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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
141

Adolescência e anticoncepção: conhecimento e o uso de métodos anticoncepcionais por estudantes da zona urbana de Cruzeiro do Sul, Acre / Adolescence and contraception: knowledge and use of contraceptive methods by students of urban area of Cruzeiro do Sul, Acre

Rocha, Maria José Francalino da 03 February 2010 (has links)
Objetivo: Caracterizar o conhecimento e uso de métodos anticoncepcionais entre adolescentes de escolas públicas. Métodos: Estudo transversal, realizado com amostra probabilística e representativa de 363 adolescentes, de ambos os sexos, que não viviam conjugalmente, com idades entre 13 e 17 anos, matriculados no período diurno, de escolas públicas, da zona urbana do município de Cruzeiro do Sul, Estado do Acre, em 2008. A pesquisa contemplou as exigências éticas. A caracterização de conhecimento e uso de métodos anticoncepcionais foi feita, a partir da aplicação de um questionário estruturado, contendo perguntas fechadas e abertas sobre sexualidade e métodos contraceptivos. Dados coletados foram digitados, revisados e processados. O banco de dados foi constituído e analisado, estatisticamente, com a utilização do software Epi Info (version 3.5.8; 2008). Os dados foram descritos, utilizando a estatística descritiva: distribuição de freqüência, medidas de tendência central e medida de dispersão. Para identificação de diferenças entre grupos de adolescentes foi utilizado o teste Quiquadrado de Pearson ou Exato de Fisher. Resultados: Dos 363 adolescentes, 55,4por cento eram do sexo feminino e 44,6por cento, do masculino, com média de idade de 14,7 (dp=1,3) anos; 32,0por cento afirmaram que haviam iniciado a vida sexual, as moças, com média de idade de 15,0 (dp=1,3) anos e os rapazes, com 13,3 (dp=1,3) anos; 98,9por cento referiram conhecer algum tipo de MAC, especialmente, o preservativo (95,3por cento) e a pílula (80,1por cento). Mais do que metade das moças e rapazes, respectivamente, 58,3por cento e 59,6por cento, referiram conhecer entre 1 e 4 tipos de MAC. Dentre os que iniciaram, ou não, a vida sexual, 78,4por cento e 65,6por cento, respectivamente, já tinham ouvido falar sobre dupla proteção. Dentre aqueles com vida sexual ativa, 79,3por cento das moças e 81,0por cento dos rapazes referiram terem feito uso de preservativo na primeira e na última relação sexual. Igualmente, 87,5por cento das garotas e 72,1por cento dos garotos, referiram fazer uso de camisinha em todas as relações sexuais. Conclusão: O alto nível de conhecimento de MAC e o elevado uso de preservativo sexual masculino entre esses adolescentes podem expressar resultados positivos das políticas públicas de saúde sexual e reprodutiva atuais, contribuindo para diminuição de gravidez não planejada e de infecções por doenças transmitidas por via sexual / To characterize the knowledge and use of contraceptive methods among public school students. Methods: Transversal study, accomplished with probabilistic and representative sample of 363 adolescents, man and woman, who didnt live conjugally, between 13 and 17 years old, matriculated in diurnal period, in public schools, in the urban area of Cruzeiro do Sul District, Acre State, in 2008. The research observed the ethic requirements. The characterization of the knowledge and use of contraceptive methods was done with the application of a structured questionary, containing open and closed questions about sexuality and contraceptive methods. The gathered data were digitated, revised and processed. The data bank was constituded and analyzed, statistically, using the software Epi Info (version 3.5:8; 2008). The data were described, using the descriptive statistic: frequency distribution, central trend measures and dispersion measure. For the identification of the differences among the adolescent groups it was used the Qui-square test of Pearson or Exact of Fisher. Results: From the 363 adolescents, 55,4per cent were female and 44,6per cent male, with average age of 14,7 (dp=1,3) years old; 32,0per cent told that they had begun sexual life, the girls with average age of 15,0 (dp=1,3) years old and the boys, with 13,3 (dp=1,3) years old; 98,9per cent affirmed to know some kind of MAC, especially the preservative (95,3per cent) and the contraceptive pills (80,1per cent). More than half of the girls and boys, respectively, 58,3per cent and 59,6per cent affirmed to know between 1 and 4 kinds of MAC. Among the ones who had begun, or not, sexual life, 78,4per cent and 65,6per cent, respectively, had already heard about double protection. Among the ones with active sexual life, 79,3per cent of the girls and 81,0per cent of the boys affirmed that they had already made use of preservative during the first and the last intercourse. Identically, 87,5per cent of the girls and 72,1per cent of the boys affirmed that they use condom in every intercourse. Conclusions: The high level of knowledge of MAC and the high use of male sexual preservative among those adolescents can express positive results of the current public sexual and reproductive health policies, contributing with the decrease of the non-planned pregnancy and infections by sexually transmitted diseases
142

A sexualidade após a maternidade: a expeiência de mulheres usuárias do SUS / The sexuality after motherhood: the experience of user women of SUS.

