O planejamento familiar é uma ação de saúde que permite a regulação da fecundidade, faz parte da Atenção Básica, atualmente vem sendo oferecido através do Programas de Saúde da Família é um direito reprodutivo. A qualidade da assistência em planejamento familiar é imprescindível para os índices de saúde reprodutiva e sexual, sendo a oferta, a livre escolha por métodos contraceptivos e a informação dada aos clientes são elementos fundamentais para garantir a qualidade dessa assistência. Este estudo teve como objetivo descrever a assistência prestada em planejamento familiar segundo as mulheres em idade fértil e os profissionais de saúde do Núcleo de Saúde de Família I no município de Ribeirão Preto, São Paulo. Trata-se de um estudo descritivo, com abordagem quantitativa. A amostra foi composta por 242 mulheres em idade fértil cadastradas no Núcleo de Saúde da Família I e por 11 profissionais de saúde que atuavam neste serviço. Os dados foram coletados através de entrevistas estruturadas em domicilio e no serviço de saúde. A estatística descritiva e os testes quiquadrado de Pearson ou Exato de Fisher foram utilizados para a análise dos dados. Os resultados revelam que a maioria das mulheres (69,8%) utiliza o Núcleo de Saúde da Família I para segmento de saúde, possuem em média 32,6 anos, são casadas (43%), possuem vida sexual ativa (65,7%), já engravidaram sem planejar utilizando métodos contraceptivos (46,2%), utilizam métodos contraceptivos para o controle da fecundidade (66,5%), sendo a pílula e o preservativo masculino os mais conhecidos e utilizados, já suspenderam o uso de métodos contraceptivos sem orientação médica (57,8%). O Núcleo de Saúde da Família I não se constituiu em local de orientação para 51,2% das mulheres sobre planejamento familiar, bem como para homens e adolescentes. As mulheres recebem orientações sobre planejamento familiar de forma individual (90,1%), há pouca utilização de material ilustrativo durante as orientações (38,7%), A mulheres utilizam os métodos contraceptivos mais orientados e oferecidos pelos profissionais de saúde, recebem acompanhamento clínico (75,6%). O conhecimento das mulheres, sobre as principais características dos métodos contraceptivos, está associado ao método em uso. Há orientação para o uso de preservativo masculino visando prevenir DST/HIV, porém este método é pouco utilizado. Os profissionais de saúde estão formados, em média, há 13 anos, atuam, em média, há quatro anos e nove meses no Núcleo de Saúde da Família I e atuam, em média, há sete anos em planejamento familiar e a maioria não recebeu capacitação em planejamento familiar. Atividades de orientação em grupo são desenvolvidas esporadicamente. Os métodos contraceptivos mais eficazes são os mais orientados e oferecidos para as mulheres pelos profissionais de saúde. Concluímos que a informação sobre os diversos métodos contraceptivos e a escolha livre não é realidade das mulheres do Núcleo de Saúde da Família I, já que utilizam os métodos contraceptivos mais orientados e oferecidos pelos profissionais de saúde. A falta de capacitação profissional, assim como as ações educativas descontinuas e pouco concretizadas, colocam em risco a saúde reprodutiva e sexual das mulheres. A assistência em planejamento familiar apresenta-se deficitária, necessitando de adequação com vistas a uma assistência de qualidade na perspectiva dos direitos reprodutivos e sexuais. / Family planning is a health action that permits regulating fecundity and is part of Basic Health Care services. The quality of family planning care is essential for reproductive and sexual health ratios, in which the offering and free choice of contraceptive methods and the information given to clients are fundamental elements to guarantee care quality. This study aimed to describe family planning care delivery according to women of fertile age and health professionals at Family Health Center I in Ribeirão Preto, São Paulo. This is a descriptive study with a quantitative approach. The sample was composed of 242 women of fertile age registered at Family Health Center I and 11 health professionals working at this service. Data were collected through structured interviews held at home and at the health service. Descriptive statistics and Pearsons Chi-Square or Fishers Exact test were used for data analysis. The results reveal that most women (69.8%) use Family Health Center I for the health segment. Their average age is 32.6 years; they are married (43%); have an active sexual life (65.7%); have already been pregnant without planning to use contraceptive methods (46.2%); use contraceptive methods for fecundity control (66,5%), with the pill and the male condom as the most known and used methods; have already suspended the use of contraceptive methods without medical advice (57.8%). The Health Service under analysis did not represent a place of family planning advice for 51.2% of the women, nor for men and adolescents. The women receive individual advice about family planning (90.1%) and little illustration material is used during the advice sessions (38.7%). They use the contraceptive methods that are most indicated and offered by health professionals, and receive clinical follow-up (75.6%). The womens knowledge about the main characteristics of the contrace3ptive methods is associated with the method they are using. Advice is given about the use of the male condom with a view to preventing STD/HIV, although this method is little used. Average time since graduation for the health professionals is 13 years; they have been working at Family Health Centre I for four years and nine months on the average, have been active in family planning for seven years on the average and most of them did not receive any training on family planning. Group orientation activities occur sporadically. The most effective contraception methods are also those the health professionals indicate and offer most frequently. We conclude that information about the different contraceptive methods and free choice are not a reality for the women in this study, as they use the contraceptive methods that are most indicated and offered by the health professionals. The lack of professional training, as well as discontinued and not very concrete education actions put the reproductive and sexual health of these women at risk. Deficits in family planning care are found, demanding adaptation with a view to offering high-quality care from the perspective of reproductive and sexual rights.

