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  • Title: Acceptability of the once-a-month injectable contraceptives Cyclofem and Mesigyna in Egypt.
    Author: Hassan EO, el-Nahal N, el-Hussein M.
    Journal: Contraception; 1994 May; 49(5):469-88. PubMed ID: 8045133.
    Abstract:
    A study of the acceptability of two once-a-month injectable contraceptives, Cyclofem and Mesigyna, in Egypt included 1091 women participating in the clinical trial of the two methods carried out during the period from November 1989 to July 1992. The acceptability of the two contraceptives proved to be high when measured by the rate of continuation at 12 months of injectable use, by method satisfaction, service satisfaction, rec recommending use to others, intent of future use, as well as willingness to pay for them when the injectables are marketed. The most important determinants of use discontinuation were young age, large family size, first time contraceptive use, previous experience with menstrual problems, dissatisfaction with clinic services, lack of counseling, lack of social support, as well as the husband's negative attitude towards contraceptive use. Side effects were more frequently reported by discontinuers; however, continuers appeared to be more tolerant of the same side effects. This study provided in-depth information about the social aspects affecting the acceptability of monthly injectable contraceptives in the different Egyptian localities, in addition to its being useful in monitoring activities in the clinical setting during these trials. Between November 1989 and July 1992 in Egypt, staff of public health departments interviewed 1091 women who had accepted the monthly injectable contraceptives Cyclofem and Mesigyna and had attended family planning centers in Assiut, Alexandria, Mansoura, and Ein Shams to learn the acceptability of these 2 injectables. The overall continuation rate was more than 60%. The center in Alexandria had the highest continuation rate (1 year life table rate, 86.9%), while Assiut had the lowest rate (45%). Women who continued to use the injectables were more likely than those who discontinued them to be satisfied with the method (96.1% vs. 61.5%) and the service (99.4% vs 94.7%), to be willing to pay for the injectables (58.5% vs. 20.8%), to recommend the injectables to others (78% vs. 34.9%), and to intend to use it in the future (76.9% vs. 29.4%) (p .001 for all variables). The logistic regression analysis showed that the most important determinant of discontinuation was service dissatisfaction (odds ratio [OR] = 7.8). Other significant determinants of discontinuation were age under 30, desired pregnancy, first-time use of a contraceptive method, discontinuance of previous method due to menstrual problems, lack of counseling, husband's negative attitude, and problems encountered during use of injectables (ORs = 1.4-2.). Continuers were more likely not to experience side effects than discontinuers (58% vs. 33.4%). Menstrual irregularities occurred at the same rate in both groups (about 30%), but continuers tolerated the problem better than the discontinuers. These results suggest that women accepted Cyclofem and Mesigyna well. Acceptability depended on quality services and counseling, a supportive program, and social support. Providers should pay special attention to first-time users and to women who had discontinued previous contraceptives due to menstrual problems.
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