Marilaine Balestrim Andrade 30 May 2014 (has links)
A chegada do primeiro filho traduz um cenário de intensas mudanças na rotina das mulheres, o qual é pautado por diferentes percepções a respeito da sexualidade e da maternidade. As formas como as novas mães percebem tais mudanças e, identificam suas necessidades em relação ao exercício da sexualidade exercem influência sobre o cotidiano e a saúde das mulheres. Este estudo teve por objetivo compreender como as mulheres que se tornaram mães pela primeira vez percebem as mudanças e identificam as suas necessidades em relação ao exercício da sexualidade durante o primeiro ano do período pós-parto. Especificamente buscou analisar as perspectivas das participantes sobre a maternidade e a sexualidade; compreender a vivência da sexualidade em função dos significados atribuídos a maternidade; identificar o conhecimento e a importância atribuída aos diferentes métodos contraceptivos e; identificar a importância das orientações profissionais nas questões ligadas à saúde sexual e reprodutiva das mulheres. Em virtude dos fenômenos estudados desenvolvemos uma pesquisa de cunho qualitativo com 12 mulheres primíparas e usuárias de Unidades Básicas de Saúde do município de Ribeirão Preto, interior do estado de São Paulo. O instrumento utilizado para a realização da coleta de dados foi a entrevista semiestruturada e, através da Análise de Conteúdo o material oriundo da transcrição integral das entrevistas foi fragmentado dando origem a categorias, as quais foram reagrupadas por temáticas relevantes ao objeto estudado. Da análise de conteúdo obtivemos categorias que dizem respeito a concepção de sexualidade, ao sexo e maternidade, a concepção de maternidade, a gravidez, ao parceiro e pai e, ao planejamento familiar. Portanto, a compreensão que as mulheres têm acerca do seu novo papel social imprime novos direcionamentos às experiências diárias no ambiente doméstico, nas relações sociais e no relacionamento com o parceiro. Muitas questões permeadas pelo desequilíbrio nas relações de gênero estão envolvidas nesta dinâmica como a qualidade do acesso ao planejamento familiar, a forma como se apropriam das informações recebidas e a qualidade do atendimento pré e pós-natal. A forma como a mulher exerce a sexualidade e a maternidade é indissociável da construção social da identidade feminina, construção esta que determina as práticas relativas a atenção à saúde das mulheres e que pode interferir nas escolhas e no cuidado com a saúde e na procura da assistência. / The coming of a firstborn son represents a scene of intense changes in routine of women which is lined for different perceptions related to sexuality and motherhood. The ways new mothers notice these changes and identify their needs related to sexuality influences their daily lives and the women health. This study had the goal understand how women became mothers for the first time realize the changes and identify their needs in relation to their sexuality during the first year postpartum period. Specifically sought analyze the participants perspective about motherhood and sexuality; understand the experiences of sexuality according to the meanings assigned to motherhood; identify the knowledge and the importance given to different contraceptive methods; identify the importance of professional orientation linked to maters of sexual and reproductive health of the women researched. In view of the phenomena studied we developed a qualitative research with 12 primiparous women and users of public health system in Ribeirão Preto, countryside of São Paulo state. The instrument used to perform the data collection was semi-structured interview and through the content analysis of the material from the whole interviews transcription, it was fragmented originating categories, which were regrouped by relevant themes to the object of study. Content analysis categories obtained concerning the conception of sexuality, sex and motherhood, conception of motherhood, pregnancy, partner and father, and, family planning. Therefore, the understanding women has about their new social role requires new directions to daily experiences in the home environment, in social relations and in the relationship with their partner. Many questions are permeated by the imbalance of gender relation involved in this dynamic with quality familiar planning access, the way they appropriate information received and the quality of pre and postnatal treatment. At long last, the way which the women practice the sexuality and the motherhood is inseparable from the social construction of female identity, construction that determines the practices related to the attention to womens health that could interfere in the choices and care with health and in the search for assistance.
143

