Family Planning Services

计划生育服务
  • 文章类型: Journal Article
    背景:多用途预防技术(MPT)是能够同时满足多种性健康和生殖健康需求的产品,例如意外怀孕,性传播感染包括HIV-1和其他生殖道感染。迫切需要MPT来解决计划外怀孕和艾滋病毒的双重负担。虽然避孕套是目前唯一可以使用的MPT,他们不是完全在一个女人的控制之下,女性避孕套由于可接受性差和成本高而面临局限性。
    方法:我们对参加MTN045研究的39对夫妇的定性数据进行了亚分析,以检查夫妇对结合HIV和妊娠预防的“2合1”MPT的选择和可接受性的看法。
    结果:夫妇认识到MPT对艾滋病毒和妊娠预防的好处,但与每种适应症和一种新型预防技术工具相关的看法引起了与未来MPT使用相关的重要问题。在研究中,参与者对MPT使用的看法受妊娠计划的影响。当时机不那么关键时,他们把预防艾滋病毒列为优先事项。关于计划生育方法的错误信息,包括MPT,影响决策,有可能阻碍未来MPT的采用。担心副作用,比如体重增加和荷尔蒙失衡,影响了使用MPT的意愿。
    结论:解决围绕使用避孕药的神话和误解对于促进其接受和最终使用至关重要。随着新的MPT在开发渠道和方法推广中取得进展,应制定解决妇女在使用特定产品时可能遇到的缺点的战略。
    BACKGROUND: Multipurpose prevention technologies (MPTs) are products capable of simultaneously addressing multiple sexual and reproductive health needs such as unwanted pregnancy, STIs including HIV-1, and other reproductive tract infections. MPTs are urgently needed to address the double burden of unplanned pregnancy and HIV. While condoms are currently the only accessible MPTs, they are not solely under a woman\'s control, and female condoms face limitations due to poor acceptability and high cost.
    METHODS: We conducted a sub-analysis of qualitative data from 39 couples participating in the MTN 045 study to examine the perception of couples on choice and acceptability of a \"2 in 1\" MPT that combines HIV and pregnancy prevention.
    RESULTS: Couples recognized the benefits of MPTs for HIV and pregnancy prevention but perceptions tied to each indication and a novel prevention technology tool raised important concerns relevant to use of future MPTs. In the study, participants\' perceptions of MPT use were influenced by pregnancy planning. When the timing was less critical, they prioritized HIV prevention. Misinformation about family planning methods, including MPTs, affected decision-making with potential to hinder uptake of future MPTs. Concerns about side effects, such as weight gain and hormonal imbalances, influenced willingness to use MPTs.
    CONCLUSIONS: Addressing the myths and misconceptions surrounding the use of contraceptives is crucial in promoting their acceptance and ultimate use. Strategies for addressing the drawbacks women might experience while using a particular product should be in place as new MPTs progress through the development pipeline and approach roll-out.
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  • 文章类型: Journal Article
    Though tertiary students studying health-related programs are assumed knowledgeable about family planning, this does not always translate to increased use of family planning services. In a cross-sectional survey, this study assessed 411 nursing, midwifery and allied health students\' knowledge of family planning, contraceptive use, perceptions, and factors affecting the utilisation of family planning services. Each student completed a 24-itemised questionnaire in a Computer-Assisted Personal Interviewing Survey. The data was analysed with Stata /IC version 16. Statistical significance was set at p<0.05. Overall knowledge of family planning was 99.7%, commonly gained in school (51.8%), followed by clinics and hospitals (41.4%). Only 21.7% of the students used family planning services. Menstrual cramps (57.9%), infertility (33.1%), and weight gain (32.5%) were the commonly perceived side effects of contraceptive use. The high proximity of participants to family planning service providers and lack of community, family, and partner acceptance of modern contraceptives were associated with underutilisation. Despite the high level of knowledge of family planning, the student\'s utilisation of family planning services was poor. To boost family planning service uptake among tertiary health students, it is essential to tackle barriers related to community, family, and partner acceptance. This can be achieved through educational programs that involve men in family planning discussions and by enhancing service accessibility.
