Sarika Gupta1,2, Glen Mola3, Philippa Ramsay4, Greg Jenkins5, Wendy Stein6, John Bolnga7, Kirsten Black4. 1. Department of Obstetrics and Gynaecology, John Hunter Hospital, Newcastle, New South Wales, Australia. 2. School of Public Health, Faculty of Medicine, University of Sydney, Camperdown, New South Wales, Australia. 3. Department of Obstetrics and Gynaecology, School of Medicine and Health Sciences, UPNG and The Port Moresby General Hospital, Port Moresby, Papua New Guinea. 4. Discipline of Obstetrics and Gynaecology and Neonatology, Central Clinical School, University of Sydney, Camperdown, New South Wales, Australia. 5. Department of Obstetrics and Gynaecology, Westmead Hospital, Sydney, New South Wales, Australia. 6. 'Spacim-Pikinini Organisation', Rotary Australia World Community Services, Sydney, New South Wales, Australia. 7. Department of Obstetrics, Modilon Hospital, Madang, Papua New Guinea.
Abstract
BACKGROUND: Poor access to contraception contributes to persistently high maternal mortality rates in Papua New Guinea (PNG). Since 2012 contraceptive implants have been provided to women in rural areas of PNG through outreach services but follow-up data in these communities on continuation and acceptability is lacking. OBJECTIVE: To gain insight into women's experience with contraceptive implants by assessing the acceptability, satisfaction, 12 month continuation rates and efficacy of contraceptive implants among women in rural PNG. MATERIAL AND METHODS: We undertook a cross-sectional survey of women in two rural provinces who had received a contraceptive implant at least 12 months prior using a structured questionnaire. We sought information on device continuation rates, satisfaction scores, side effects and failure rates. RESULTS: Of the 860 women surveyed, 97% (n = 836) still had the device in situ after 12 months and 92% (n = 793) were very happy with it. Seventy-six percent of women (n = 654) reported no side effects. Irregular bleeding was the most commonly reported side effect (n = 178, 20.6%) but only 7% (n = 13) said the bleeding was bothersome. Documented failure rates were 0.8% although pregnancy at the time of insertion could not be excluded in any of these cases. CONCLUSION: Twelve month implant follow-up data in this study showed high continuation rates and high levels of satisfaction among a rural population in PNG. Implants have the potential to lower maternal morbidity and mortality and simultaneously address the unmet need for contraception in these communities.
BACKGROUND: Poor access to contraception contributes to persistently high maternal mortality rates in Papua New Guinea (PNG). Since 2012 contraceptive implants have been provided to women in rural areas of PNG through outreach services but follow-up data in these communities on continuation and acceptability is lacking. OBJECTIVE: To gain insight into women's experience with contraceptive implants by assessing the acceptability, satisfaction, 12 month continuation rates and efficacy of contraceptive implants among women in rural PNG. MATERIAL AND METHODS: We undertook a cross-sectional survey of women in two rural provinces who had received a contraceptive implant at least 12 months prior using a structured questionnaire. We sought information on device continuation rates, satisfaction scores, side effects and failure rates. RESULTS: Of the 860 women surveyed, 97% (n = 836) still had the device in situ after 12 months and 92% (n = 793) were very happy with it. Seventy-six percent of women (n = 654) reported no side effects. Irregular bleeding was the most commonly reported side effect (n = 178, 20.6%) but only 7% (n = 13) said the bleeding was bothersome. Documented failure rates were 0.8% although pregnancy at the time of insertion could not be excluded in any of these cases. CONCLUSION: Twelve month implant follow-up data in this study showed high continuation rates and high levels of satisfaction among a rural population in PNG. Implants have the potential to lower maternal morbidity and mortality and simultaneously address the unmet need for contraception in these communities.
Authors: Elizabeth Peach; Christopher Morgan; Michelle J L Scoullar; Freya J I Fowkes; Elissa Kennedy; Pele Melepia; Primrose Homiehombo; Lucy Au; Stanley Luchters; Alexandra J Umbers; Andrew Vallely; Lisa M Vallely; Angela Kelly-Hanku; Leanne J Robinson; Brendan S Crabb; Arthur Elijah; Peter M Siba; William Pomat; James G Beeson Journal: Sci Rep Date: 2021-01-13 Impact factor: 4.379
Authors: A N Wilson; N Spotswood; G S Hayman; J P Vogel; J Narasia; A Elijah; C Morgan; A Morgan; J Beeson; C S E Homer Journal: Lancet Reg Health West Pac Date: 2020-09-23