A prescrição da pílula anticoncepcional na década de 1960: a perspectiva de médicos ginecologistas / The contraceptive pill prescription in the 1960s: the perspective of gynecologists

Francine Even de Sousa Cavalieri 21 February 2017 (has links)
Introdução: A prescrição da pílula anticoncepcional passa a ser realizada no Brasil a partir de 1962. Sua prática trouxe transformações políticas e sociais ao país: a pílula passa a ter grande aceitabilidade das mulheres e permanece como o método anticoncepcional mais utilizado por elas até a atualidade. Seu uso influenciou na queda da taxa de fecundidade e compõe, atrelada a uma série de outros fatores, um conjunto de transformações que modifica a formulação de políticas públicas referentes à saúde reprodutiva e à saúde sexual feminina. Objetivo: Compreender como a prescrição da pílula anticoncepcional por médicos ginecologistas era realizada no Brasil na época em que começa a ser utilizada no país. Metodologia: Trata-se de uma pesquisa qualitativa, tendo como material empírico as narrativas de seis médicos ginecologistas que atuaram na década de 1960, no estado de São Paulo. Resultados e Discussão: A partir das entrevistas, foram identificados quatro eixos temáticos de análise, que contemplaram a descrição Introdução: A prescrição da pílula anticoncepcional passa a ser realizada no Brasil a partir de 1962. Sua prática trouxe transformações políticas e sociais ao país: a pílula passa a ter grande aceitabilidade das mulheres e permanece como o método anticoncepcional mais utilizado por elas até a atualidade. Seu uso influenciou na queda da taxa de fecundidade e compõe, atrelada a uma série de outros fatores, um conjunto de transformações que modifica a formulação de políticas públicas referentes à saúde reprodutiva e à saúde sexual feminina. Objetivo: Compreender como a prescrição da pílula anticoncepcional por médicos ginecologistas era realizada no Brasil na época em que começa a ser utilizada no país. Metodologia: Trata-se de uma pesquisa qualitativa, tendo como material empírico as narrativas de seis médicos ginecologistas que atuaram na década de 1960, no estado de São Paulo. Resultados e Discussão: A partir das entrevistas, foram identificados quatro eixos temáticos de análise, que contemplaram a descrição sobre o primeiro contato dos médicos com a pílula, seguido das diferentes formas de utilização da pílula anticoncepcional como uma nova tecnologia. Também foi identificada a relação entre a prescrição médica e a indústria farmacêutica, assim como o uso da pílula anticoncepcional e a construção do discurso médico sobre o corpo feminino. Esses achados foram analisados à luz dos estudos sobre medicalização do corpo feminino, e como a sua prescrição foi sendo incluída na clínica médica a partir da década de 1960. Considerações Finais: O uso da pílula anticoncepcional apresentou-se como uma nova tecnologia de controle da reprodução e dos corpos femininos. Compreender a história da prescrição da pílula é levar em consideração os múltiplos agentes, interesses e práticas que ainda se inscrevem sobre os corpos das mulheres / Introduction: The prescription of the contraceptive pill began in Brazil in 1962. This practice brought political and social changes to the country: the pill becomes highly accepting of women and remains the contraceptive method most used by them until nowadays. The pill use has influenced the fall in fertility rate and, based on a series of other factors, is a set of transformations that modifies the formulation of public policies regarding reproductive health and female sexual health. Goal: To understand how the prescription of the contraceptive pill happened in Brazil, carried by gynecologists at the time when it begins to be used in the country. Methodology: This is a qualitative research, having as empirical material the narratives of six gynecologists who worked in the 1960s, at São Paulo state. Results and Discussion: From the interviews, four thematic axes of analysis were identified, which included the description of the first contact of the doctors with the pill, followed by different ways of using the contraceptive pill as a new technology. Also, were identified the relationship between medical prescription and the pharmaceutical industry, as well as the use of the contraceptive pill and the construction of the medical discourse about the female body. These findings were analyzed in light of the studies on medicalization of the female body, and how the contraceptive pill prescription was included in the medical clinic from the 1960s. Final Considerations: The use of the contraceptive pill was presented as a new technology for the control of Reproduction and of female bodies. Understanding the history of pill prescription is to take into account the multiple agents, interests, and practices that are still inscribed on women\'s bodies
144

