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A randomised comparative study of Triquilar versus Marvelon: the Malaysian experience

Ismail MT

Malays J Reprod Health, 1991 Jun;9(1):9-17.
PMID: 12317444

PIP:
Health workers in Malaysia randomly assigned either a low-dose triphasic or a low-dose monophasic oral contraceptive (Triquilar and Marvelon, respectively) to 198 women to examine discontinuation rates and reasons for discontinuation. 15.3% of Triquilar women and 9.1% of Marvelon women forgot to take 1 pill at some time during the study while 6.1% and 3% forgot to take at least 3 consecutive pills. There were more complaints and/or complications among Triquilar women than among Marvelon women. The most serious complication was severe headaches (only 1 woman from each group). 2 women in the Marvelon group complained of either generalized itchiness or digestion impairment. Complaints of women in the Triquilar group included localized and generalized itchiness, weight gain, digestion impairment, dryness of vagina, and numbness of extremities. Women in the Triquilar group were more likely to have menstrual complaints than those in the Marvelon group (14.3% vs. 9.1%). The leading menstrual complaint in both groups was spotting (6.1% vs. 4%). No Marvelon women reported menorrhagia, scanty menses, or intermenstrual pelvic pain or discomfort while at least 1 woman did from the Triquilar group. The percentage of women with changes in complaints since admission were the same for both groups. Total discontinuation rates which included lost to follow ups were 46.9% and 40%, respectively. The most common reason for discontinuation for both groups was desired method change (11.2% Triquilar and 14.1% Marvelon). Method unrelated reasons (unable to return to clinic, moving/travel, and not interested in the study) were the next most common reason for discontinuation. 3 women conceived while taking Triquilar. These pregnancies were attributed to method failure, perhaps due to incomplete pituitary suppression. There were no accidental pregnancies in the Marvelon group.

Matched MeSH terms: Contraception Behavior*
Utilization of Private Sector Family Planning Services in Malaysia

Lai SL, Tey NP, Mahmud A, Ismail N

Int Q Community Health Educ, 2021 Jul;41(4):395-403.
PMID: 33167794 DOI: 10.1177/0272684X20972864

BACKGROUND: The private sector is playing an increasingly important role in family planning services globally. The active participation of private providers is associated with a higher contraceptive prevalence rate.
OBJECTIVES: To examine the differentials and determinants of the utilization of private providers for family planning services.
METHOD: This study used the 2014 Malaysian Population and Family Survey data. Cross-tabulations and logistic regression were performed on 1,817 current users of modern methods.
RESULTS: Overall, 26% of modern method users obtained their supplies from private clinics/pharmacies and 15.2% from other sources, such as drug stores and sundry shops. The odds of utilizing the private sector for family planning services differ significantly across regions and socio-economic groups. The odds of obtaining supply from the private clinics/pharmacies were higher among the Chinese and urban women (AOR > 1), and it was lower among those from the eastern region (AOR = 0.47, 95% CI = 0.30-0.73). Non-Bumiputera, urban, higher educated, and working women, and those whose husbands decided on family planning had higher odds of obtaining the supply from the other sources (AOR > 1).
CONCLUSION: The private sector complements and supplements the public sector in providing family planning services to the public.

Matched MeSH terms: Contraception Behavior
Efficacy of Contrasperm as a male contraceptive: clinical trials in Malaysian men

Hamid A, Jaffar A

Malays J Reprod Health, 1983 Jan;1(1):75-82.
PMID: 12279893

PIP:
The efficacy of a recently marketed posttesticular male oral contraceptive, Contrasperm, was assessed in a clinical trial involving 32 Malaysian volunteers ages 21-39 years. Contrasperm is claimed to be a pure botanical extract free of toxic chemicals, steroids, and hormones. The drug is believed to cause cells surrounding the sperm in the seminiferous tubules to secrete carbon dioxide, producing a weakly acidic environment that greatly increases the sperms' metabolism and reduces the pH of semen from its normal level of 7.5 to 1.5. The manufacturer claims that this drop in pH decreases motility from 95% to 0%. Semen samples were collected by masturbation from subjects to provide baseline data. 3 days after the initial sperm analysis, subjects were given 1 capsule of Contrasperm containing 10 mcg of the active ingredient. Additional semen analyses were conducted 30 minutes, 6 hours, and 24 hours after ingestion. Sperm count and sperm motility were greatly reduced in most subjects 30 minutes after ingestion. However, 6 subjects had increased sperm counts and 4 subjects demonstrated increased sperm motility, indicating an enhancing effect. At 6 hours after ingestion, 20 subjects had lowered sperm motility and 12 subjects showed normal sperm motility, contradicting the manufacturer's claim that motility is reduced to 0%. Although Contrasperm is claimed to be effective for 6-8 hours after ingestion, its effect wore off in less than 6 hours in 37% of subjects. Both sperm count and sperm motility returned to normal levels 24 hours after ingestion, confirming the reversibility of this drug. Most subjects reported mild side effects such as muscle weakness, blurred vision, dizziness, perspiration, urgency, abnormal muscle tension, and dry throat which persisted longer than 24 hours. Further studies, with proper controls, are needed to assess the reliability and toxicity of this preparation.

