Contraceptive Methods

避孕方法
  • 文章类型: Journal Article
    在巴西,大约有4870万育龄妇女,了解避孕方法对于应对公共卫生挑战至关重要。这项研究评估了知识,用法,以及巴西妇女对避孕方法的看法,强调社会经济和人口因素对他们选择的影响。
    我们对2000名年龄在18-49岁的巴西女性进行了横断面调查。问卷收集了关于他们意识的详细信息,preferences,以及各种避孕方法的利用,除了人口和社会经济数据。
    口服避孕药,避孕套,注射剂,宫内节育器(IUD)是最受认可的方法。年轻女性对现代方法表现出更高的认识。社会经济差异很明显,低收入妇女对避孕套和宫内节育器的了解有限,但对注射避孕药的使用率较高。口服避孕药是最常用的方法,在南方使用较多,在中西部和东北地区较低。对现行避孕方法的满意度较高(87.5%),在方法选择中与个人责任密切相关。尽管大多数人自筹资金使用避孕药具(63.1%),相当一部分低收入女性(27.7%)依赖公共卫生保健.医生的建议主要影响避孕选择(53.9%),年轻女性也受到其他影响的引导。
    避孕意识和获取方面的持续差异突出了教育举措和政策干预的必要性。卫生保健提供者在促进知情避孕选择方面发挥着至关重要的作用。提高对该方法的满意度的机会。
    UNASSIGNED: In Brazil, where approximately 48.7 million women are of reproductive age, understanding contraceptive practices is essential for addressing public health challenges. This study evaluated into the knowledge, usage, and perceptions of contraceptive methods among Brazilian women, highlighting the influence of socioeconomic and demographic factors on their choices.
    UNASSIGNED: We conducted a cross-sectional survey with a representative sample of 2000 Brazilian women aged 18-49 years. The questionnaire collected detailed information on their awareness, preferences, and utilization of various contraceptive methods, alongside demographic and socioeconomic data.
    UNASSIGNED: Oral contraceptives, condoms, injectables, and intrauterine devices (IUDs) were the most recognized methods. Younger women demonstrated greater awareness of modern methods. Socioeconomic disparities were evident, with lower-income women displaying limited knowledge about condoms and IUDs but a higher usage for injectable contraceptives. Oral contraceptives were the most used method, with higher use in the South, and lower in the Central-West and Northeast regions. Satisfaction with current contraceptive methods was high (87.5%), closely associated with personal responsibility in method choice. Although the majority self-financed their contraceptives (63.1%), a significant portion of lower-income women (27.7%) relied on public health care. Physicians\' recommendations predominantly influenced contraceptive choice (53.9%), with younger women also guided by other influences.
    UNASSIGNED: Persistent disparities in contraceptive awareness and access highlight the need for educational initiatives and policy interventions. Health care providers play a vital role in facilitating informed contraceptive choices, enhancing the chances of satisfaction with the method.
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  • 文章类型: Journal Article
    使用避孕药可以避免与产妇有关的疾病和与怀孕有关的死亡,特别是长效方法,因为它们的好处使计划生育的整体机会得到改善,例如减少对医疗机构的访问,更高的效率和物有所值。在南非卫生系统中引入ImplanonNXT引起了人们的极大关注,即在插入后几个月内返回医疗机构提前将其移除的妇女人数。
    本文重点探讨了女性早期去除ImpanonNXT的经验。
    这项研究是在E区街道的四个选定的诊所进行的,约翰内斯堡市。
    采用半结构化个人访谈收集数据的定性探索性方法。采用内容分析法对数据进行分析。
    其不连续性被引用最多的原因是女性经历了令人不快的副作用,例如闭经,过度出血和头痛,而其他女性发现它是可靠和方便的。
    避孕方法使妇女能够控制自己的生活,并决定合适的生育时间。是的,因此,重要的是使妇女掌握有关避孕方法的相关信息,以便她们能够做出明智的决定和选择。
    该研究呼吁健康促进者根据《国家避孕政策指南》的指导,定期与妇女进行信息交流,以确保最新的实践。
    UNASSIGNED: Maternal-related illnesses and pregnancy-related deaths could be averted using contraceptives, particularly long-acting methods because they improve overall access to family planning because of their benefits, such as fewer visits to the healthcare facility, higher effectiveness and value for money. The introduction of Implanon NXT in the South African health system raised great concern about the number of women who returned to healthcare facilities for its early removal within a few months of insertion.
    UNASSIGNED: This article focussed on exploring the experiences of women regarding early removal of Implanon NXT insertion.
    UNASSIGNED: The study was conducted in four selected clinics in Region E sub-district, city of Johannesburg.