    Même si les étudiants du supérieur qui étudient dans des programmes liés à la santé sont censés connaître la planification familiale, cela ne se traduit pas toujours par une utilisation accrue des services de planification familiale. Dans le cadre d\'une enquête transversale, cette étude a évalué les connaissances de 411 étudiants en soins infirmiers, obstétricaux et paramédicaux en matière de planification familiale, d\'utilisation des contraceptifs, de perceptions et de facteurs affectant l\'utilisation des services de planification familiale. Chaque étudiant a rempli un questionnaire en 24 points dans le cadre d\'une enquête par entretien personnel assisté par ordinateur. Les données ont été analysées avec Stata/IC version 16. La signification statistique a été fixée à p<0,05. La connaissance globale de la planification familiale était de 99,7 %, généralement acquise à l\'école (51,8 %), suivie par les cliniques et les hôpitaux (41,4 %). Seulement 21,7% des étudiants ont utilisé les services de planification familiale. Les crampes menstruelles (57,9 %), l\'infertilité (33,1 %) et la prise de poids (32,5 %) étaient les effets secondaires couramment perçus de l\'utilisation de contraceptifs. La grande proximité des participants avec les prestataires de services de planification familiale et le manque d\'acceptation des contraceptifs modernes par la communauté, la famille et les partenaires étaient associés à la sous-utilisation. Malgré le niveau élevé de connaissances en matière de planification familiale, l\'utilisation des services de planification familiale par les étudiants était faible. Pour stimuler le recours aux services de planification familiale parmi les étudiants de l\'enseignement supérieur en santé, il est essentiel de s\'attaquer aux obstacles liés à l\'acceptation par la communauté, la famille et les partenaires. Cet objectif peut être atteint grâce à des programmes éducatifs qui impliquent les hommes dans les discussions sur la planification familiale et en améliorant l\'accessibilité des services.
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  • 文章类型: Journal Article
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  • 文章类型: Case Reports
    背景:庞贝氏症,归类为糖原贮积病II型,源于酸性α-葡萄糖苷酶(GAA)酶的缺乏,导致糖原在多个组织中积累。基因型和酶活性之间的独特相关性是关键特征。这个案例突出了一种婴儿发作形式,强调遗传咨询和产前检查的重要性。
    方法:一名18周大的呼吸窘迫婴儿,紫癜,发烧了。出生健康,她的兄弟姐妹死于庞贝氏症.她表现出心脏肥大,低张力,和缺乏反应。通过显著降低的GAA活性证实了诊断。尽管开始治疗,病人死于心脏骤停.
    结论:该案例强调了遗传咨询的作用,提供对产前检测进展的见解,通过超声心动图进行产前诊断,以及早期干预的意义,特别是在婴儿发作的Pompe病中。
    结论:遗传风险评估和产前检测对于有庞贝氏症病史的家庭至关重要,以改善早期诊断和治疗结果。
    BACKGROUND: Pompe disease, classified as glycogen storage disease type II, arises from a deficiency in the acid alpha-glucosidase (GAA) enzyme, leading to glycogen accumulation in multiple tissues. The unique correlation between genotype and enzyme activity is a key feature. This case highlights an infantile-onset form, emphasizing genetic counseling and prenatal testing importance.
    METHODS: An 18-week-old infant with respiratory distress, cyanosis, and fever was admitted. Born healthy, her sibling died from Pompe disease. She presented with cardiomegaly, hypotonia, and absent reflexes. Diagnosis was confirmed by significantly reduced GAA activity. Despite treatment initiation, the patient succumbed to cardiac arrest.
    CONCLUSIONS: The case underscores genetic counseling\'s role, offering insights into prenatal testing advancements, antenatal diagnosis through echocardiography, and the significance of early intervention, particularly in infantile-onset Pompe disease.
