Presentation on theme: "FAMILY PLANNING METHODS AND SERVICES AVAILABLE IN GHANA"— Presentation transcript:
1FAMILY PLANNING METHODS AND SERVICES AVAILABLE IN GHANA Desiree M. OpokuFP Trainer /Service Provider
2Family PlanningIt is the ability of individuals and couples to enjoy their sexual life and decide freely and responsibly, whether they would:have a familyhow many children they want to havehow they want to space them- when they’ll start- when they’ll finish
3Rationale for Contraceptive Use Designed to help individuals and couples in their reproductive age group to:Space their childrenPrevent unintended pregnanciesManage infertilityImprove their reproductive healthEnsure that there is a balance between population and resources.
4Factors to consider when choosing a contraceptive method Ones lifestyleAgeNumber of ChildrenHealth statusRelationshipsSafer sex plan.Effectiveness
5FAMILY PLANNING METHODS Family Planning Methods Currently Available in GhanaShort Term Methods:CondomsSpermicidesOral contraceptive pillsInjectables /InjectionsLactational Amenorrhoea Method (LAM)Natural Family Planning Methods
6Long Term Methods: Intrauterine Devices (IUDs) -Copper T (CuT 380A) -Levonorgestrel Intrauterine System (LNG- IUS)or hormonal IUD (MIRENA)Implants-Jadelle- Zarin-Implanon
8Male CondomIt is a thin rubber covering that fits over a man’s erect penis.There are varieties of male condomsCondom prevents both pregnancy and STIs including HIV(Dual protection)Condoms may be used in addition to another family planning method to prevent pregnancy and STIs including HIV(Dual method)
9Male Condom Effectiveness 98% effective when used correctly and consistently.How does it work?Forms a barrier that keeps sperm out of the vagina, preventing pregnancy.Also keep infections in the semen, on the penis or in the vagina from infecting the other partner.
10Male condom cont’d Who can use it Clients who : Are looking for a back up method (example: in case the woman forgets to take her contraceptives pills)Have a medical condition that poses a health risk with the use of other contraceptive methodsHave sexual intercourse occasionally and do not want a regular contraceptionAre at risk for exposure to transmission of STIs/ HIV.
11Male Condom cont’d Who cannot use it? Any one who is allergic to or reacts to latexBenefitsAre inexpensive and easy to getCan help relieve premature ejaculationProvides effective contraception immediatelyCan be used with other methods (except female condoms)Offer protection against STIs/HIV
13Female CondomIt is a soft smooth covering made from polynitrile which is a synthetic material worn inside the vagina.It has a ring at each end. The inner ring at the closed end of the condom is used to insert the condom.The ring at the open end of the condom remains outside the vagina.
14Female Condom cont’d Effectiveness 95% effective if used correctly and consistently.How does it work?Forms a barrier which blocks the passage of sperms to meet the ovum.Also keep infections in the semen, on the penis or in the vagina from infecting the other partner.
15Female Condom cont’d Who can use it? Anyone looking for a back up method (example: in case the woman forgets to take her contraceptives Pills)Has a medical condition that poses a health risk with the use of other contraceptive methodsHas sexual intercourse occasionally and does not want a regular contraceptionIs at risk for exposure to transmission of STIs/ HIV.
16FC2 Benefits Offer protection against STIs/HIV infections Generates heat and therefore increases sexual stimulation.Does not interrupt foreplay and there is no risk of partner losing erection because it can be inserted ahead of time (6-8hrs).
18Spermicides These are chemicals that kill sperms. Spermicides are available in a variety of preparations.Examples are:-creams, film, foaming tablets,vaginal suppositories, aerosol foams and jellies
19Spermicides82% effective if used appropriately. Using spermicides with a condom increases effectiveness.How does it work?Spermicides kill the sperm thus preventing them from meeting the ovum.