    UNASSIGNED: A qualitative exploratory approach was followed using semi-structured individual interviews to collect data. Data were analysed using the content analysis method.
    UNASSIGNED: The most cited reasons for its discontinuity were that women experienced unpleasant side effects such as amenorrhoea, excessive bleeding and headaches, whilst other women found it to be reliable and convenient.
    UNASSIGNED: Contraceptive methods empower women to take control of their lives and to decide on the right time for them to have children. It is, therefore, important to equip women with relevant information about the contraceptive methods so that they can make informed decisions and choices.
    UNASSIGNED: The study calls for health promoters to periodically conduct information sessions with women as guided by the National Contraception Policy Guidelines to ensure up-to-date practice.
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  • 文章类型: Journal Article
    目的:探讨受教育程度较高的智利年轻女性使用避孕方法的相关因素。
    方法:使用第9次智利全国青年调查,进行了多项模型,以预测已经完成高中学业的17-29岁的性交女大学生(n=1828)在最后一次性交中使用的避孕方法。
    结果:结果表明,在性活动开始时使用避孕方法与所有避孕方法的使用呈正相关(相对风险比[RRR]立即=3.97,RRR每天=2.95,RRR长期=1.82,P<0.05)。先前的意外怀孕增加了使用长期避孕方法的几率(RRR=2.13,P<0.05)。性开始年龄的增加与使用立即避孕方法的几率增加相关(RRR青春期=2.57,RRRyoung成年期=3.75,P<0.05)。物质使用与使用的避孕方法无关。中等社会经济地位,与高相比,降低了使用立即和每日避孕方法的几率(RRR=0.26,P<0.05)。低社会经济地位与使用每日避孕的几率降低相关(RRR=0.39,P<0.05)。最后,不完全(RRR=2.21,P<0.05)或完全(RRR=2.38,P<0.05)专业教育增加了立即避孕方法的几率。
    结论:为了制定针对大学生的计划生育政策,与性行为有关的个人因素应根据当地现实和性别重点来解决。
    OBJECTIVE: To explore factors related to the use of contraceptive methods in young Chilean women with higher education.
    METHODS: Using the 9th Chilean National Youth Survey, multinomial models were conducted to predict contraceptive methods used during the last intercourse among sexually initiated female college students aged 17-29 years who had already completed high school (n = 1828).
    RESULTS: The results indicate that using contraceptive methods at onset sexual activity was positively associated with the use of all contraceptive methods (relative risk ratio [RRR]immediate = 3.97, RRRdaily = 2.95, RRRlong-term = 1.82, P < 0.05). Having a previous unintended pregnancy increased the odds of using long-term contraceptive methods (RRR = 2.13, P < 0.05). Increased age of sexual initiation was associated with increased odds of using immediate contraception methods (RRRadolescence = 2.57, RRRyoung adulthood = 3.75, P < 0.05). Substance use was not associated with contraception methods used. Medium socioeconomic status, compared with high, decreased the odds of using immediate and daily contraceptive methods (RRR = 0.26, P < 0.05 for both). Low socioeconomic status was associated with decreased odds of using daily contraception (RRR = 0.39, P < 0.05). Finally, incomplete (RRR = 2.21, P < 0.05) or complete (RRR = 2.38, P < 0.05) professional education increased the odds of immediate contraceptive methods.
    CONCLUSIONS: To generate family planning policies aimed at university students, individual factors related to sexual behavior should be addressed in accordance with the local reality and with a gender focus.
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  • 文章类型: Journal Article
    由于生育率很高,产后妇女在避孕方法的可获得性和选择方面的差异会影响她们的生活质量,尼日利亚的避孕药具使用率持续较低。
    这项研究评估了尼日利亚产后妇女避孕选择的决定因素。
    从四个地方政府中随机选出两个地方政府。在这两个地方政府中,选择了五个卫生设施。采用多阶段抽样技术选择240名受访者,而结构化问卷用于收集数据。
    这项研究的结果表明,81.7%的受访者计划生现在的孩子,分娩后约有65.4%的妇女恢复了性活动。在那些恢复性行为的人中,大多数,91.1%在分娩后6周这样做。在59.2%的受访者中,某种形式的避孕药具使用较为突出,最常用的避孕方法是戒断(24.8%).城市受访者的避孕普及率略低于农村受访者,虽然关系并不显著。此外,目前使用避孕药具与分娩后恢复性活动之间存在统计学上显著的关系(p=.001),月经恢复(p=.001),以及收到的有关产后计划生育的信息(p=0.013)。
    这项研究的结果强调迫切需要提高避孕方法的可及性和可用性,同时强调有针对性的干预措施和有效的沟通策略,以促进避孕药具的使用和计划生育。在研究领域,解决这些决定因素对于改善产后妇女的整体生活质量至关重要。
    UNASSIGNED: Differences in availability and choices of contraceptive methods among postpartum women have been found to influence their quality of life as the fertility rate is very high, and the contraceptive usage rate persistently remains low in Nigeria.