    CONCLUSIONS: Genetic risk assessment and prenatal testing are crucial for families with a history of Pompe disease to improve early diagnosis and management outcomes.
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  • 文章类型: Journal Article
    背景:未满足的计划生育需求是育龄妇女中希望停止或推迟生育但不使用任何避孕方法的比例。全球十分之一的已婚妇女面临未满足的计划生育需求,非洲五分之一的女性。因此,通过了解与特定于研究区域的未满足需求相关的因素;该研究有助于计划和干预计划,为早期研究中的争议提供了额外的发现,也有助于作为其他研究人员进行类似主题研究的基线。
    方法:一项基于社区的无匹配病例对照研究于2021年3月29日至4月25日在DewaChefa区对462名目前已婚育龄妇女(154例和308名对照)进行。目前已婚育龄妇女多产,并希望限制或延迟生育但不使用任何避孕方法作为案例,目前正在使用计划生育或不想使用的已婚育龄妇女作为对照。使用结构化和预先测试的问卷来收集数据。将收集的数据输入到Epi-data3.1中,并输出到SPSS23进行分析。进行二元Logistic回归分析,将p值<0.05的变量视为有统计学意义。
    结果:共有462名妇女参加了这项研究,100%的反应率。受访者的平均年龄为27.92岁(SD为±6.3),女性35-49岁[AOR=6.6(1.1-39)],对计划生育缺乏了解[AOR=1.9(1.1-3.1)],使用由丈夫决定的计划生育[AOR=3.8(2.1-6.9)],使用计划生育共同决定[AOR=2.3(1.07-5.1)]和没有支持和不赞成丈夫使用计划生育[AOR=2.1(1.08-4)]是与未满足需求显着相关的因素。
    结论:女性的年龄,计划生育使用的主要决策者,关于计划生育的知识以及支持和批准配偶用于计划生育的知识被发现与未满足的计划生育需求有显著关联。因此,计划生育提供者,区卫生局,其他有关机构应加强女性赋权和男性参与该计划,并提供强有力的夫妻咨询,以减少未满足的需求。
    BACKGROUND: Unmet need for family planning is a proportion of women among reproductive age group who want to stop or delay childbearing but are not using any method of contraception. One in ten married women face unmet need for family planning world-wide whereas, one in five women in Africa. Thus, by understanding factors associated with unmet need specific to the study area; the study contributes to planning and intervention of programs, gives additional finding for controversies in earlier studies, and also helps as a baseline for other researchers conducting studies on similar topics.
    METHODS: A community-based unmatched case-control study was conducted from March 29-April 25, 2021 G.C on 462 currently married reproductive age women (154 cases and 308 controls) in Dewa Chefa District. Currently married reproductive-age women who were fecund, and wanted to limit or delay childbearing but were not using any contraceptive methods were taken as cases and currently married reproductive-age women who were using family planning or did not want to use were taken as controls. A structured and pre-tested questionnaire was used to collect data. Collected data were entered into Epi-data 3.1 and exported to SPSS 23 for analysis. Binary Logistic regression was conducted and variables with p-value < 0.05 were taken as statistically significant.
    RESULTS: A total of 462 women participated in this study, with 100% response rate. The mean age of the respondents was 27.92 years (with SD of ± 6.3) Age of woman 35-49 [AOR = 6.6 (1.1-39)], having poor knowledge on family planning [AOR = 1.9 (1.1-3.1)], using family planning decided by husband [AOR = 3.8 (2.1-6.9)], using family planning decided together [AOR = 2.3 (1.07-5.1)] and have no support and disapproval of husband for family planning use [AOR = 2.1 (1.08-4)] were factors significantly associated with unmet need.
    CONCLUSIONS: Age of the woman, main decider of family planning use, knowledge about family planning and support and approval of spouse for family planning use were found to have significant association with unmet need for family planning. Thus, family planning providers, District health office, and other concerned bodies should strengthen female empowerment and male involvement in the program with strong couple counseling to reduce unmet need.
