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Summary Over all services Some providers and clients were not aware of adverse effects of contraceptives and the possibility of sex transmitted diseases.

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Presentation on theme: "Summary Over all services Some providers and clients were not aware of adverse effects of contraceptives and the possibility of sex transmitted diseases."— Presentation transcript:

1 Summary Over all services Some providers and clients were not aware of adverse effects of contraceptives and the possibility of sex transmitted diseases including HIV/AIDs when used only contraceptives without condoms. Quality of services is questionable on the understanding, and knowledge of providers result in various form of practices. Contraceptive services differed among health facilities; health centers and pharmacies provided mainly oral contraceptive pills and condoms. There was no difference between practices of pharmacist and non-pharmacist in the pharmacies. ECP Knowledge in adolescents ECP is quite popular among adolescents insufficient knowledge of ECP among this group, particular on the potency issue. Discussion Variations in practices on reproductive health were found among various sectors partly because of lack of understanding women’s needs Adverse drug reaction monitoring system for contraceptives were lack both in the public and private sectors Thai women can easily get access to ECP but the problems are lack of knowledge on the products in both private providers and users Empowering Thai women’s reproductive rights are prior to improving their health Conclusion & Policy Recommendation The quality of contraceptive services both in the government and private sectors needs to be improved, especially in providing information and standard practices. Women clients should be informed their enough information related to risks and benefits before receiving all of contraceptive services. Appropriate information of ECP should also be disseminated to adolescents to ensure rational use. Abstract Problem Statement: Thai contraceptive policy and contraceptive campaigns have been established for nearly half a century. Many problems still occur, especially in women who use contraceptives and struggle with the adverse effects by themselves. Health providers are believed to be key success factors in contraceptive use; however, consumers can also act to make sure they are using the right contraceptives correctly. Objectives: To investigate behaviors of health providers in the government and private sectors related to contraceptive services; clients’ behaviors when facing adverse effects of contraceptives; and knowledge on emergency contraceptive pills (ECP) among adolescents. Designs: A mixture of techniques, including document reviews, interviews, simulated case surveys, observations, and questionnaires. Settings: Government sector: public provincial hospital ม university hospital ม health centers of the Bangkok Metropolitan Administration, and health centers of the Ministry of Public Health. Private sector: pharmacies in Bangkok and vicinity. Public university in Bangkok were a setting in an ECP survey. Study Population: From the government sector: 12 health providers, 246 patients, one university hospital, one public provincial hospital near Bangkok, 10 health centers of the Bangkok Metropolitan Administration, and two health centers of the Ministry of Public Health. From the private sector: 23 pharmacies in Bangkok and vicinity. In addition, 335 adolescent students of one public university in Bangkok were a sample in an ECP survey. Outcome Measures: Types and quality of contraceptive services offered, adverse effects of contraceptives, knowledge of ECP among adolescents, public awareness of contraceptives. Results: : Contraceptive services differed among health facilities; health centers and pharmacies provided mainly oral contraceptive pills and condoms. Sixteen percent of clients in the government sector suffered from adverse effects of contraceptives. Eighty eight percent provided how to take medications and 59% refered to related side effects. In simulated client visits, more pharmacists provided information to clients than did nonpharmacists. Thirty percent provided how to take medications and only 10 % refered to related side effects. Knowledge of ECP in adolescents ranged from 34.5% to 88% with various topics; adolescents sometimes introduced ECP to their friends (50.9%). Some providers and clients were not aware of adverse effects of contraceptives and the possibility of sex transmitted diseases including HIV/AIDs when used only contraceptives without condoms. Conclusions: The quality of contraceptive services in the government and private sectors needs to be improved, especially in providing information. Appropriate information of ECP should also be disseminated to adolescents to ensure rational use. Funding Sources: Health System Research Institute, Thailand Introduction Thai contraceptive policy and contraceptive campaigns have been established for nearly half a century and Thailand is recognized as success in population control shown by the decline in growth rate as being less than one. Family planning policy has focused on birth control hence ignored safety of hormone use for women. Many problems still occur, especially in women who use contraceptives and struggle with the adverse effects by themselves. Health providers are believed to be key success factors in contraceptive use; however, consumers can also act to make sure they are using the right contraceptives correctly. Objectives To investigate behaviors of health providers in the government and private sectors related to contraceptive services. To investigate clients’ behaviors when facing adverse effects of contraceptives. To investigate knowledge on emergency contraceptive pills (ECP) among adolescents.Methods Research Design A mixture of techniques, including document reviews, interviews, simulated case surveys, observations, and questionnaires Setting and Population From the government sector: 12 health providers and 246 patients of one university hospital, one public provincial hospital near Bangkok, 10 health centers of the Bangkok Metropolitan Administration, and 2 health centers of the Ministry of Public Health. From the private sector: 23 pharmacies in Bangkok and vicinity. In addition, 335 adolescent students of one public university in Bangkok were a sample in an emergency contraceptive survey. Results (1) Government sector: By interviewing health providers and their clients together with the observations, it was found that services of these facilities are delivered to response more on birth control than on women health needs, reproductive rights, and women integrity. Various practices among providers particular on the information of the long term use of injectable contraceptives. 16% of clients in the government sector suffered from adverse effects of contraceptives. 88 % of providers provided how to take pills or contraceptives and 59% refered to possible related side effects to the clients. Results (2) CONTRACEPTIVE SERVICES OF GOVERNMENT AND PRIVATE SECTORS IN THAILAND: VOICES TO POLICY MAKERS Kiatying-Angsulee N. 1, Amrumpai Y. 2, Chantapasa K. 3 Chaisumritchoke S. T. 1, Jamniendumrongkarn S. 4 1 Faculty of Pharmaceutical Sciences, Chulalongkorn University, 2 Faculty of Pharmacy, Silpakorn University, 3 Faculty of Pharmacy, Khonkaen University, 4 Health and Development Foundation, Thailand Private sector: Using 4 scenarios simulated client visits at the pharmacies; (a) 24 clients asking for the first use of oral contraceptive, (b) 21 clients asking for the first use of oral contraceptive with migrane, (c) 46 clients asking for the first use of emergency contraceptive (d) 45 clients asking for the regular use of emergency contraceptive. From 136 simulated visits, 42.6% were serviced by pharmacists. More pharmacists provided contraceptive information to clients than did nonpharmacists. Thirty percent of all pharmacies provided how to take pills or contraceptives and only 10 % refered to related side effects. Results (3) Knowledge of emergency contraceptive (ECP) in 335 adolescents ranged from 34.5% to 88% with various details ; insufficient knowledge were related to the potency of ECP compare to condom or oral contraceptive pills or abortion pills. Only 2.7 % of the adolescents had used ECP but 50.9% sometimes introduced ECP to their friends ใ Obvious results from this study Government services Private services Various practices among providers Providing not enough information Not enough knowledge in precautions of OC Pharmacists provided more information than non-pharmacists Adolescents ECP knowledge is insufficient Women clients Received insufficient information Suffering from adverse effects of contraceptives


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