Presentation is loading. Please wait.

Presentation is loading. Please wait.

PREVALENCE, AVAILABILITY AND ACCESSABILITY OF IUD IN HUNGARY

Similar presentations


Presentation on theme: "PREVALENCE, AVAILABILITY AND ACCESSABILITY OF IUD IN HUNGARY"— Presentation transcript:

1 PREVALENCE, AVAILABILITY AND ACCESSABILITY OF IUD IN HUNGARY
I. Batár Department of Obstetrics and Gynecology University of Debrecen, Hungary 7th ESC SEMINAR, September , 2003 Budapest, Hungary

2 Cornerstone international and Hungarian events
SHORT HISTORY OF IUD Cornerstone international and Hungarian events 1909 Dr. Richard Richter (Germany): dried silkworm gut 1923 Dr. Karl Pust (Germany): similar device with tail 1929 Dr. Ernst Gräfenberg (Germany): Gräfenberg ring 1934 Dr. T. A. Ota (Japan): Ota ring 1959 Reconsideration of IUD use (Oppenheimer/IL, Ishihama/J) 1960 Dr. Lazar Margulies (USA): Margulies spiral 1962 Dr. Jack Lippes (USA): Lippes loop (Gold Standard!) 1965 Dr. Ferenc Szontágh (Hungary): Szontágh IUD (plastic) 1972 Szontágh IUD marketed in Hungary after clinical trials 1074 Limited number of TCu 200 IUD for clinical trials 1970s-1980s Clinical trials with new IUDs in designated centers 1990s Wide range of devices became available in Hungary Sept 2003 I.B. * 7th ESC Seminar, Budapest

3 PREVALENCE OF IUD USE IN HUNGARY I.
1970s – 1980s: exact figures (all-country reporting system)  insertions/year (minus illegal export to Romania?) 1990s – 2000s: no central recording, only estimations Marketing surveys:  insertions/year (Schering) Contraceptive survey/demographic data: a) IUD use: 14% of married women in reproductive age b) No of married women in reproductive age (2001):  1.3 M c) Calculated number of users:  d) If changed every 5 (?) years:  insertions/year (?) (plus non married women) IUD is the second in the rank of methods next to the pill (33%) Sept 2003 I.B. * 7th ESC Seminar, Budapest

4 PREVALENCE OF IUD USE WORLDWIDE (1998)*
Country/Region Percentage of women of reproductive age Contraception total IUD Rank # Hungary WORLD USA (min) Finland (max) Moldova (max) Less developed regions More developed regions CEEC Northern Europe Western Europe Southern Europe * Source: UN Sept 2003 I.B. * 7th ESC Seminar, Budapest

5 AVAILABILITY OF IUD IN HUNGARY I.
x Szontágh IUD TCu 200 TCu 380 GyneFix Nova T 380 Mirena * = available in three sizes Plastic = no metal content 1. Types of devices Utering SilverLily/GoldLily SilverLily-Zn/Plastic* Alloy IUDs: Nova T MLCu 250/375 (Mona Lisa) X = not available anymore (non-medicated) Sept 2003 I.B. * 7th ESC Seminar, Budapest

6 AVAILABILITY OF IUD IN HUNGARY II.
2. Where to get it? pharmacies (Mirena is exclusively available here) company sales (directly or through distributors) physician’s office (mainly in private praxis) 3. When to insert? interval (usually on cycle days 1-7) post abortion (not everywhere accepted) post partum (6-8 weeks following delivery) post placental (limited number of cases in clinical trials; no suitable devices are available) post coital (emergency contraception: not well known) Sept 2003 I.B. * 7th ESC Seminar, Budapest

7 ACCESSABILITY OF IUD IN HUNGARY I.
1. Legal restrictions nulligravidas (sometimes neglected) only gynecologists are allowed to insert insertion in centers with lying-in background (?) (nowadays neglected) Sept 2003 I.B. * 7th ESC Seminar, Budapest

8 ACCESSABILITY OF IUD IN HUNGARY II.
2. Medical (ob/gyn) limitations „optimal for those with completed family size” „suggested after the second child” side effects/problems are more publicized than benefits not widely known as emergency contraception Sept 2003 I.B. * 7th ESC Seminar, Budapest

9 ACCESSABILITY OF IUD IN HUNGARY III.
3. Financial limitations not subsidized by the health insurance (since 1993) high price (compared to salary; the cheapest!) not exempted for VAT (12%  25%!) “punishment” instead of support indirect effect (IUD use has not been a medical indication for abortion since 1993) Sept 2003 I.B. * 7th ESC Seminar, Budapest

10 I.B. * 7th ESC Seminar, Budapest
CONCLUSIONS I. Hungary was pioneer for IUD use in the s, and has a good position even nowadays as for inventions (see alloy devices) Prevalence: although acceptable (14%), but it could further be increased through eliminating or decreasing the restrictive and limiting factors Sept 2003 I.B. * 7th ESC Seminar, Budapest

11 I.B. * 7th ESC Seminar, Budapest
CONCLUSIONS II. Availability: market has a wide choice of IUDs, but new types are welcomed devices are easy to get (pharmacies, clinics) positive attitude needs to be increased (correct information, postabortal insertion, emergency contraception) Sept 2003 I.B. * 7th ESC Seminar, Budapest

12 I.B. * 7th ESC Seminar, Budapest
CONCLUSIONS III. Accessibility: eliminating legal restrictions (gravidity/parity, who/where to insert) decreasing medical barriers through CME modifying health care, social and taxation policy to reduce prices Sept 2003 I.B. * 7th ESC Seminar, Budapest


Download ppt "PREVALENCE, AVAILABILITY AND ACCESSABILITY OF IUD IN HUNGARY"

Similar presentations


Ads by Google