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  • 文章类型: Journal Article
    孟加拉国的计划生育计划已经成功运行了半个多世纪,实现生育率的显著下降。承认对妇女自由的限制,最初的计划设计大部分集中在为妇女提供家庭用品上。然而,这些外展服务的一个不幸影响是,通过绕过直接挑战重男轻女态度的机会,他们无意中加强了现状的权力关系。因此,我们对孟加拉国计划生育计划中的决策结构提出了质疑。我们认为,孟加拉国的计划生育计划的根本缺陷是缺乏有意识的努力来理解妇女的健康选择和决策作为一个复杂的背景关系过程,结构,和体制力量。此外,在这些项目中避免男性通常会给女性带来新的依赖,因为这种方法并不直接寻求建立基于性别平等的关系桥梁。因此,许多妇女仍然依赖丈夫和家庭的许可获得生殖健康服务,面临着有限的计划生育选择和获得护理的机会。我们建议计划生育方案采取更广阔的视野,在不断协商性别的不断发展的社会关系环境中创造新的和更可持续的可能性。在后Covid世界中,这样的策略更加紧迫,因为国家体系面临不确定性和模糊性。
    Family planning programs in Bangladesh have been successfully operating for over half a century, achieving phenomenal reductions in fertility rates. Acknowledging restrictions on women\'s freedoms, much of the initial program design was concentrated on giving household supplies for women priority. However, one unfortunate impact of these outreach services is that, by bypassing the opportunity to challenge patriarchal attitudes directly, they inadvertently reinforce the power relationships of the status quo. Hence, we problematise the decision-making structures within Bangladesh\'s family planning programs. We argue that the fundamental flaw with Bangladesh\'s family planning program is the lack of conscious effort to understand women\'s health choices and decision-making as a complex contextual process of relational, structural, and institutional forces. Additionally, avoiding men in these programs often creates new dependencies for women, as this approach does not directly seek to build relational bridges based on equality between genders. As a result, many women still depend on permission from their husbands and family for reproductive health services and face constrained family planning choices and access to care. We recommend that family planning programs adopt a broader vision to create new and more sustainable possibilities in an ever-evolving social relations landscape where gender is constantly negotiated. Such strategies are even more pressing in the post-Covid world, as national systems are exposed to uncertainty and ambiguity.
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  • 文章类型: Journal Article
    计划生育计划主要在个人层面运作,寻求增强个人的知识,改变态度,并改善有效避孕的持续使用。社会科学研究通过强调塑造个人避孕态度的结构性影响来增加这些努力,信仰,和行为。这样的工作强调了体现知识的重要性,这些知识是由社会环境提供的,并为个人提供了一种确定感,即知道哪种避孕方法对他们(以及在他们体内)有效。然而,通过对2017年至2018年美国特拉华州59名自我认同的女性进行深度访谈的定性分析,我们认为,避孕决策有一个强大的方面,它超越了表达能力,有意识的知识,我们称之为“体现厌恶”。“我们利用情感理论和污名理论来引入内化的厌恶作为一种有影响力的感觉和取向,远离可植入和可插入的避孕方法,这种方法是由生殖身体周围的内化污名产生的。具体的厌恶压倒了对避孕益处如功效的有意识理解,易用性,和长寿。我们的研究将厌恶表现为对避孕药具理解的缺失,我们认为这对于更全面地概念化避孕药具使用的经验维度至关重要。这样做可以增强以患者为中心的护理,共同决策,和生殖自主权。
    Family planning programs have largely operated at the individual level, seeking to enhance individuals\' knowledge of, change attitudes towards, and improve consistent use of efficacious contraception. Social science research has added to these efforts by emphasizing the structural influences that shape individuals\' contraceptive attitudes, beliefs, and behaviors. Such work highlights the importance of embodied knowledge which is informed by social contexts and provides individuals with a sense of assuredness in knowing which contraception works well for them (and within their bodies). However, through qualitative analysis of in-depth interviews with 59 self-identified women conducted from 2017 to 2018 across the state of Delaware in the United States, we argue that there is a powerful facet of contraceptive decision-making that lies beyond articulatable, conscious knowledge, which we name \"embodied aversion.\" We draw on affect theory and stigma theory to introduce embodied aversion as an influential feeling and orientation away from implantable and insertable contraceptive methods that arises from internalized stigma around the reproductive body. Embodied aversion overpowers conscious understanding of contraceptive benefits like efficacy, ease of use, and longevity. Our research presents embodied aversion as a missing piece of contraceptive understanding that we argue is vital in more fully conceptualizing experiential dimensions of contraceptive use. Doing so enhances patient-centered care, shared decision-making, and reproductive autonomy.