    UNASSIGNED: This study assessed the determinants of contraceptive options among postpartum women in Nigeria.
    UNASSIGNED: Two Local Governments were randomly selected from the four Local Governments. Within these two local governments, five health facilities were selected. A multistage sampling technique was used to select the 240 respondents, while a structured questionnaire was used to collect data.
    UNASSIGNED: Findings from the study indicated that 81.7% of the respondents have planned to have their current baby, and about 65.4% of the women have resumed sexual activities since delivery. Of those who have resumed sexual activities, the majority, 91.1% did so 6 weeks after delivery. Some form of contraceptive usage was prominent among 59.2% of the respondents, as the most common contraceptive method used was withdrawal (24.8%). Contraceptive prevalence was slightly lower for urban respondents than rural respondents, although the relationship was not significant. Also, there was a statistically significant relationship between the current use of contraceptives and resumption of sexual activities since delivery (p = .001), resumption of menstruation (p = .001), and information received about postpartum family planning (p = 0.013).
    UNASSIGNED: Findings from this study emphasize the urgent need for enhanced accessibility and availability of contraceptive methods, with a parallel emphasis on targeted interventions and effective communication strategies to promote contraceptive uptake and family planning. Addressing these determinants is vital in improving postpartum women\'s overall quality of life in the study area.
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  • 文章类型: Journal Article
    在Covid-19大流行期间,由于难以获得安全堕胎和避孕服务,妇女的生殖健康受到不成比例的影响。这项研究旨在评估Covid-19大流行对MTP病例患病率的影响,并找出在印度不同医院-政府和私营部门的三次Covid浪潮中接受MTP的女性的临床人口统计学特征。
    这项回顾性多中心队列研究是在三次新冠肺炎大流行浪潮中进行的。记录从中心的医疗记录部分和妇产科的MTP登记册中检索。
    平均而言,在covid波中,1.1名妇女/天接受MTP,而在covid之前的2019年为1.9名妇女/天。与第三波(2.88)和第二波(1.12)相比,第一波Covid波的平均MTP/天非常低(0.71),分别。这些差异具有统计学意义(p<0.0001)。MTP最常见的适应症是避孕失败245(50.9%),其次是优生/先天性畸形88(18.9%)。共有244例(50.6%)报告MTP≤7周,114例(23.6%)报告7至12周。超过一半(54%)的妇女因无法获得药物流产(MA)药物而接受了手术流产方法。在第一次和第二次Covid浪潮中,IUCD和灭菌受到严重影响。
    安全堕胎是育龄期妇女的基本服务。由于未来Covid的不确定性,就像紧急情况一样,我们应该加强我们的远程医疗网络,以便妇女能够尽早伸出援手,并可以开始MMA,以减少手术流产和意外怀孕的数量。
    UNASSIGNED: During the Covid-19 pandemic, reproductive health of women was disproportionately affected due to difficult access to safe abortion and contraceptive services. This study aims to assess the impact of the Covid-19 pandemic on the prevalence of MTP cases and to find out the clinicodemographic profiles of women undergoing MTP during three Covid-waves in different hospitals-Government and private sectors in India.
    UNASSIGNED: This retrospective multicentric cohort study was conducted during three Covid-19 pandemic waves. The records were retrieved from the centers\' medical record section and the MTP register from the Department of Obstetrics and Gynaecology.
    UNASSIGNED: On an average, 1.1 women/day underwent MTP during covid waves compared to 1.9 women/day during the pre-covid 2019. The first Covid wave\'s average MTP/day was very low (0.71) compared to the third (2.88) and second wave (1.12), respectively. These differences were statistically significant (p<0.0001). The most common indication for MTP was contraceptive failure 245(50.9%), followed by eugenic/congenital anomalies 88(18.9%). A total of 244 cases (50.6%) reported for MTP ≤ seven weeks and 114(23.6%) presented between 7 and 12 weeks. More than half (54%) of the women underwent surgical methods for abortion as the unavailability of medical abortion (MA) drugs. IUCD and sterilization were severely affected during the first and second Covid waves.
    UNASSIGNED: Safe abortions are essential services for reproductive-age women. With the uncertainty of future Covid-like an emergency, we should strengthen our telemedicine network so that women can reach out early and MMA can be initiated to reduce the number of surgical abortions and unwanted pregnancies.
