18-month progestogen-only contraception during breast-feeding in Libyan women

This study was undertaken to evaluate the efficacy and the influence of progestogen-only contraceptives (POCs) in postpartum lactating mothers over a period of 18-months. 250 mothers were randomised to either the study groups or the control group. In the study groups, 100 mothers were given an oral progestogen pill; lynestrenol and another 100 mothers were assigned to injectable progestogens; depot medroxy-progesterone acetate (DMPA) and norethisterone oenanthate (NET EN), 50 each.The control group (n=50) was given nonhormonal methods.There was no contraceptive failure or negative influence on lactation among the medication groups.There were no significant differences between the groups with respect to the continuation rates and to the adverse effects that led to premature discontinuation. In conclusion, POCs can be used by lactating mothers effectively and safely for at least 18 months.Therefore, the wide use of these methods should be recommended if the international targets to protect, promote and support breast-feeding as well as family planning are to be achieved

Consultation on the Libyan health systems: towards patient-centred services

The extra demand imposed upon the Libyan health services during and after the Libyan revolution in 2011 led the ailing health systems to collapse. To start the planning process to re-engineer the health sector, the Libyan Ministry of Health in collaboration with the World Health Organisation (WHO) and other international experts in the field sponsored the National Health Systems Conference in Tripoli, Libya, between the 26th and the 30th of August 2012. The aim of this conference was to study how health systems function at the international arena and to facilitate a consultative process between 500 Libyan health experts in order to identify the problems within the Libyan health system and propose potential solutions. The scientific programme adopted the WHO health care system framework and used its six system building blocks: i) Health Governance; ii) Health Care Finance; iii) Health Service Delivery; iv) Human Resources for Health; v) Pharmaceuticals and Health Technology; and vi) Health Information System. The experts used a structured approach starting with clarifying the concepts, evaluating the current status of that health system block in Libya, thereby identifying the strengths, weaknesses, and major deficiencies. This article summarises the 500 health expert recommendations that seized the opportunity to map a modern health systems to take the Libyan health sector into the 21st century