Implant users: Over five years after insertion (Further analysis of previous study data)

This secondary analysis report presents the characteristics of a subgroup of 235 women who are overdue in getting Norplant® implants removed after five years, factors related to the risk of nonremoval after five years, and issues related to accessing information about removal of implants. The main source of data for the present study is the “Norplant Implants® Assessment Study: Insertion, Use, and Removal” carried out in Indonesia in April 1996. This study consisted of a representative sample of 2,979 current and former Norplant users who had an insertion from April 1, 1987, to March 31, 1991, five or more years prior to 1996. The selected sample represented 14 provinces, 50 districts, 150 subdistricts, and 300 villages using stratified, multistage probability proportional to size. The secondary analysis used simple cross tabulations of characteristics and the current use status to study the characteristics of the sample women. The relative risk ratio values were calculated to understand factors related to the risk of not getting implants removed after five years

Follow-up household survey in Agra District

This follow-up household survey in Agra District, India, was conducted with funding from USAID under the Population Council’s Asia and Near East Operations Research and Technical Assistance (ANE OR/TA) Project. The main objective of this study, as noted in this report, is to assess changes in the program indicators of family welfare activities, including some of the selected reproductive health indicators, from 1995 (before method-specific targets were withdrawn) and 1997 (30 months after targets were withdrawn). The study’s objectives are to detect changes in FP knowledge and use among currently married women in rural areas; detect changes in level of unmet need for spacing and limiting births; detect changes in use of health services by pregnant and postpartum women; identify the differential use of FP methods, antenatal and postnatal services, child immunization, and other reproductive health services; assess reproductive tract infections among ever-married women in rural areas as reported by them; and assess the level of unwanted pregnancies, incidence of abortions, and post-abortion services

Iron supplementation: Knowledge, perceptions, and usage among pregnant women in rural India

In India, severe anemia has been one of the causes of high maternal mortality and death of newborns and infants due to low birthweight. The prevalence of anemia among women ages 15–44 is extremely high. The Government of India has provided iron and folic acid tablets (IFA) as a prophylaxis against nutritional anemia among pregnant women as part of the Child Survival and Safe Motherhood program and will continue to do so in the Reproductive and Child Health package. This paper presents findings of both qualitative and quantitative research conducted among pregnant women to investigate the extent of distribution and use, information provision, and knowledge and perceptions regarding IFA tablets and reasons for nonuse. The study shows that consumption rate of IFA tablets is high if women are knowledgeable and have positive experiences after taking the tablets. Findings suggest that more accurate and complete information should be provided to pregnant women while distributing IFA tablets along with health and nutritional education messages. At the same time, follow-up visits and counseling are essential to address symptoms that are not related to IFA

Observations from a study tour of Bangladesh and Indonesia on their family welfare programme

Bangladesh has a successful family planning (FP) program and has succeeded in bringing about a demographic transition at a much faster rate than many of its neighboring countries. The contraceptive prevalence rate in Bangladesh increased from 3 percent in 1971 to 45 percent in 1993, and the fertility rate decreased from 7.0 to 3.4 births per woman during the same period. This reflects the effort that the Government of Bangladesh, with the help of international agencies, has made to educate couples about FP and increase access and choice of contraceptive methods, even in remote areas. Another predominantly Muslim country that has achieved remarkable success in FP is Indonesia which has had unprecedented economic growth in recent years. A visit to these countries to study their FP programs provided opportunities to closely observe activities that have contributed to this success. The Population Council, under the Asia and Near East Operations Research and Technical Assistance (ANE OR/TA) project funded by USAID, organized a study tour of Bangladesh and Indonesia for Indian officials, and results are provided in this report

Follow-up household survey in Sitapur District

This follow-up household survey in Sitapur, India, was conducted with funding from USAID under the Population Council\u27s Asia and Near East Operations Research and Technical Assistance (ANE OR/TA) Project. The main objective of the study, as noted in this report, is to assess changes in the program indicators of family welfare activities, including some of the selected reproductive health indicators, from 1994–95 (before the method-specific targets were withdrawn) and 1997 (30 months after the targets were withdrawn). The study has the following immediate objectives: detect changes in family planning (FP) knowledge and use among currently married women in rural areas; detect changes in level of unmet need for spacing and limiting births; detect changes in use of health services by pregnant and postpartum women; identify the differential use of FP methods, antenatal and postnatal services, child immunization, and other reproductive health services; assess reproductive tract infections among ever-married women in rural areas; and assess the level of unwanted pregnancies, incidence of abortions, and post-abortion services