FATORES DETERMINANTES DA PRÁTICA DE MÉTODOS CONTRACEPTIVOS ENTRE UNIVERSITÁRIAS DA ÁREA DA SAÚDE / DETERMINATIVE FACTORS OF THE PRACTICAL ONE OF CONTRACEPTIVE METHODS AMONG COLLEGES STUDENT OF HEALTH AREA

Faray, Helone Eloísa Frazão Guimarães 03 July 2008 (has links)
Made available in DSpace on 2016-08-19T18:15:55Z (GMT). No. of bitstreams: 1 Helone Eloisa Frazao Guimaraes Faray.pdf: 330641 bytes, checksum: 10147d27f87acff1a0cc466f765c9c7c (MD5) Previous issue date: 2008-07-03 / The research objective the study of the determinants factors of the practical of contraceptive methods between colleges student of the health area. It was used of form with structuralized questions applied the 440 colleges student with age of 18 the 24 years of Faculdade Santa Terezinha (CEST). The analysis statistics it s being through the program Epi-Info and by means of the test qui-square. Amongst the searched colleges student 66.7% they had answered already to have initiated the sexual life. Most part of the colleges student initiated the sexual life with the age of 19 - 20 years 41.9%. In the first sexual relation 65.2% it used some contraceptive method. The used method more in the first sexual relation was condom 80.3%, currently 82.7% of the colleges student they use contraceptive and the preference continues being condom 84.9%. The majority of the colleges student declared to present frequency in the sexual relations of one or more times in week 54.2% and with a partner in the year 78.9%. The results in this population show that it has a proeminence for the bachelor condition, say to know condom as contraceptive method and affirm not to present doubts about the methods. Already they had initiated the sexual life and they had used contraceptive in the first relation presenting the frequency of one or more times in week and a partner in the last year. / O objetivo desta pesquisa é estudar os fatores determinantes da prática de métodos contraceptivos entre universitárias da área da saúde. Utilizou-se um formulário com perguntas estruturadas aplicado a 440 universitárias com idade de 18 a 24 anos da Faculdade Santa Terezinha (CEST). A análise estatística foi realizada através do programa Epi-Info e por meio do teste qui-quadrado. Dentre as universitárias pesquisadas 66,7% responderam já ter iniciado a vida sexual. Grande parte das universitárias iniciou a vida sexual com a idade entre 19 a 20 anos 41,9%. Na primeira relação sexual 65,2% usou algum método contraceptivo. O método mais utilizado na primeira relação sexual foi o condom 80,3% e, atualmente, 82,7% das universitárias utilizam contraceptivo e a preferência continua sendo para o condom 84,9%. A maioria das universitárias declarou apresentar freqüência nas relações sexuais de uma ou mais vezes por semana 54,2% e com um parceiro ao ano 78,9%. Os resultados nesta população mostram que há uma predominância para a condição de solteira, dizem conhecer o condom como método contraceptivo e afirmam não apresentar dúvidas com relação aos métodos. Já iniciaram a vida sexual e usaram contraceptivo na primeira relação apresentando a freqüência de uma ou mais vezes por semana e um parceiro no último ano.
145

Padrões e determinantes das descontinuidades contraceptivas no uso de pílula oral, hormonal injetável e preservativo masculino / Patterns and determinants of contraceptive discontinuations in the use of oral pill, hormonal injections and condoms