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  • 文章类型: Journal Article
    刚果民主共和国(DRC)的国家计划生育战略计划(FP)呼吁在2025年提高现代避孕普及率。刚果民主共和国的规模和薄弱的卫生基础设施对初级卫生保健所有领域的规划提出了重大挑战,包括FP。尽管如此,在过去的十年里,组织了一组倡导者,开展了一系列活动,以改善刚果民主共和国FP的政策环境。我们概述了迄今为止的四项主要成就:在国家和省一级振兴多部门FP利益攸关方小组,以2018年通过的新公共卫生法的形式废除1920年法律,征求包括两位总统在内的政治人物对FP有利的公开声明,并确保政府支付购买避孕药具的资金。我们揭示了获得这些倡导胜利所需的幕后工作。鉴于倡导领域不适合使用随机试验或准实验设计进行严格评估,重要的是要记录和分析如何获得这种倡导胜利。
    The national strategic plan for family planning (FP) in the Democratic Republic of the Congo (DRC) calls for an increase in modern contraceptive prevalence in 2025. The DRC\'s size and weak health infrastructure pose significant challenges to programming in all areas of primary health care, including FP. Notwithstanding, in the past decade, a group of advocates organized to undertake a series of activities to improve the policy environment for FP in the DRC. We outline the 4 major accomplishments to date: revitalizing a multisectoral FP stakeholder group at the national and provincial levels, obtaining the repeal of the Law of 1920 in the form of a new Public Health Law passed in 2018, soliciting public statements favorable to FP from political figures including 2 presidents, and securing the disbursement of government funds for the purchase of contraceptives. We reveal the work behind the scenes needed to obtain these advocacy wins. Given that the field of advocacy does not lend itself to rigorous evaluation using randomized trials or quasi-experimental design, it is important to document and analyze how such advocacy wins can be attained.
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  • 文章类型: Journal Article
    目的:本研究旨在确定吉尔吉特已婚妇女继续使用激素避孕方法的相关因素,巴基斯坦在他们开始后至少6个月。
    方法:无匹配病例对照研究。
    方法:吉尔吉特的社区设置,巴基斯坦从2021年4月1日至2021年7月30日。
    方法:病例为已婚育龄妇女,在面试的时候,连续使用激素避孕方法至少6个月,对照组为已婚育龄妇女,她们过去使用激素方法,目前使用非激素方法至少6个月.
    方法:或继续使用激素避孕药。
    结果:我们来自吉尔吉特的样本与连续使用激素避孕方法显着相关的因素是计划生育中心与家庭的距离(校正OR(AOR)6.33,95%CI3.74至10.71),对当前使用的方法的满意度(AOR3.64,95%CI2.06至6.44),访问计划生育中心以利用服务(AOR1.86,95%CI1.07至3.45)和年龄相对较大的妇女(AOR1.07,95%CI1.02至1.12)。此外,受过正规教育的女性(AOR0.27,95%CI0.12~0.6)使用现代避孕方法的可能性较小.
