Policy Memo: Public Policy Analyis:

Responsible for Ministry budget with part of National Family Planning

Program
Pilot project, Eastern Nigeria to explore advisability of NORPLANT;
availability in public hospitals Nigeria NEED TO WORK ON BASIS OF
THIS EVALUATIONS; and also other countries experiences
should this methods be part of national budget??
o Pro vs Contra
o Cost vs. Benefits



General questions:

What does this birth control entail? Is it mandatory? Free?

Norplant: (successor Jadelle; only 3 years)

Implant in upper arm for birth control
Effective for five years
Pro & Con of Hormons
Pro & Con of practicality of application
o No requirement of daily administration, access to hospitals,
continual supply (condoms, pills); highly effective and low costs
o No protection from AIDS and STDs
Pro & Contra of side-effects

Background:
UNTH ( University of Nigeria Teaching Hospital) WITH departure of family
planning
The program's functions are aimed at population activities including fertility,
sexually transmitted diseases (STDs), and acquired immunodeciency
syndrome (AIDS) control, as well as maternal health.

Norplant introduces in 1992 in Nigeria; study from 1992-1995; only 8% chose to
use it; less highly educated; connected to fear?
Importance:
Reasons:
Family Size , economic reasons, health

High morbidity and mortality rates decrease would lead to enhancement of
quality of life


Experience from Pilot Project
No forced treatment has been reported good outlook for wider
implementation of product

For a device such as Norplant requiring clinical cooperation for removal, the
accessibility and quality of service can have an important impact on the
continuation rate
Menstrual irregularity led to most of the discontinuations in this study, and has
been reported to be the most frequent and signicant complaint in other settings
Nigeria's total fertility rate of 6 [2] is one of the highest in Africa, and the
fertility rate of the locality studied may be higher than the overall national rate.
Tradition, in some parts of Eastern Nigeria, honors women who deliver 9 or
more children in their lifetime. At the occasion of the 9th birth, a goat is
slaughtered to celebrate what is called the `ewu ukwu' [22] ceremony (roughly
translated as `goat for pelvis').
he choice of Norplant by many women as an alternative to steriliza-
tion has also been reported from the UK [23]. Long-acting methods such as
Norplant may, therefore, be fullling an unmet need for contraception in this
community.
Results from this study show that Norplant is safe and acceptable to a small
sector of Nigerian women, characterized by high parity, older age, and
moderate (but not high) educational status.
This will consequently improve the general health and socioeconomic status of
the country.

Theme Pro Contra
Ethics: Choice of Usage Participants were
selected carefully; Well-
balanced presentation of
different contraceptions
by nurses (110;pilot)
Few knowledge about
family planning 46% ( 1;
Pilot Program)
Usage Norplant is well-know
product therefore it does
not evoke elicit fears (
110;pilot)
Mainly used with women
between 30-34
Effort Few contact with
patients;
1,3,6, and then 12
months intervals in case
of no complications

Co
Compulsory vs voluntary

http://www.thisdaylive.com/articles/family-planning-birth-control-and-the-
raging-controversy/125670/

Good database on medical publications
http://europepmc.org/abstract/MED/18072445


http://www.ncbi.nlm.nih.gov/pubmed/21970242

Preeliminary experience of Jadelle