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  • 文章类型: Journal Article
    通过制造国际紧急情况,COVID-19大流行可能导致生殖保健受损,包括计划生育服务,因此增加了意外怀孕和不安全堕胎。这项研究是为了比较避孕方法,流产,以及伊朗巴博尔市卫生中心服务的意外怀孕,在COVID-19大流行之前和期间。
    进行了一项横断面研究,其中包括425名在巴博尔市卫生中心注册的参与者,Mazandaran省,伊朗。使用多阶段方法,选择了6个城市卫生中心和10个农村中心进行纳入。采用比例分配法抽取符合纳入标准的样本。通过针对避孕方法和准备的6个问题,使用问卷调查来收集与个体特征和生殖行为有关的数据。堕胎的数量和类型,以及2021年7月至11月意外怀孕的数量和原因。使用SPSS软件版本26对数据进行分析。在所有测试中,显著性水平被认为是p<0.05。
    大多数年龄在20至29岁之间的参与者具有文凭教育水平,是家庭主妇,住在城市里。在大流行之前,在大流行期间,有32.0%的人使用了现代避孕方法,而31.6%的人使用了现代避孕方法。在这两个时期之间,未观察到所用避孕方法的组合变化。大约三分之二的人在这两个时期都使用了提款方法。这两个时期的大多数参与者都从药房购买了避孕药具。意外怀孕从大流行前的20.4%增加到大流行期间的25.4%。堕胎率从大流行前的19.1%上升到大流行期间的20.9%,尽管这些发现没有统计学意义.避孕方法与年龄有统计学意义的关系,教育,配偶的教育,配偶的职业,和居住地。意外怀孕的次数与年龄有很大关系,参与者及其配偶的教育水平和社会经济地位,人工流产次数与配偶年龄、文化程度有统计学意义(p>0.05)。
    尽管与大流行前相比,避孕方法没有变化,意外怀孕的数量增加,观察到堕胎和非法堕胎。这可能表明在COVID-19大流行期间对计划生育服务的需求未得到满足。
    By creating an international emergency, the COVID-19 pandemic may have led to compromised reproductive health care, including family planning services, and thus increased unintended pregnancies and unsafe abortions. This study was conducted to compare methods of contraception, abortion, and unintended pregnancies in those served by the health centers of Babol city in Iran, both before and during the COVID-19 pandemic.
    A cross-sectional study was conducted including 425 participants registered to the health centers of Babol city, Mazandaran province, Iran. Using a multi-stage method, 6 urban health centers and 10 rural centers were selected for inclusion. Proportional allocation method was used for sampling those who met the inclusion criteria. A questionnaire was used to collect data in relation to individual characteristics and reproductive behaviors via 6 questions focused upon methods and preparation of contraception, number and type of abortions, and number and causes of unintended pregnancy from July to November 2021. The data were analyzed using SPSS software version 26. Significance level was considered to be p < 0.05 in all tests.
    Most participants aged between 20 and 29 years old had a diploma level of education, were housewives and lived in the city. Prior to the pandemic, 32.0% used modern contraceptive methods and 31.6% used these during the pandemic. No change in the combination of contraceptive methods used was observed between these two periods. Approximately two-thirds used the withdrawal method in both periods. The majority of participants in both periods purchased their contraceptives from a pharmacy. Unintended pregnancy increased from 20.4% prior to the pandemic to 25.4% during the pandemic. Abortions increased from 19.1% prior to the pandemic to 20.9% during the pandemic, although these findings were not found to be statistically significant. Contraceptive methods had a statistically significant relationship with age, education, spouse\'s education, spouse\'s occupation, and place of residence. The number of unintended pregnancies had a significant relationship with age, the educational level of both participants and their spouses and socio-economic status, and the number of abortions had a statistically significant relationship with the age and education level of the spouse (p > 0.05).
    Despite there being no change in contraceptive methods compared to the pre-pandemic period, an increase in the number of unintended pregnancies, abortions and illegal abortions was observed. This may be indicative of an unmet need for family planning services during the COVID-19 pandemic.