<p>Background: About 22.4 million people were living with HIV/AIDS in 2008 out of which women constitute approximately 57%. Namibia is one of the highly affected countries with a national HIV prevalence of 17.8% among women attending antenatal clinics. Antiretroviral medications have become available in Namibia since 2002 and presently all district hospitals and some health centres provide ARVs to those in need. Namibia is rated as one of the few countries in sub-Sahara Africa with a high coverage of ART, with 80% of those in need of ART receiving the treatment. An increasing trend has been observed whereby HIV+ women on ARV are becoming pregnant. Little is known about the attitude, knowledge and behavior of these women towards family planning and use of contraceptives and what barriers they may be facing in accessing these services.Aim: To determine the factors affecting the utilization of family planning services by HIV+ pregnant women receiving PMTCT services. Methodology: The study was a cross sectional study using both quantitative and qualitative methods to assess the critical elements of knowledge, attitude and perceptions of the study participants towards family planning services. The study also assessed the health system and other factors that impact on the use of contraceptives by HIV+ women. It was conducted in northern Namibia at Oshakati Health centre among randomly selected pregnant HIV+ women attending for PMTCT services.Results: Among the 113 respondents, who participated in the study, 97.3% knew at least one method of family planning but only 53.6% actually used any method of contraception prior to current pregnancy. Among the 46.4% who did not use any contraception, the reasons often cited for non-use were because they wanted a baby (52%), spouse objection (10%), being afraid of the effects (14%) and other reasons such as belief, culture and distance to travel to the health facility. 88% of the respondents indicated a willingness to use contraceptives after current pregnancy and expressed general satisfaction with services at the health centre while asking for more information on family planning services.Conclusion: HIV+ women have high awareness on some contraceptives but use of contraceptives is not as high as many of them have a desire to have children for self esteem and leave a legacy for the future. Knowledge of the risks of pregnancy on HIV+ woman may be limited and there is a need to improve educational intervention in this regard as well as integrate family planning services into all HIV/AIDS services.</p>

<p>Background: About 22.4 million people were living with HIV/AIDS in 2008 out of which women constitute approximately 57%. Namibia is one of the highly affected countries with a national HIV prevalence of 17.8% among women attending antenatal clinics. Antiretroviral medications have become available in Namibia since 2002 and presently all district hospitals and some health centres provide ARVs to those in need. Namibia is rated as one of the few countries in sub-Sahara Africa with a high coverage of ART, with 80% of those in need of ART receiving the treatment. An increasing trend has been observed whereby HIV+ women on ARV are becoming pregnant. Little is known about the attitude, knowledge and behavior of these women towards family planning and use of contraceptives and what barriers they may be facing in accessing these services.Aim: To determine the factors affecting the utilization of family planning services by HIV+ pregnant women receiving PMTCT services. Methodology: The study was a cross sectional study using both quantitative and qualitative methods to assess the critical elements of knowledge, attitude and perceptions of the study participants towards family planning services. The study also assessed the health system and other factors that impact on the use of contraceptives by HIV+ women. It was conducted in northern Namibia at Oshakati Health centre among randomly selected pregnant HIV+ women attending for PMTCT services.Results: Among the 113 respondents, who participated in the study, 97.3% knew at least one method of family planning but only 53.6% actually used any method of contraception prior to current pregnancy. Among the 46.4% who did not use any contraception, the reasons often cited for non-use were because they wanted a baby (52%), spouse objection (10%), being afraid of the effects (14%) and other reasons such as belief, culture and distance to travel to the health facility. 88% of the respondents indicated a willingness to use contraceptives after current pregnancy and expressed general satisfaction with services at the health centre while asking for more information on family planning services.Conclusion: HIV+ women have high awareness on some contraceptives but use of contraceptives is not as high as many of them have a desire to have children for self esteem and leave a legacy for the future. Knowledge of the risks of pregnancy on HIV+ woman may be limited and there is a need to improve educational intervention in this regard as well as integrate family planning services into all HIV/AIDS services.</p>