Osmara Alves dos Santos 21 March 2018 (has links)
Introdução: O uso de métodos anticonceptivos modernos pela maior parte das mulheres brasileiras não diminuiu, conforme esperado, assim como a ocorrência de gestações não desejadas, abortamentos e, consequentemente, mortes maternas, o que revela uso com perfil irregular e descontínuo. No Brasil, há pouca informação sobre os padrões e os determinantes da ocorrência dessas descontinuidades contraceptivas. Devido às inconsistências no uso de métodos serem relativamente comuns, é necessário mensurar o quanto as mulheres interrompem seu uso a despeito de não desejarem engravidar e/ou os alternam inúmeras vezes, nem sempre com opção por um método mais eficaz. Objetivo: Analisar os padrões e os determinantes das descontinuidades contraceptivas no uso da pílula oral, do hormonal injetável e do preservativo masculino. Método: Estudo longitudinal retrospectivo, conduzido com amostra probabilística de 1.551 mulheres de 18 a 49 anos de idade, usuárias de 57 Unidades Básicas de Saúde da cidade de São Paulo/SP (2015) e Aracaju/SE (2016). Os dados foram coletados por entrevista face a face usando o calendário contraceptivo. No Stata 14.2, as análises das taxas de descontinuidade contraceptiva no período de doze meses foram realizadas pelo método de Kaplan-Meier e dos fatores associados por meio dos Modelos de Riscos Proporcionais de Cox, ambos para descontinuidade total, abandono, troca para método menos eficaz e troca para método mais eficaz. Resultados: A taxa de descontinuidade total no uso de métodos foi 41,9% aos doze meses, sendo maior entre usuárias do preservativo masculino (48,1%), seguida de hormonal injetável (39,0%) e pílula oral (38,6%). Entre as usuárias de pílula oral, a taxa de abandono foi a maior; entre as usuárias do hormonal injetável, foi a troca para um método menos eficaz; e, entre as usuárias do preservativo masculino, foi a troca para um método mais eficaz. Os aspectos associados às descontinuidades variam segundo o tipo de método. A descontinuidade no uso da pílula oral foi associada à idade (18-24 anos), vivência de abortamento, incerteza quanto à intenção reprodutiva e aos efeitos colaterais/preocupação com a saúde. A descontinuidade no uso do hormonal injetável foi associada ao maior número de parceiros sexuais, à vivência de abortamento e aos efeitos colaterais/preocupação com a saúde. A descontinuidade no uso do preservativo masculino foi associada à idade (25-34 e 35-49 anos), à união conjugal, ao menor poder aquisitivo (classe econômica D/E) e ao maior número de filhos vivos. Conclusões: Foram observadas altas taxas de descontinuidades no uso de métodos contraceptivos, que variaram conforme o tipo de método. Chama a atenção o papel dos efeitos colaterais na determinação da ocorrência de descontinuidade no uso dos métodos hormonais. Por sua vez, a troca por método mais eficaz foi pouco frequente, com exceção das usuárias de preservativo masculino. Sugere-se ampliar o acesso aos métodos contraceptivos mais eficazes e de longa duração e melhorar a assistência em contracepção nos serviços do Sistema Único de Saúde, de forma a contemplar as necessidades de saúde das mulheres e seus direitos sexuais e reprodutivos. / Introduction: Use of modern contraceptive methods by the majority of Brazilian women did not reduce the occurrence of unintended pregnancies, abortions or maternal deaths as expected, which means that it might be an irregular and discontinuous use. In Brazil, there is a little information on the patterns and determinants of the occurrence of these contraceptive discontinuations. Because inconsistencies in the use of methods are relatively common, it is necessary to measure how much women discontinue their use despite they are willing to get pregnant and/or switching them countless times, not always with the option of a more efficient method. Objective: Our purpose is to investigate patterns and determinants of contraceptive discontinuations in the use of oral pill, hormonal injection and condom. Method: We conducted a retrospective longitudinal study with probabilistic sample of 1,551 women among 18-49 year old who are primary users of 57 health care facilities, both in Sao Paulo (2015) city and Aracaju city (2016). Data were collected by face-to-face interview in line with contraceptive calendar. In Stata 14.2 analyzes of 12-month contraceptive discontinuation rates were performed using the Kaplan-Meier Survival Estimates method and associated factors using the Cox Proportional Hazards Models, both for total discontinuation, abandonment, and switching to a less efficient method and switching to more efficient method. Results: The discontinuation rate in the use of methods was 41.9% at 12 months, being higher among male condom users (48.1%), followed by hormonal injection (39.0%) and oral pill (38.6%). Among oral pill users, the abandon rate was the highest; among users of hormonal injections, was the switching to a less efficient method; and among male condom users, it was the switching to a more efficient method. The aspects associated to the discontinuations varied according to the type of method. Discontinuation of oral pill users was associated with age (18-24 years old), experience of abortion, uncertainty about reproductive intention and side effects/health concern. Discontinuation in the use of hormonal injections was associated with a greater number of sexual partners, the experience of abortion, and the side effects/health concern. Discontinuation of condom users was associated with age (25-34 and 35-49 years old), marital union, lower income and the highest number of live children. Conclusion: High discontinuation rates were observed in the use of contraceptive methods, which varied according to the type of method. The role of side effects/health concern in determining the occurrence of discontinuation in the use of hormonal methods is noteworthy. On the other hand, switching to more efficient method was infrequent, except for the male condoms users. It is suggested to amplify access to the more effective methods as well as long active also improving care in contraception in the all health care facilities services, in order to take into account both women health needs and their sexual and reproductive rights.
146