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  • 文章类型: Journal Article
    近几十年来,秘鲁避孕方法的使用显着增加。然而,尽管计划生育方法的完整性和可及性,秘鲁的现代避孕方法利用率仍低于南美平均水平。因此,这项研究旨在阐明与现代避孕药具使用相关的因素,以及2019年15-49岁秘鲁女性不平等的存在和空间分布。
    使用2019年秘鲁人口与健康调查的信息进行了二次数据分析。我们进行了描述性统计,双变量分析,和泊松多元回归。通过浓度曲线和Erreygers归一化浓度指数估算不平等。空间分析包括脉络膜图,全球Moran\'sI,克里格插值和Getis-Ord-Gi*统计量。
    在秘鲁育龄妇女中,现代避孕药具的使用率为39.3%。现代避孕药具的使用与青年直接相关(aPR1.39),女性在18岁之前第一次性交(aPR1.41),和结婚但不在一起(APR1.87)。此外,讲Quechua或Aymara(aPR0.87)和没有孩子(aPR0.59)与现代避孕药具的使用呈负相关。我们发现避孕方法的使用存在不平等(亲富分布),虽然幅度很低。空间分析揭示了集群分布模式的存在(莫兰指数=0.009);然而,现代避孕药具使用的预测患病率存在部门间和部门内异质性.此外,在秘鲁发现了重要的热点和冷点。
    五分之二的秘鲁育龄妇女使用现代避孕药具。这与年轻女性的年龄有关,第一次性交时年龄较小,已婚或同居,在其他人中。在现代避孕药具使用中没有发现实质性的不平等。在部门内和部门间的患病率是异质的。那些位于南部的部门,东南,东北部的患病率最低。因此,必须通过多部门和跨部门努力解决非金融障碍,并继续普遍提供现代避孕药具。
    The use of contraceptive methods in Peru has remarkably increased in recent decades. Nevertheless, despite the completeness and accessibility of family planning methods, modern contraceptive methods utilization in Peru remains below the South American average. Thus, this study aimed to elucidate the factors associated with modern contraceptive use, as well as the presence of inequalities and the spatial distribution in Peruvian women aged 15-49 years in 2019.
    A secondary data analysis was conducted using information from the 2019 Peruvian Demographic and Health Survey. We performed descriptive statistics, bivariate analysis, and Poisson multiple regression. Inequalities were estimated through concentration curves and Erreygers\' normalized concentration index. Spatial analysis included choropleth map, Global Moran\'s I, Kriging interpolation and Getis-Ord-Gi* statistic.
    The prevalence of modern contraceptive use was 39.3% among Peruvian women of reproductive age. Modern contraceptive use was directly associated with youth (aPR 1.39), women having their first sexual intercourse before the age of 18 (aPR 1.41), and being married but not together (aPR 1.87). In addition, speaking Quechua or Aymara (aPR 0.87) and having no children (aPR 0.59) were inversely associated with utilization of modern contraceptives. We found the presence of inequalities in the use of contraceptive methods (pro-rich distribution), although the magnitude was low. Spatial analysis unveiled the presence of a clustered distribution pattern (Moran\'s Index = 0,009); however, there was inter-departmental and intra-departmental heterogeneity in the predicted prevalence of the use of modern contraceptives. In addition, significant hot and cold spots were found in Peru.
    Two out of five Peruvian women of reproductive age used modern contraceptives. It was associated with younger women\'s age, younger age at first sexual intercourse, being married or cohabitant, among others. No substantial inequality was found in modern contraceptive use. The prevalence was heterogeneous at the intra- and inter-departmental level. Those departments located in the south, south-east, and north-east had the lowest prevalence. Therefore, nonfinancial barriers must be tackled through multi- and cross-sectoral efforts and continue to universally provide modern contraceptives.
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  • 文章类型: Journal Article
    在像埃塞俄比亚这样由男性控制的社会中,没有让男性参与计划生育计划,有严重的后果,即使妇女有兴趣使用避孕,他们的丈夫反对他们。因此,向男性指出避孕方法干预措施可以通过提供信息来有意义地提高避孕方法的接受度,教育和沟通。因此,这项研究评估了Durame镇男性参与计划生育的患病率,埃塞俄比亚南部,2021年。
    采用了基于社区的横断面研究。采用系统随机抽样技术选择研究对象。数据是使用预先测试的结构化面试官管理问卷收集的。进行描述性分析以描述研究人群。进行了双变量和多变量逻辑回归分析,以确定与男性参与计划生育相关的因素。
    来自接受采访的382名已婚男性,366份问卷得到答复,答复率为96%。参与者的平均年龄为34(±6.1)岁。大多数参与者按种族划分为Kembata311(85%),按宗教划分为新教徒257(70.2%)。关于受访者的职业,约有153人(41.8%)是商人,超过一半的受访者的月收入>2500埃塞俄比亚比尔。男性参与计划生育的患病率为255(69.7%)。男性参与计划生育与受教育程度显著相关,目前在世儿童的数量,信息来源,受访者的知识和态度。
    旨在提高避孕普及率的策略和方案应适当解决男性的参与问题,并将其整合使用避孕方法。
    UNASSIGNED: failure to involve men in the family planning programs in a male-controlled society as Ethiopia, has serious consequences even if women are interested to use contraception their husbands oppose them. Therefore, pointing men for contraceptive methods interventions may meaningfully increase contraceptive acceptance by the provision of information, education and communication. Thus, this study assessed prevalence of men participation in family planning utilization in Durame Town, Southern Ethiopia, 2021.