    结论:继续使用激素方法与容易进入计划生育中心有关,对目前的方法和经常访问计划生育中心感到满意。在受教育程度低的妇女中也出现了继续使用激素方法的情况。在居民区附近建立计划生育中心的重要性再强调不过了。这不仅提供了方便获得计划生育方法,但也向妇女保证,当她们在使用这些方法时面临任何不愉快的影响时,她们会继续使用现代方法。
    This study aimed to determine the factors associated with continuation of hormonal contraceptive methods among married women of Gilgit, Pakistan at least 6 months after their initiation.
    Unmatched case-control study.
    Community settings of Gilgit, Pakistan from 1 April 2021 to 30 July 2021.
    The cases were married women of reproductive age who, at the time of interview, were using a hormonal method of contraception for at least 6 months continuously, and controls were married women of reproductive age who had used a hormonal method in the past and currently were using a non-hormonal method for at least 6 months.
    OR for continuation of hormonal contraceptive.
    The factors significantly associated with continuous use of hormonal contraceptive methods for our sample from Gilgit were the family planning centre\'s distance from home (adjusted OR (AOR) 6.33, 95% CI 3.74 to 10.71), satisfaction with current method used (AOR 3.64, 95% CI 2.06 to 6.44), visits to the family planning centre to avail services (AOR 1.86, 95% CI 1.07 to 3.45) and relatively older age of women (AOR 1.07, 95% CI 1.02 to 1.12). In addition, women with formal education (AOR 0.27, 95% CI 0.12 to 0.6) were less likely to use a modern contraceptive method.
    Continuation of using a hormonal method was associated with easy access to family planning centres, satisfaction with the current method and frequent visits to the family planning centres. Continuation of using a hormonal method was also seen in women with low education status. The importance of the presence of family planning centres near residential areas cannot be emphasised more. This does not only provide easy access to family planning methods, but also reassure women of continuation of modern methods when they face any unpleasant effects while using these.
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  • 文章类型: Journal Article
    目标:围绕性别和性的规范信念将个人置于两种精神中,拉拉,同性恋,双性恋,trans,和酷儿(2SLGBTQ)社区与他们的异性恋和顺性者相比,在医疗保健系统内面临较差健康结果的风险,特别是在性别化的护理领域,包括计划生育和生育意愿。这项研究的目的是探索异性恋和顺势的规范性信念对从事计划生育的2SLGBTQ人的经历的影响,并开始了解医疗保健提供者如何提供适当的,安全,和整体护理。方法:我们使用案例研究方法进行了定性研究,并对11名具有不同性别和性别的参与者进行了半结构化访谈。调查结果:对于2SLGBTQ社区的成员,计划生育受正常理想的影响很大,身份的交叉点,卫生保健系统,和社区。当与计划生育有关时,他们可能会面临额外的情感劳动和有意的决策。异质性和顺应性极大地影响了所接受的医疗保健。结论:这些发现在与2SLGBTQ社区相关的有限研究领域中提供了信息,并可能支持医疗保健提供者提供整体护理。
    Objectives: Normative beliefs around gender and sexuality place individuals in the Two Spirit, lesbian, gay, bisexual, trans, and queer (2SLGBTQ) community at risk for poorer health outcomes within the health care system compared with their heterosexual and cisgender counterparts, particularly within gendered areas of care including family planning and fertility intentions. The purpose of this research was to explore the effect that the normative beliefs of heteronormativity and cisnormativity had on the experiences of 2SLGBTQ people engaged in family planning, and to begin to understand how health care providers can provide appropriate, safe, and holistic care. Methods: We conducted a qualitative study using case study methodology and completing semi-structured interviews with 11 participants with diverse genders and sexualities. Findings: For members of the 2SLGBTQ community, family planning is greatly affected by ideals of normal, intersections of identities, health care systems, and community. They may face additional emotional labor and intentional decision-making when related to family planning. Heteronormativity and cisnormativity greatly impact the health care that is received. Conclusions: The findings contribute information in the limited field of research related to the 2SLGBTQ community and may support health care providers in providing holistic care.
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