Knowledge, attitudes and perceptions of secondary school going girls towards implanon contraceptive at Bokamoso Secondary School, Polokwane District Municipality, Limpopo Province, South Africa

Mkansi, Mantsi Annah January 2018 (has links)
Thesis ( MPH.) -- University of Limpopo, 2018 / Background: Contraception is the pillar in reducing teenage pregnancy. Birth control methods are aimed at improving the lives of women and young girls; through minimising unplanned pregnancies and subsequent termination of pregnancy. Teenage pregnancy is a major public health problem worldwide therefore the purpose of the study was to determine knowledge, perceptions and attitudes of secondary school going girls towards implanon contraceptive. Methodology: The current study was conducted using quantitative study approach and cross-sectional study design. Data collection was done using self-administered questionnaire and data analysis was done using SPSS version 24.0. A total of 404 school going girls from grade 8-11 participated in the study. Results: The findings of the study showed that majority of participants in the study were from rural area and are black. Nearly quarter of the school girls had menarche between the ages of 12-14 and third of them received health reproductive education from school and parents. Prevalence of teenage pregnancy among study participants was low. Participants had low knowledge, displayed positive attitude and positive perception towards implanon method of contraception. Discussions: Low knowledge on what an implanon is, how it works and its side effects can serve as a barrier to its usage among teenagers. The common contributory factor to discontinuation and non-use of implanon is fear of side effects. The participants viewed implanon as effective and reliable. Conclusion: School going girls had insufficient knowledge on implanon, which may lead to non-use and early termination in the use of the method. Participants displayed positive attitude and positive perception towards implanon indicating that proper health education can increase uptake among adolescent girls. Recommendations: Provision of adolescents and youth friendly services in public health facilities can contribute to school going girls accessing implanon contraceptive method. Health education on the implanon should be strengthened by health care providers, school programs and educators to empower them and to increase the uptake of implanon.
147

An Evaluation of Prenatal Care Clinic Selection and the Association with Subsequent Process/Outcome Measures among Medicaid Beneficiaries

VanderWielen, Lynn 07 April 2014 (has links)
In 2010 Medicaid financed approximately 48% of all births in the United States and nearly 30% of all births in Virginia. Due to strict state-specific eligibility criteria, many low-income women qualify for Medicaid coverage exclusively as a result of pregnancy status. As the nation moves forward with the Patient Protection and Affordable Care Act (PPACA), state-elected Medicaid expansion has the potential to expand services to women of reproductive age that would precede pregnancy events and offer continuous access to care postpartum. Despite this potential influx of newly insured women, little is known about how this population may make decisions regarding reproductive healthcare services and if these selections influence process and outcome measures. This study examines two research aims that provide insight into these knowledge gaps. First, utility theory and discrete choice modeling is used to examine clinic and patient level factors associated with clinic type choice. Specifically, this study examines the role of high risk pregnancy status and travel distance to clinic as associated with clinic selection. Second, Donabedian’s Structure, Process, Outcome framework provides a conceptual lens to examine if clinic selection is associated with maternal and infant measures. The linear probability model and logistic regression models are employed to examine two process measures, including prenatal care inadequacy and postpartum visit nonattendance, and three outcome measures including maternal long acting reversible contraceptive method (LARC) use and infant birthweight and gestational age. Results examining clinic type selection reveal significant associations between independent and dependent variables. Women experiencing a high risk pregnancy are significantly more likely to select a hospital based clinic for care, compared to women experiencing a normal risk pregnancy. However, when specifically examining women experiencing their first pregnancy, this association is no longer significant. Additionally, as distance to clinic type increase, women are significantly less likely to select that clinic type for prenatal care. Clinic selection was found to be significantly associated with maternal measures, but not significantly associated with infant outcomes. Selecting a public health department or Federally Qualified Health Center for prenatal care services was associated with a significant decrease in inadequate prenatal care, postpartum visit nonattendance, and non-LARC use compared to a private physician office. Clinic type selection, however, was not found to be significantly associated with infant outcomes including preterm birth and low birthweight babies. Results from Research Aim 1 have a variety of implications for clinic and public policy and offer guidance for future research. Clinics that seek to provide care to pregnant Medicaid beneficiaries should examine local residential patterns of current and potential future pregnant Medicaid recipients and consider how these might affect decisions about future clinic locations. Results suggest that women are more likely to attend clinic types closer to their area of residence, and this close proximity may have additional implications beyond shorter travel time to clinic including the minimization of transportation and childcare issues. Results from Research Aim 2 analyses offer a variety of public policy implications and guidance for future research. This research provides evidence that public health facilities including public health departments and FQHCs have improved prenatal care adequacy and postpartum visit attendance compared to private physician offices, providing evidence that public funding should continue for these facility types. As the United States moves forward with PPACA, healthcare organization administration should turn to the public facilities in their communities to learn how to manage and improve the health of these patient populations and ultimately aim to improve access and quality care among the nation’s most vulnerable populations.
148