    UNASSIGNED: a community based cross-sectional study was employed. Systematic random sampling technique was used to select study subjects. Data was collected using pretested structured interviewer administered questionnaire. Descriptive analysis was done to describe the study population. Bi-variable and multi-variable logistic regression analyses were done to identify factors associated with participation of men in family planning.
    UNASSIGNED: from 382 currently married men who were interviewed, 366 were responded to the questionnaires making the response rate of 96%. The mean age of the participants was 34 (± 6.1) years. Majority of the participants were Kembata 311 (85%) by ethnicity and Protestant 257 (70.2%) by religion. Regarding respondent\'s occupation about 153 (41.8%) were merchants and more than half of respondents´ monthly income was >2500 Ethiopian birr. The prevalence of male participation in family planning was 255 (69.7%). Men\'s participation in family planning was significantly associated with educational, number of currently living children, source of information, knowledge and attitude of the respondents.
    UNASSIGNED: strategies and programs aimed at increasing contraceptive prevalence should appropriately address the involvement of males and integrating them use the contraceptive methods.
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  • 文章类型: Journal Article
    背景:鉴于年轻女性的慢性病正在增加,这些女性的意外怀孕与不良的母婴结局有关,这些妇女将受益于有效的孕前保健。然而,人们对这些妇女如何使用或不使用避孕药来告知这些干预措施缺乏了解。这项研究调查了澳大利亚年轻女性队列中避孕药具的使用模式,并调查了慢性病对避孕药具使用的影响。
    方法:使用来自澳大利亚妇女健康纵向研究(1989-1995年出生)的15,244名年轻女性的数据,我们进行了潜在过渡分析,以确定有意外怀孕风险的女性中不同的避孕模式.使用多项混合效应模型来评估避孕组合与慢性病之间的关系。
    结果:在观察期间,患有心脏和自身炎性疾病的女性使用避孕药与没有慢性疾病的女性不同。与没有慢性疾病的女性使用避孕药相比,患有心脏病的女性使用其他避孕药和避孕套的几率增加了一倍(OR=2.20,95%CI1.34,3.59),使用口服避孕药和避孕套的几率略有增加(OR=1.39,95%CI1.03,1.89).与使用避孕药的没有慢性病的女性相比,患有自身炎性疾病的女性使用LARC和避孕套的几率增加(OR=1.58,95%CI1.04,2.41),使用“其他”避孕和避孕套(OR=1.69,95%CI1.11,2.57),并联合使用口服避孕药和避孕套(OR=1.38,95%CI1.09,1.75)。与没有慢性病的女性相比,患有哮喘或糖尿病的女性在观察期间的避孕方式没有差异。
    结论:研究发现,作为常规慢性病护理的一部分,需要有效的避孕咨询,并改善卫生保健提供者与慢性病妇女之间的沟通,以提高年轻妇女的避孕知识和避孕机构选择,特别是对于那些患有心脏或自身炎症的人。这可能是减少这一弱势群体中高风险意外怀孕的关键。
    慢性疾病在年轻女性中正在增加,这些女性的意外怀孕与母亲和婴儿的不良结局有关。为了优化结果,对于这些妇女来说,重要的是计划怀孕并在这段时间之前使用有效的避孕方法。然而,对这些妇女如何使用或不使用避孕药缺乏了解,特别是在高效避孕方面。这项研究调查了澳大利亚年轻女性队列(1989-1995年出生)中避孕药具的使用方式,并调查了慢性病对避孕药具使用的影响。我们发现,随着时间的推移,患有心脏病的女性和患有自身炎性疾病的女性使用避孕药具的差异。重要的是,与没有慢性疾病的女性相比,仅使用避孕药,患有心脏病的女性使用低疗效避孕的可能性增加了一倍.虽然患有自身炎性疾病的女性使用长效方法结合避孕套的可能性增加了69%,这些女性使用低功效避孕的可能性也增加了70%,与仅使用避孕药的无慢性病女性相比。患有哮喘或糖尿病的女性与没有慢性疾病的女性的避孕方式没有差异。调查结果确定,作为常规慢性病护理的一部分,需要有效的避孕咨询,并改善医疗保健提供者与慢性病妇女之间的沟通,以提高年轻妇女的避孕知识和避孕决策,特别是对于那些患有心脏或自身炎症的人。这可能是减少这一弱势群体中高风险意外怀孕的关键。
    BACKGROUND: Given chronic disease is increasing among young women and unintended pregnancies among these women are associated with poor maternal and fetal outcomes, these women would benefit from effective preconception care. However, there is a lack of understanding of how these women use or don\'t use contraception to inform such interventions. This study examined patterns of contraceptive use among an Australian cohort of young women and investigated the influence of chronic disease on contraceptive use over time.
