physicians and patients to adverse publicity about the possibility of cancer among women using combined oral contraceptives (OCs) were studied in 2 separate locations: the main family planning clinic in the city of Aberdeen, and a provincial general practice of 10 doctors based in the Peterhead Health Centre. A press release was issued 1 day prior to publication of 2 articles in the Lancet of 22 October 1983, reporting possible risks of breast and cervical cancer in some patients on combined OCs. For the 20 workdays immediately after publication, the 16 participating doctors at both locations collected survey data on the ages of patients and outcomes of consultations for all patients who expressed concern about the OCs. In the family planning clinic, 207 consultations with clinic doctors were prompted by anxiety over the pill and accounted for 24.8% of the workload over the 20 days. In the practice, 73 women (7.8% of all the pill users) who attended over the 20 days expressed concern about OCs. The general practitioners reported lower than expected levels of patient response, whereas the family planning clinic required extra sessions to accomodate the temporary upsurge in demand. At each consultation, the doctor either changed the type of pill, changed the method of contraception, or offered reassurance only. At the family planning clinic and practice respectively, the 1st outcome choices were a change of pills for 58.5% and 39.7% of patients, a change of method for 14.0% and 2.7%, and reassurance only for 27.5% and 57.5%. The mean age of patients was 25.1 years at the family planning clinic and 25.6 years at the health center. This limited study suggests that the predicted "pill scare" did not occur at the Peterhead Health Centre, while in contrast the family planning clinic reported a marked increase in workload including inquiries from the press and local radio stations. Factors accounting for the general practitioners' more conservative responses to patients with pill-related anxiety may have included differences in the type of patient seen; the greater time constraints on the general practitioners, whose patients were booked at 6-minute intervals compared to 12-minute intervals in the clinic; or the continuity of care provided by the general practitioners.