20Spermicides Who can use it? Anyone needing a backup method (for example in the case of a skipped /missed oral contraceptive pills)Has sexual intercourse occasionally and does not need regular contraceptionWho cannot use it?Anyone that is allergic to or reacts to spermicides
21Spermicides cont’d Benefits Can be inserted by a partner as part of foreplay.Easily available -can be purchased from pharmacies, chemical shops and supermarkets.Increases vaginal lubrication.Can be used ahead of time and does not interrupt sexual activity .
22How to use spermicidesUsually requires 10 to 20 minutes after insertion before intercourse can beginThey are effective only for one hour after insertionIt is inserted deep into her vagina just before sexual intercourse while lying down, squatting or standingAfter intercourse the vagina should not be washed until 6 to 8 hoursSpermicides should be used with each act of sexual intercourseIf more than 30 minutes elapses after insertion before intercourse ,insert another one.
23Spermicides cont’d Side Effects Spermicides may cause vaginal or penile irritation.LimitationsDoes not protect against STIs/ HIV.
24Combined Oral Contraceptive Pill (COCs) It is a pill that contains estrogen and progesterone which are similar to the natural hormones in a woman’s body.COCs contain 28 pills in a pack. Some have 21 active pills and 7 nonactive pills which must all be taken as shown on the pack.Some examples in Ghana are Microgynon, Secure, my Pearl, Yasmin
26Combined Oral Contraceptive Pill Who cannot use it?Clients who:Are breastfeeding because estrogen can decrease the quantity of breast milk.Have undiagnosed vaginal bleedingAre taking medication for seizures or convulsions, tuberculosis , and on ART (must use condoms in addition )BenefitsThe woman re-gains her fertility quicklyIt may protects against certain cancers eg. Ovarian and endometrial cancer
27Combined Oral Contraceptives How to use COCsEach 28-day pill pack has 21 active pills and 7 non active pills (the iron pills).Swallow one active pill every day at the same time for 21 days as shown on the pack and then continue with the inactive (the iron pills)Side effectsMost side effects go away after the first few months of use Side effects include:Bleeding in between periodsHeadacheNausea and/or vomitingBreast tendernessWeight changes
28Combined Oral Contraceptive Pill LimitationsDoes not provide protection against STIs/ HIVWhat to do if a client skips/misses a pillMissing 1 or 2 active pills in a row :Take 1 active pill as soon as client remembers and then continue taking the pills 1 each day. Client can also take the 2 pills at the same timeMissing 3 or more active pills in a row:A back up protection eg use condoms until the pill has been taken for 7 days in a row.If client misses these pills in week 3 or row3, she should skip the remaining pills and start a new pack.
29 Progestin Only Pills (POPs) Mini-pill It is a pill that contains only progestinIt does not affect the production of breast milk so it can be used by breastfeeding mothersEffectivenessOver 99% effective when taken correctly and consistently
30Progestin Only Pills (POPs) Mini-pill How does it work?The pill prevents ovulationIt thickens the cervical mucusIt thins the endometrial liningWho can use it?Women who:For medical reasons cannot use the combined contraceptive pillsAre breastfeeding below 6mths
31Progestin Only Pill Who cannot use it? Women who: Have abnormal vaginal bleedingAre taking medication for seizures/convulsions, tuberculosis and on ART ( must use condoms in addition because these medications suppress the effect of the family planning hormones)BenefitsCan be used whilst breastfeeding.Safe and immediately effective.Immediate return of fertility after stopping.
32Progestin Only PillHow to use the PillTake one pill at the same time every day.When you finish a pack of pills, start a new pack the next day.If breastfeeding, you can start 6 weeks after childbirth.Side effectsMost side effects go away after the first few months of use.Common side effects include:Nausea, headaches , changes in monthly bleeding including irregular bleeding, spotting, heavier bleeding or no monthly bleeding are common but safe.LimitationsDoes not provide protection against STIs/HIV.