Follow-up study among IUD acceptors of Java

As of April 1993, an estimated 5.3 million women in Indonesia were using IUDs. In 1991, the IUD was the second most commonly used family planning method in Indonesia (13.4 percent). According to the Indonesia Demographic and Health Survey, in 1994 it became the third most commonly used method among currently married women (10.3 percent), primarily on the islands of Java and Bali. The National Family Planning Coordinating Board (BKKBN), in collaboration with the Faculties of Medicine, Diponegoro University in Semarang, Airlangga University in Surabaya, and BKS-Penfin in Bandung, conducted a Follow-up Study Among IUD Acceptors of Java,” from November to December 1994. As this report states, 1,825 IUD acceptors who had their IUD inserted from April 1989 to March 1994 were interviewed. The study collected data on follow-up mechanisms; frequency, type, and management of side-effects; switching of method and clinic; and use-effectiveness of IUD, by type

The persistence of high fertility in Nepal

For a number of years, the fertility level has remained high in Nepal. The government-supported family planning programme began in the late 1960s and expanded comparatively rapidly in the mid-1970s. But the use of contraception had not been widespread; consequently, levels of fertility remained unchanged at a high level. The low level of contraceptive prevalence and lack of fertility differentials suggest that Nepal, being a traditional society and economically having had little development to make any impression on the fertility level, is in a 'pre-demographic transition' phase. This study analyses the reproductive behaviour of Nepalese women and in particular examines marriage and contraceptive use patterns in an attempt to identify the prime determinants of the persistence of high levels of fertility. It is based primarily on data from two surveys: the Nepal Fertility Survey(NFS), 1976 and the Nepal Contraceptive Prevalence Survey(CPS), 1981. Analysis of marriage and fertility was based on the data from the former survey and analysis of contraceptive use on data from the latter. Both these surveys are nationally representative sample surveys. The analysis revealed a number of important findings which, Partly at least, explained the sustained high fertility in Nepal. They are: high child and infant mortality; social customs which encourage early and universal marriage and a large family size with a strong preference for sons; low level of contraceptive prevalence due to limited knowledge of and access to family planning service outlet; and lack of socio-economic development activities. To alleviate the economic and social problems resulting from rapid population growth requires not only a strong family planning programme but also other socio-economic measures if lower fertility levels are to be achieved in Nepal

Indonesia Norplant® removal assessment study

The Indonesia Norplant® Removal Assessment Study was prepared for the World Bank and USAID/Indonesia. All women interviewed had Norplant (contraceptive implant) inserted for five or more years before the interview. For the entire sample, 8.2 percent had not yet had Norplant removed at the time of the interview. This report indicates a very high continuation rate for each Norplant insertion cohort from 1987 through 1991. Almost all Norplant users continue through the fourth year. Between the end of the fourth year and the end of the fifth year, there is a sharp drop in use from 90 percent to 66 percent. This drop continues and accelerates from 66 percent to 10 percent use at the end of the sixth year. For this study, 2,979 women in 14 provinces were interviewed. The study’s goal is to provide the National Family Planning Coordinating Board, the Ministry of Health, and various donor agencies with information on the experience of Norplant clients who had an insertion at least five or more years ago and thus had the potential of using the implant at least five years

Improvements in knowledge of Norplant® implants acceptors: An intervention study in West Sumatra and West Java

Previous studies on Norplant® implants in Indonesia have shown that there are a substantial number of implant acceptors, providers, fieldworkers, and volunteers who are unaware of the basic facts about Norplant. In addition, information, education, and communication materials are lacking for providers, fieldworkers, volunteers, and clients. With these issues in mind, the Training and Development Center for Biomedical and Human Reproduction Studies of the National Family Planning Coordinating Board launched an Operations Research intervention study with Study Groups on Human Reproduction from Andalas University, Padang, West Sumatra, and Padjajaran University, Bandung, West Java, with support from the Population Council. The study began on November 1, 1993, and ended on June 30, 1995. The objectives of the study were to provide accurate information on Norplant implants to women prior to insertion, and to assess the effectiveness of a system of approaches to providing information in order to increase acceptors’ knowledge of the implants. This final report presents findings from the study