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  • Title: Programmatic challenges: training, counseling and removals.
    Author: Finger WR.
    Journal: Netw Res Triangle Park N C; 1990 Dec; 11(4):9-12. PubMed ID: 12283721.
    Abstract:
    In order to move beyond the controlled environment of clinical trials and successfully introduce NORPLANT into a country's family planning system, certain programmatic challenges must be overcome. These include: training providers, ensuring access to removal of the contraceptive implants, and dispensing clear information on the new method. While relatively simple procedures, NORPLANT insertions and removals require specialized training. Providers must also possess knowledge of proper storage of NORPLANT supplies, proper care of equipment, and proper sterile techniques. But most importantly, providers of the new contraceptive must be trained in patient screening and counseling. Not only should patients be told what to expect during the insertion and removal procedure, they should also be made aware that many NORPLANT users experience menstrual irregularities. Furthermore, follow-up counseling is crucial in helping women feel comfortable with the new method. Another programmatic obstacle centers around the issue of removal. Not only should providers and patients understand that women have a right to request removal of NORPLANT at any time, family planning systems must make sure that the implants are removed after five year -- the time when their effectiveness declines. Finally, a successful large scale introduction of NORPLANT requires the dispersion of thorough and clear information. Unlike other contraceptive methods, information on NORPLANT cannot be successfully transmitted through mass media, since it requires a substantial amount of explanation which only health professionals can provide. Furthermore, information campaigns must target not only potential users, but also their spouses and other members of the medical community. While overcoming these programmatic challenges will vary according to the specific conditions of a country, a successful adoption of NORPLANT will require a strong delivery system.
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