33Progestin Only Pill What to do if a client misses a pill If a woman is three or more hours late in taking a pill or misses a pill completely she should take a pill as soon as possible and keep taking pills as usual, one each day.She may take 2 pills at the same time on the same day. She should use a back up method for the next 2 days.
34Lactational Amenorrhoea Method (LAM) This is a method that uses the temporary infertility that occurs during breast feedingFeeding a new baby continuously only on breast milk can postpone ovulation (the release of an egg from an ovary) for up to six months if her period has not returnedWhen used as a family planning method, this pattern of exclusive breastfeeding is called the Lactational Amenorrhea Method (LAM)It provides protection against pregnancy for up to six months.
35LAM 98% effective How does it work? A baby suckling suppresses the production of hormones that are necessary for ovulationWho can use LAM?A mother:Who is exclusively breastfeeding day and nightWhose menstrual periods have not yet returned after delivery.Whose baby is less than six months old.It is effective when practiced correctly attaching and positioning to breast
36LAM Who cannot use LAM A mother who: Is not practicing exclusive breast feedingHer menstrual period has returned after delivery.Her baby is older than six monthsBenefits for the MotherIt does not affect natural hormonal balance of the womanIt is immediately effectiveIt reduces bleeding after deliveryNo supplies are neededIt has no side effects
37LAM Benefits for the baby It decreases the likelihood of infection from germs in water, milk or formula feedsIt increases bonding between mother and child.It passes on some of the mother’s antibodies to protect the baby from certain bacteria and virusesProvides the best natural nutrition for the babyLimitationIt does not protect against STIs/HIV.
38Emergency Contraception They are used to help prevent a woman from unintended pregnancy after having unprotected sex. There are 2 types of emergency contraceptives:1. Emergency Contraceptive Pills (ECPs)
39Emergency Contraception – CUT IUD Highly effective for preventing pregnancyA Copper releasing IUD (Cu-IUD) can be used within 5 days of unprotected sexual intercourse as an emergency contraceptive
40Emergency Contraception How ECs workThe pills inhibit or delay the release of eggs from the ovaries. They do not work if the woman is already pregnant.The copper IUD slows the movement of the sperms .Who can use it?Almost all women can use ECsWomen who have been assaulted (e.g. rape, incest)When a woman misses two or more contraceptive pills in a cycleWhen a condom breaks or slips off
41Emergency Contraception BenefitsIt is safe, effective and easy to useHow to use itThe EC tablets must taken within 5 days after unprotected sex.1 tablet start followed by 1 after 12 hrs or 2 startTake 4 combined (active) oral contraceptive at once (e.g. Microgynon or Secure) followed by 4 more active pills after 12 hours orIntrauterine device (IUD) inserted within 5 days of having unprotected sexLimitationECPs do not protect against pregnancy for any future sex.Cannot be used as regular contraceptive methodOffer no protection against STIs/HIV
42Method failureWhat options are available to clients incase a method fails ?Emergency contraception (EC)Comprehensive Abortion care (CAC)Counsel for ANC
43How to be reasonably sure your client is not pregnant; Did you have a baby less than 6 months (LAM) ?Have you abstained from sexual intercourse since your LMP ?Have you had a baby in the last 4 weeks ?Did your LMP start within the past 7 days (for IUD within 12 days) ?Have you had a miscarriage or abortion in the past 7 days ?Have you been using a reliable contraceptive method consistently and correctly ?
45CLINICAL METHODS OF CONTRACEPTION Zenabu AddoFP Trainer/Service Provider
46INFORMATION ON CLINIC BASED METHODS InjectablesThey are methods that are given by injection in the arm and the buttocks. There are three kinds of injectables:Depo Provera/Petogen - It is effective for 3 monthsNoristerat It is effective for 2 monthsNorigynon It is effective for 1 month
48Benefits Almost all women can use it It is very effective and safe It is easy to useIt is reversibleIt does not interfere with intercourseIt can be used by women who cannot take estrogenIt does not require daily attention
49Limitations/Side Effects Irregular bleeding, dizziness and nausea. These side effects disappear after few months of useThere may be delay return to fertilityDoes not provide protection against STIs/HIVIt may cause amenorrhea
50NorigynonIt works just like the COCs. Its benefits and limitations are also like the COCs.It is given once a month intramuscularly (IM).