    METHODS: Using data from 15,244 young women from the Australian Longitudinal Study on Women\'s Health (born 1989-1995), latent transition analysis was performed to identify distinct contraceptive patterns among women who were at risk of an unintended pregnancy. Multinomial mixed-effect models were used to evaluate the relationship between contraceptive combinations and chronic disease.
    RESULTS: Contraceptive use for women with cardiac and autoinflammatory diseases differed to women without chronic disease over the observation period. Compared to women without chronic disease using the pill, women with cardiac disease had double the odds of using \'other\' contraception and condoms (OR = 2.20, 95% CI 1.34, 3.59) and a modest increase in the odds of using the combined oral contraceptive pill and condoms (OR = 1.39, 95% CI 1.03, 1.89). Compared to women without chronic disease who used the pill, women with autoinflammatory disease had increased odds of using LARC and condoms (OR = 1.58, 95% CI 1.04, 2.41), using \'other\' contraception and condoms (OR = 1.69, 95% CI 1.11, 2.57), and using the combined oral contraceptive pill and condoms (OR = 1.38, 95% CI 1.09, 1.75). No differences in contraceptive patterns over the observation period were found for women with asthma or diabetes when compared to women without chronic disease.
    CONCLUSIONS: The findings identified a need for effective contraceptive counselling as part of routine chronic disease care and improved communication between health care providers and women with chronic disease to improve young women\'s contraceptive knowledge and agency in contraceptive choice, particularly for those with cardiac or autoinflammatory conditions. This may be the key to reducing high-risk unintended pregnancies among this vulnerable population.
    Chronic disease is increasing among young women and unintended pregnancies among these women are associated with poor outcomes for both the mother and baby. To optimise outcomes, it is important for these women to plan pregnancies and use effective contraception until such time. However, there is a lack of understanding of how these women use or don’t use contraception, particularly with respect to highly effective contraception. This study examined patterns of contraceptive use among an Australian cohort of young women (born 1989–1995) and investigated the influence of chronic disease on contraceptive use over time. We found differences in contraceptive use over time for women with cardiac disease and those with autoinflammatory diseases. Importantly, compared to women without chronic disease using the pill alone, women with cardiac disease had double the odds of using low efficacy contraception. While women with autoinflammatory disease were 69% more likely to use long-acting methods combined with condoms, these women were also 70% more likely to use low efficacy contraception, compared to women without chronic disease who used the pill only. Contraceptive patterns did not differ for women with asthma or diabetes from women without chronic disease. The findings identified a need for effective contraceptive counselling as part of routine chronic disease care and improved communication between health care providers and women with chronic disease to improve young women’s contraceptive knowledge and contraceptive decision-making, particularly for those with cardiac or autoinflammatory conditions. This may be the key to reducing high-risk unintended pregnancies among this vulnerable population.
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  • 文章类型: Journal Article
    背景:肯尼亚的避孕普及率很低,为53%,组成全国的47个县之间的差距很大(2-76%)。需要大量的财政投资来维持这一避孕药具的使用水平,并将其提高到较发达国家的水平。这是在人口增长的背景下,捐助资金下降,有限的财政空间和相互竞争的健康挑战。研究表明,长期避孕方法比短期避孕方法更具成本效益。然而,目前尚不清楚这是否适用于撒哈拉以南非洲;财政资源有限,用户的社会经济地位较低,和公共管理的商品供应链,在垂直计划中,很大程度上取决于捐助者的资金。这项研究评估了肯尼亚使用的避孕方法的成本效益。
    方法:2018年年中在县转诊医院进行了一项横断面研究。对5名计划生育诊所提供者进行了针对性抽样,并对每种方法进行了15次服务提供会议的系统抽样。进行了问卷调查辅助访谈,以确定提供服务所需的输入,并直接观察以衡量提供每种方法所需的时间。每种方法的成本是使用基于活动的成本计算确定的,通过几年保护转换系数的有效性,成本效益表示为每两年保护的成本。
    结果:子宫内铜装置的成本效益最高,为每两年保护4.87美元,其次是2杆植入物为6.36,1杆植入物为9.50,DMPA为23.68,而联合口服避孕药的成本效益最低,为每两年保护38.60美元。与短期方法相比,长期方法吸引了更高的服务交付初始成本。
    结论:长期避孕方法更具成本效益。因此,尽管提供服务的初始成本较高,但投资于长期避孕药具将节省成本。建议,因此,撒哈拉以南非洲国家为提供避孕服务分配更多的国内财政资源,最好有多年规划和预算承诺。应将资源投资于广泛的干预措施,以增加对长期方法的吸收,包括减少年轻人的成本障碍,从而提高了避孕普及率。