Knowledge and attitudes of pregnant teenagers with regard to usage of contraceptives at Pietersburg Hospital, Limpopo Province, South Africa

Mohlake, Kgabo Linny January 2014 (has links)
Thesis (MPH.) -- University of Limpopo, 2014 / Background The use of contraceptives among sexually-active teenagers in South Africa is known to be very poor and is currently estimated to be at a rate of 25% (DoH 2002). Teenagers who have unprotected sex are at a high risk of reproductive Health problems, such as Sexually Transmitted Infections (STIs) and HIV/AIDS, and unsafe abortion, amongst others (DoH 2002). Contraceptive use progressively declined between 2002 and 2004 among girls under 18 years in the Kwa-Zulu Natal Province as a whole (Health Statistical Bulletin, 2004). Aim The aim was to determine knowledge, attitudes and perceptions of pregnant teenagers with regard to usage of contraceptives at the Pietersburg Hospital, Limpopo Province, South Africa. Method of data collection and analysis A cross-sectional descriptive survey was used in this study. A self-administered questionnaire was used to collect data from pregnant clients aged 13-19 years of age. Data analysis was carried out by using the computer software called Statistical Program for Social Sciences (SPSS). The findings revealed that lack of knowledge, attitudes and perceptions of pregnant teenagers was a problem. Findings The findings of this study indicated that culture and attitude of nursing personnel were not the barriers. Barriers were “not having enough time to choose the method and just not being serious about contraception”. Thirty-six ix per cent (36%) of the participants said they had enough time to choose the method, but they did not choose. Sixty per cent (60%) said they were not serious about contraception, 40% said they were serious but did not use contraception. Married participants who did not hear about emergency contraception, the percentage was small, 6%, while the percentage of single women was higher (94%). Conclusion The study revealed that the participants had knowledge of contraceptives, both single and married; however, married women seemed to have negative attitudes towards contraceptives, based on the culture and the believe that, once married, the usage of contraception was not necessary. Based on the findings of the study, it is recommended that there should be effective ways of information giving to the public regarding family planning.
149

Contraception and unmet-needs in Africa.

Stiegler, Nancy Lisbeth Nicole. January 2009 (has links)
<p>The first objective of this study is to show if diffusion of contraception in areas of traditional high fertility has gone through profound changes. Indeed, we would like to know if contraceptive behaviours have evolved because of new fertility perceptions and also because partners now have greater freedom to make choices in a relationship. The second objective of this study is not only to highlight the levels and trends of contraception and the factors influencing their use (government policies, role of family planning, etc.) in developing countries, but also to consider the population of unmet-needs of contraception. Indeed, the level of contraceptive use depends obviously on users, but also on non-users with no needs and non-users with unsatisfied needs. The understanding of this last category of females is essential to a more accurate estimation of contraception levels, and, therefore for the estimation of fertility levels. This study analyses the contraceptive use in several developing countries in Africa and highlights the unsatisfied needs of contraception, to understand why such needs exist. To do so, we shall analyse available demographic data for thirty-five African countries by using the available Demographic and Health Surveys (DHS), from the 1980&rsquo / s to 2000&rsquo / s considering the DHS I, DHS II, DHS III and DHS IV. This great variety of surveys, seventy-nine in total, permits one to compare levels of contraception and &ldquo / unmet-needs&rdquo / from country to country. The surveys also, make it possible to compare the evolution over time of specific countries or specific regions, and to subsequently comprehend the determining factors of contraceptive use or non-use.</p>
150

Attitude, perceptions and behaviour towards family planning amongst women attending PMTCT services at Oshakati Intermediate Hospital, Namibia

Akpabio, Alma January 2010 (has links)
<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>

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