51Natural Family Planning (NFP) -Fertility Awareness Natural family planning refers to a variety of methods used to plan/prevent pregnancy without the use chemicals.Methods include:Standard Days Method (SDM)Calendar (rhythm) methodBasal body temperature (BBT) methodCervical mucus method (CMM) Two Day MethodHow does it work?It is based on identifying the woman’s fertile days and avoiding intercourse during the fertile days to prevent pregnancy.
53SDM with cycle beadsThe Cycle Beads, are color-coded string of beads to help a woman to track her cycle days, know when she is fertile and monitor her cycle length.It is appropriate for women with menstrual cycles between 26 and 32 days long. It identifies days 8-19 of the cycle as fertile periodHow does it work?It works by allowing the couple to identify “fertile period” (days intercourse can result in pregnancy) of the menstrual cycle
54SDMWho can use it?Women with cycles 26 to 32 days long; women who have their monthly periods within this rangeCouples who can abstain or use condom during the fertile periodWomen who know when their last period started can use the SDM right away. Women who do not know can begin the SDM when their next period starts.
56LONG-TERM METHODS Copper bearing Intrauterine Device (IUD) The most commonly used IUD in family planning is copper bearing CuT380A, which is effective for 10 – 12 years of use.There are also hormone-releasing IUDs -Levonorgestrel releasing intra uterine system (LNG-IUS). It is effective for 5 years.
57IUD 99% effective How does it work? How does it work?The copper kills or weakens the sperms and so slows the movement of the sperm preventing it from meeting the egg. It may also damage the egg or change its speed of movement.The LNG-IUS prevents fertilizationThickens the cervical mucus.
58IUD Benefits Highly effective. Long lasting solution Immediately effectiveOne of the most private methods of birth controlsQuick return to fertility when IUD is removedThe LNG-IUS reduces menstrual bleeding and crampsLimitationsIt must be inserted and removed by a trained health care provider.It does not provide protection against STIs/HIV.
59WARNING SIGNS &SYMPTOMS P -if period is late or abnormal bleeding or spottingA - Abdominal pain , pain during intercourseI -Infection exposure abnormal vaginal dischargeN - Not feeling well, fever chillsS - string missing has become shorter or longer or feel the hard part of IUD in the vagina or cervix
60ImplantsImplants are small flexible rods or capsules that contain synthetic progestin.They are inserted under the skin of the inner aspect of a woman’s upper arm.
61Implants Types Jadelle – 2 rods effective for 5 years Sino Implants (Zarin) – 2 rods effective for 4 yearsImplanon – 1 rod effective for 3 years
62Implants Effectiveness Over 99% effective How do they work? Implants partially prevent the eggs from being released or stops ovulationThickens cervical mucus.Thins endometrial lining
63Implants Benefits Almost all women can use it Completely reversible Are safe for breastfeeding mothers and their babies.Highly effective and easy to useLimitationsMust be inserted and removed by a trained health care provider.Does not provide protection against STIs/HIV.
64PERMANENT METHODS Female Sterilization Female sterilization is also called bilateral tubal ligation (BTL).Simple operation in which the fallopian tubes are located , ligated /blocked and excised or cut and sealed.
66Female Sterilization/Bilateral Tubal Ligation BenefitsIt is very effectiveNo more worry about pregnancy after mini lapWoman still menstruates till menopauseLimitationsIt is not reversibleRequires a trained physician or surgeon to perform the operation.It does not protect against STIs /HIV
67VASECTOMYVasectomy is a simple operation in which the vas deference that carry the sperms are located ligated and excised/cut.After vasectomy a man will still have erections and ejaculations.The only difference is that there will be no sperms in the fluid that is discharged.