Thesis (M.A. (Population and Reproductive Health Research))--Mahidol University, 2003.

O planejamento familiar é uma ação de saúde que permite a regulação da fecundidade, faz parte da Atenção Básica, atualmente vem sendo oferecido através do Programas de Saúde da Família é um direito reprodutivo. A qualidade da assistência em planejamento familiar é imprescindível para os índices de saúde reprodutiva e sexual, sendo a oferta, a livre escolha por métodos contraceptivos e a informação dada aos clientes são elementos fundamentais para garantir a qualidade dessa assistência. Este estudo teve como objetivo descrever a assistência prestada em planejamento familiar segundo as mulheres em idade fértil e os profissionais de saúde do Núcleo de Saúde de Família I no município de Ribeirão Preto, São Paulo. Trata-se de um estudo descritivo, com abordagem quantitativa. A amostra foi composta por 242 mulheres em idade fértil cadastradas no Núcleo de Saúde da Família I e por 11 profissionais de saúde que atuavam neste serviço. Os dados foram coletados através de entrevistas estruturadas em domicilio e no serviço de saúde. A estatística descritiva e os testes quiquadrado de Pearson ou Exato de Fisher foram utilizados para a análise dos dados. Os resultados revelam que a maioria das mulheres (69,8%) utiliza o Núcleo de Saúde da Família I para segmento de saúde, possuem em média 32,6 anos, são casadas (43%), possuem vida sexual ativa (65,7%), já engravidaram sem planejar utilizando métodos contraceptivos (46,2%), utilizam métodos contraceptivos para o controle da fecundidade (66,5%), sendo a pílula e o preservativo masculino os mais conhecidos e utilizados, já suspenderam o uso de métodos contraceptivos sem orientação médica (57,8%). O Núcleo de Saúde da Família I não se constituiu em local de orientação para 51,2% das mulheres sobre planejamento familiar, bem como para homens e adolescentes. As mulheres recebem orientações sobre planejamento familiar de forma individual (90,1%), há pouca utilização de material ilustrativo durante as orientações (38,7%), A mulheres utilizam os métodos contraceptivos mais orientados e oferecidos pelos profissionais de saúde, recebem acompanhamento clínico (75,6%). O conhecimento das mulheres, sobre as principais características dos métodos contraceptivos, está associado ao método em uso. Há orientação para o uso de preservativo masculino visando prevenir DST/HIV, porém este método é pouco utilizado. Os profissionais de saúde estão formados, em média, há 13 anos, atuam, em média, há quatro anos e nove meses no Núcleo de Saúde da Família I e atuam, em média, há sete anos em planejamento familiar e a maioria não recebeu capacitação em planejamento familiar. Atividades de orientação em grupo são desenvolvidas esporadicamente. Os métodos contraceptivos mais eficazes são os mais orientados e oferecidos para as mulheres pelos profissionais de saúde. Concluímos que a informação sobre os diversos métodos contraceptivos e a escolha livre não é realidade das mulheres do Núcleo de Saúde da Família I, já que utilizam os métodos contraceptivos mais orientados e oferecidos pelos profissionais de saúde. A falta de capacitação profissional, assim como as ações educativas descontinuas e pouco concretizadas, colocam em risco a saúde reprodutiva e sexual das mulheres. A assistência em planejamento familiar apresenta-se deficitária, necessitando de adequação com vistas a uma assistência de qualidade na perspectiva dos direitos reprodutivos e sexuais. / Family planning is a health action that permits regulating fecundity and is part of Basic Health Care services. The quality of family planning care is essential for reproductive and sexual health ratios, in which the offering and free choice of contraceptive methods and the information given to clients are fundamental elements to guarantee care quality. This study aimed to describe family planning care delivery according to women of fertile age and health professionals at Family Health Center I in Ribeirão Preto, São Paulo. This is a descriptive study with a quantitative approach. The sample was composed of 242 women of fertile age registered at Family Health Center I and 11 health professionals working at this service. Data were collected through structured interviews held at home and at the health service. Descriptive statistics and Pearsons Chi-Square or Fishers Exact test were used for data analysis. The results reveal that most women (69.8%) use Family Health Center I for the health segment. Their average age is 32.6 years; they are married (43%); have an active sexual life (65.7%); have already been pregnant without planning to use contraceptive methods (46.2%); use contraceptive methods for fecundity control (66,5%), with the pill and the male condom as the most known and used methods; have already suspended the use of contraceptive methods without medical advice (57.8%). The Health Service under analysis did not represent a place of family planning advice for 51.2% of the women, nor for men and adolescents. The women receive individual advice about family planning (90.1%) and little illustration material is used during the advice sessions (38.7%). They use the contraceptive methods that are most indicated and offered by health professionals, and receive clinical follow-up (75.6%). The womens knowledge about the main characteristics of the contrace3ptive methods is associated with the method they are using. Advice is given about the use of the male condom with a view to preventing STD/HIV, although this method is little used. Average time since graduation for the health professionals is 13 years; they have been working at Family Health Centre I for four years and nine months on the average, have been active in family planning for seven years on the average and most of them did not receive any training on family planning. Group orientation activities occur sporadically. The most effective contraception methods are also those the health professionals indicate and offer most frequently. We conclude that information about the different contraceptive methods and free choice are not a reality for the women in this study, as they use the contraceptive methods that are most indicated and offered by the health professionals. The lack of professional training, as well as discontinued and not very concrete education actions put the reproductive and sexual health of these women at risk. Deficits in family planning care are found, demanding adaptation with a view to offering high-quality care from the perspective of reproductive and sexual rights.