    肯尼亚使用避孕方法的育龄妇女比例,53%是低的。需要更多的资金来确保需要避孕药具的妇女能够获得并继续使用避孕药具。先前的研究表明,保护妇女长期怀孕的避孕药具利用的资源较少。这项研究评估了肯尼亚使用避孕药具以较低的成本产生结果的潜力。这项研究于2018年年中在国家以下转诊医院进行。采访了5名计划生育诊所提供者的样本,同时观察到每种方法15次避孕服务。进行访谈是为了确定提供服务所需的用品。观察用于测量提供每种避孕方法所需的时间。与每年提供每种避孕药具相关的成本是使用基于活动的成本计算确定的。使用一年内妊娠保护率确定每种方法的有效性。成本效益是用于在使用一年内防止怀孕的资金。发现铜-T线圈在怀孕一年的保护下以较低的4.87美元的成本实现了更大的效果,其次是2杆植入物为6.36美元,1杆植入物为9.50美元,DMPA为23.68美元,药丸为38.60美元。避孕方法,保护妇女怀孕更长的时间利用较少的资源。尽管需要较高的服务提供初始成本,但投资于此类服务将节省成本。
    BACKGROUND: Kenya\'s contraceptive prevalence rate at 53% is low, with wide disparity among the 47 counties that make up the country (2-76%). Significant financial investment is required to maintain this level of contraceptive use and increase it to levels seen in more developed countries. This is in the context of a growing population, declining donor funding, limited fiscal space and competing health challenges. Studies have shown that long-term contraceptive methods are more cost-effective than short-term methods. However, it is unclear if this applies in Sub-Saharan Africa; with limited financial resources, lower social economic status among users, and publicly managed commodity supply chains, in vertical programs largely dependent on donor funding. This study assessed the cost-effectiveness of contraceptive methods used in Kenya.
    METHODS: A cross-sectional study was undertaken in a county referral hospital in mid-2018. Purposive sampling of 5 family planning clinic providers and systematic sampling of 15 service delivery sessions per method was done. Questionnaire aided interviews were done to determine inputs required to provide services and direct observation to measure time taken to provide each method. Cost per method was determined using activity based costing, effectiveness via couple year protection conversion factors, and cost-effectiveness was expressed as cost per couple year protection.
    RESULTS: The intra-uterine copper device was most cost-effective at 4.87 US dollars per couple year protection followed by the 2-Rod Implant at 6.36, the 1-Rod Implant at 9.50, DMPA at 23.68, while the combined oral contraceptive pills were least cost-effective at 38.60 US dollars per couple year protection. Long-term methods attracted a higher initial cost of service delivery when compared to short-term methods.
    CONCLUSIONS: Long-term contraceptive methods are more cost-effective. As such, investing in long-term contraceptives would save costs despite higher initial cost of service delivery. It is recommended, therefore, that Sub-Saharan Africa countries allocate more domestic financial resources towards availability of contraceptive services, preferably with multi-year planning and budget commitment. The resources should be invested in a wide range of interventions shown to increase uptake of long-term methods, including reduction of cost barriers for the younger population, thereby increasing contraceptive prevalence rates.
    The proportion of women of reproductive age using a contraceptive method in Kenya, at 53% is low. More funding is required to ensure women who need contraceptives have access and continue using them. Previous research has shown that contraceptives that protect a woman from getting pregnant for an extended period utilize less resources. This study assessed the potential of contraceptives used in Kenya to produce results at less cost.This study was undertaken in a sub-national referral hospital in mid-2018. A sample of 5 family planning clinic providers were interviewed while 15 contraceptive service sessions per method were observed. The interviews were conducted to determine the supplies required to offer services. Observation was used to measure time taken to provide each contraceptive method. The cost associated with providing each contraceptive per year was determined using activity based costing. Effectiveness of each method was determined using the rate of protection from pregnancy during one-year. Cost-effectiveness was the money utilized to achieve protection from pregnancy in one year of use.The Copper-T coil was found to achieve greater results at a lesser cost of 4.87 US dollars for one year of protection from pregnancy, followed by the 2-Rod Implant at US dollars 6.36, the 1-Rod Implant at 9.50, DMPA at 23.68, and The Pill at 38.60 US dollars.Contraceptive methods that protect a woman from getting pregnant for a longer period utilize less resources. Investing in such would save costs despite requiring higher initial cost of service provision.
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