Contraception (Birth Control) and Family Planning PubHealthInfo

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PubHealth.info® (a subsidiary of PakMed) presents scientific information mainly based on abstracts of articles published on a variety of public health issues/topics, particularly encompassing population planning, disease prevention, maternal and child health, and communicable and non-communicable diseases (like HIV AIDS, malaria, etc) that are affecting a significant portion of population in developing and developed countries. Here you can find abstracts of articles published on a variety of public health topics under category "Contraception (Birth Control) and Family Planning". Contraception (birth control) is a regimen of one or more actions, devices, or medications followed in order to deliberately prevent or reduce the likelihood of a woman becoming pregnant or giving birth. Therefore contraception is the utilization of various and sundry surgical procedures, devices, practices, agents, or drugs with the intention of preventing conception or impregnation (pregnancy). Methods and intentions typically termed birth control may be considered a pivotal ingredient to family planning. Birth control is a controversial political and ethical issue in many cultures and religions, and although it is generally less controversial than abortion specifically.

YEAR: 1994

CATEGORY: Contraception (Birth Control) and Family Planning

TITLE

Maintaining technical quality of care in the introduction of Cyclofem in a

national family planning program: findings from Indonesia.

AUTHORS

Lubis F; Fajans P; Simmons R

SOURCE

CONTRACEPTION. 1994 May;49(5):527-41.

ABSTRACT

The aim was to examine the implications for service delivery in Indonesian national family planning programs

introducing a new method, the injectable Cyclofem. Observations were made in 28 clinics and with in-depth

interviews in Jakarta, West Java, and West Sumatra. The clinics included introductory trial clinics, nontrial health

centers, community-based health posts, and private sector settings. Observations focused on the logistics of clients

moving through the clinic and on all methods provided. In-depth interviews were conducted among national leaders,

provincial and district program managers, public and private providers of services, community leaders, and clients.

Quality of care issues focused on indications and contraindications, clinical technique, management of side effects,

and appropriate follow-up in service delivery. Observations revealed that the clinical record form K-IV was not used

very well for ascertaining client's needs for spacing methods. The form also did not differentiate between injectables

and oral pills. Screening for contraindications was limited. Several patterns emerged on use of syringes and

needles, including single use and multiple use. All used alcohol to swab the injection site, but one center reused

cotton swabs. Hands were rarely washed before providing services. Many service centers were without running water

in the service area. Gloves were reused without disinfection. Insertion instruments for IUDS were not properly

sterilized. Written materials were only in one language. Side effects discussions were taken out of context and used

to motivate clients. When symptoms were reported, complaints were dismissed, and assessment of the seriousness

of bleeding or amenorrhea was not made. Clients were told to come back on a specific day. Mistiming of returns for

injection resulted in mistiming of injections and a variety of inappropriate responses for assurance of contraceptive

coverage. Most clients were responsible and returned on the appointed date. There were management problems that

interfered with quality of care delivery: supply shortages, inadequate knowledge by staff of the importance of asepsis

and technical information, heavy case loads, provider fears of discussing side effects with clients, lack of technical

supervision, and general lack of attention to quality of care issues. Recommendations were to provide technical

guidelines and instructions that are periodically updates, training for all service providers, written manuals or

guidelines, a functional supervisory system, revision of reporting forms, refinement of logistics to assure one syringe

and needle per client, and balanced staff and equipment for case load management. (PubHealth.info Document ID:

CONT2T 4064-06)

PubHealth.info NOTE: The author(s) of this article titled, "Maintaining technical quality of care in the introduction of

Cyclofem in a national family planning program: findings from Indonesia.", is(are) Lubis F; Fajans P; Simmons R.

The source of this article is "CONTRACEPTION. 1994 May;49(5):527-41.". This article was published in 1994 in

English language(s). (PubHealth.info® Document ID: CONT2T 4064-06. All rights reserved with PubHealth.info) PIN:

9064

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