Background: Adolescents in Botswana, especially women, face many sexual and reproductive health (SRH) challenges including high maternal mortality, sexually transmitted infections (STIs) including HIV, and unintended pregnancies, despite available SRH services. The youth friendly service (YFS) concept has been initiated and various strategies developed to address adolescents concerns. However, services remain underutilized and barriers to accessing services still exist. Aim: The aim of this study was to determine patterns of utilization of sexual and reproductive health services by adolescents attending senior secondary schools in Gaborone in 2012. The specific objectives were to: identify SRH services utilized by adolescents in the district; identify factors associated with adolescent utilization of YFS in the district; and determine barriers and facilitators to utilization of available YFS by adolescents. Design: This was a health systems research, which was conducted through an observational study, with descriptive and analytic components. Methods: 506 adolescents attending at the three (3) senior secondary schools in Gaborone were sampled through a simple random sampling strategy in each school. Parental consent and assent from participants was requested before respondents completed a self-administered questionnaire which was designed for the data collection. The questionnaire was pilot tested prior to the study. SPSS version 16 was used to analyse the data. A chi-squared test and logistic regression were used investigate association, and a p-value <0.05 was considered as statistically significant. Results: The findings of this study revealed that utilization of SRH by adolescents was low and the level of awareness of youth friendly services was also low. The study revealed that utilization of SRH was higher among female adolescents compared to their male counterparts. The study identified factors which hinder adolescents YFS utilization, which include: location of the facility, no interest in YFS, staff attitudes and behaviours, and inconvenient hours of operation. Conclusion: Identifying patterns of utilization of SRH services by adolescents attending senior secondary schools in Gaborone can help strengthen programmes at all levels of service delivery and the country at large. The Botswana Ministries of Health, and Education and Skills Development can re-orientate, or develop new initiatives that will deal with barriers to access and assist adolescents to fully utilize the available services. / Thesis (M.Med.Sc.)-University of KwaZulu-Natal, Durban, 2014.

This study operationalized the five dimensions of health care access in the context of contraceptive service provision and used this framework to examine access to contraceptive care at health department (HD) (Title X funded) and federally qualified health center (FQHC) (primarily non-Title X funded) clinics in South Carolina and Alabama. A cross-sectional survey was conducted in 2017/18 that assessed clinic-level characteristics, policies, and practices related to contraceptive provision. Provision of different contraceptive methods was examined between clinic types. Survey items were mapped to the dimensions of access and internal consistency for each scale was tested with Cronbach's alpha. Scores of access were developed and differences by clinic type were evaluated with an independent t-test. The overall response rate was 68.3% and the sample included 235 clinics. HDs (96.9%) were significantly more likely to provide IUDs and/or Impants on-site than FQHCs (37.4%) (P < 0.0001). Scales with the highest consistency were Availability: Clinical Policy (24 items) (alpha = 0.892) and Acceptability (43 items) (alpha = 0.834). HDs had higher access scores than FQHCs for the Availability: Clinical Policy scale (0.58, 95% CL 0.55, 0.61) vs (0.29, 95% CL 0.25, 0.33) and Affordability: Administrative Policy scale (0.86, 95% CL 0.83, 0.90) vs (0.47, 95% CL 0.41, 0.53). FQHCs had higher access scores than HDs for Affordability: Insurance Policy (0.78, 95% CL 0.72, 0.84) vs (0.56, 95% CL 0.53, 0.59). These findings highlight strengths and gaps in contraceptive care access. Future studies must examine the impact of each dimension of access on clinic-level contraceptive utilization.

Federally qualified health centers (FQHCs) provide essential contraceptive services to low-income individuals; yet, access to all method options, notably intrauterine devices (IUDs) and implants, may be limited at non-Title X FQHCs. The South Carolina (SC) Choose Well initiative is a statewide contraceptive access initiative that was launched in 2017 and extends into 2022. Choose Well established a collaborative network between training and clinical partners and is aimed at facilitating implementation of contraceptive care best practices through capacity-building and training of clinical and administrative staff in partner organizations. The initiative provided funding for workforce expansion and contraceptive methods. We examined perceptions of staff from Choose Well-participating FQHCs regarding contraceptive access during the first 2 years of the initiative, including factors that facilitated or posed access challenges as well as sustaining factors. This study informs the process evaluation of Choose Well while providing data critical for uncovering and scaling up contraceptive access initiatives. Interviews were conducted with FQHC staff ( = 34) in 2018 and 2019 to assess Choose Well implementation and were recorded, transcribed, and double-coded at least 80% interrater reliability or consensus coding. Data were analyzed according to clinical and administrative factors influencing contraceptive access. Increased capacity for contraceptive counseling and provision through training and external funding for IUDs and implants were the most noted clinical factors facilitating access. Streamlining workflow processes was also a facilitator. Buy-in and engagement among staff and leadership emerged as a facilitator at some clinics and as a barrier at others. Policy/structural factors related to costs of devices and insurance coverage were identified as threats to sustainability. The Choose Well initiative contributed to the perception of an increase in contraceptive access at participating FQHCs in SC. Statewide contraceptive access initiatives have the potential to support FQHCs in meeting their clients' contraceptive needs. Organizational buy-in, sustainability of funding, and training are key to realizing the full potential of these initiatives.

A quantitative, descriptive, explorative, contextual study was conducted to determine pharmacists and drug vendors' level of knowledge, attitude towards and practice on Emergency Contraceptive (ECl in Addis Ababa. Forty licensed service providers in Addis Ababa were randomly selected during 2008 and interviewed using a structured interview schedule. Data were analysed using a computer software package. The findings revealed that although these service providers were knowledgeable on the purpose and dOSing schedule of EC, they lacked knowledge on side-effects, contra-indications, and types of ECs. Most respondents portrayed a subjective attitude towards easy EC access of especially adolescent girls, since they believed that it will encourage promiscuity and unprotected intercourse. Their knowledge and practice need to be improved, as it has a direct effect on potential users and reducing unwanted pregnancies among young. / Health Studies / M.P.H. (Health Sudies)

This study aimed at identifying the socio-demographic and service related factors influencing intra uterine contraceptive device (IUD) utilization among family planning clients in Addis Ababa. With a quantitative, cross sectional descriptive design approach, data was collected using structured questionnaires administered by healthcare supervisors. A total of 366 family planning clients and 35 family planning service providers were interviewed. The findings indicated that the level of education, occupation, parity and fertility plan have significant (p<0.05) association with utilization of IUD. Healthcare service provider’s knowledge and skills for provision of intra uterine contraceptive device services were low. Community members lack awareness and knowledge of the benefit and side effects of the device. Therefore, community members need education to promote adherence and effective use of IUD. Similarly, healthcare service providers need skill training and education to ensure quality provision of IUD service / Health Studies / M.A. (Public Health)