Matched MeSH terms: Contraception Behavior
A qualitative exploration of contraceptive practice and decision making of Malaysian women who had induced abortion: a case study

Tong WT, Low WY, Wong YL, Choong SP, Jegasothy R

Asia Pac J Public Health, 2014 Sep;26(5):536-45.
PMID: 24368749 DOI: 10.1177/1010539513514434

This study explores contraceptive practice and decision making of women who have experienced abortion in Malaysia. In-depth interviews were carried out with 31 women who had abortions. Women in this study did adopt some method of modern contraception prior their abortion episodes. However, challenges to use a method consistently were experiences and fear of side effects, contraceptive failure, partner's influence, lack of confidence, and cost. The decision to adopt contraception was theirs but the types of contraceptive methods to adopt were influenced by their spouses/partners. The women wanted to use modern contraception but were faced with challenges that hampered its use. More proactive contraceptive promotion is needed to educate people on the array of contraceptive methods available and made accessible to them, to correct misconceptions on safety of modern contraception, to increase men's involvement in contraceptive choices, and to encourage consistent contraceptive use to prevent unintended pregnancies.

Matched MeSH terms: Contraception Behavior/psychology*; Contraception Behavior/statistics & numerical data*
Influences on family planning acceptance: an analysis of background and program factors in Malaysia

Johnson JT

Stud Fam Plann, 1979 Jan;10(1):15-24.
PMID: 442148 DOI: 10.2307/1966174

Which factors have the greater influence on family planning performance: fixed background variables such as racial composition, urbanization, and mortality, which are affected by level of development, or program inputs such as assignment of personnel and location of clinics, which are subject to manipulation by administrators? An analysis of differences in family planning acceptance among 70 districts of Malaysia shows that two main program-manipulable variables--level of personnel deployment and accessibility of clinics--have the largest direct effect upon acceptance levels. Variations in background factors explain a smaller proportion.
PIP: The application to the Malaysian family planning program of a conceptual model in which background factors, affected by the level of development, are distinguished from program input variables, subject to program manipulation, is considered in an effort to examine reasons for variations in program performance. Focus is particularly on the inputs of workers, who provide services and distribute supplies, and clinic facilities, through which services and supplies are made available. The questions asked concerned how their availability and use are affected by background factors, which themselves reflect to some extent the population's readiness to accept family planning. Distinguishing the program-manipulable factors from the background factors involved determination of the impact of both groups of variables, separately and together on levels of program acceptance, using appropriate bivariate and multivariate techniques. The evidence shows that in addition to background factors, over which program administrators can exercise no direct influence, there is a major contribution made to program acceptance through program factors over which the planner and administrator do have control. The 2 program variables contributed more in explaining performance levels than all 5 selected background variables combined, and the relative contribution of these program factors has increased over time. The key finding emerging from the different analyses is that program manipulable inputs are the dominant direct determinants of subsequent levels of family planning acceptance in Malayasia. Clearly, higher levels of development, as reflected in the measures of background variables, have facilitated acceptance, and background variables contributed significantly. Yet, whatever the level of development, the extent of deployment of program resources does significantly influence the level of program performance.

Matched MeSH terms: Contraception Behavior
Population policies in Southeast Asia and Australia: the international relevance of domestic affairs

Jones GW

J Aust Popul Assoc, 1984;1:109-20.
PMID: 12267174
Matched MeSH terms: Contraception Behavior
Fulltext Comparative study on the acceptance and use of contraceptive methods in a rural population in Kelantan

Kamalanathan JP

Malays J Reprod Health, 1990 Dec;8(2):66-71.
PMID: 12343150

PIP: Contraceptive prevalence was determined in the Kelantan region of Malaysia, an area with relatively poor health indices. 350 women attending health clinics on rubber and palm-oil estates and living in surrounding suburbs were surveyed by clinic workers or during home visits. The sample included 273 Malays, 64 Indians and 13 Chinese. This area of Peninsular Malaysia is noted for the highest infant mortality rate (17.7), second highest crude birth rate (35.2) and highest dependency ratio (88%) in the country. 44.9% practiced contraception, highest in Chinese and lowest in Indians. Methods used were pills by (55%), traditional methods (19%), tubal ligation (18%), safe period (14%), injections (5.5%), IUD (4.7%), and condom (2.3%). The Malaysian traditional methods are herbal preparations from tree bark or roots, herb pills, and exercises after coitus. 34% of the non contraceptors had used contraception before but stopped because of side effects, religious or spousal objections, or desire to conceive. 74% had married in their teens. 46% of the non-contraceptors were spacing their children by prolonged breastfeeding.

Matched MeSH terms: Contraception Behavior
Study of rigevidon for oral contraception in a family planning clinic in Kota Bahru, Kelantan

Ang Eng Suan, Karim HA

Malays J Reprod Health, 1990 Jun;8(1):31-7.
PMID: 12316342
Matched MeSH terms: Contraception Behavior
Four perspectives of women's health. Workshop participants talk about women's health issues in four countries. [Malaysia]

Kaur P

JOICFP News, 1994 Jan.
PMID: 12318571
Matched MeSH terms: Contraception Behavior*
Breastfeeding and the use of maternal health services in Sarawak

Kwa SK

Malays J Reprod Health, 1993 Jun;11(1):8-19.
PMID: 12318984

An increase in the use of health services and contraception is usually associated with a decrease in breastfeeding. This study seeks to establish the relationship between maternal use of health services and breastfeeding practice. Data was obtained from the Sarawak Population and Family Survey of 1989. The breastfeeding pattern of 1583 children born to 1047 women aged between 15-49 years in the five years preceding the study were analyzed and compared among the various groups using maternal health services and contraception. Results showed that Sarawak has a very short mean duration of about 6 months for breastfeeding. Women attending antenatal and postnatal clinics had shorter breastfeeding durations but higher initiation rates compared to those who did not. Those whose delivered by doctors and those delivering in private hospitals were least likely to breastfeed. Contraceptive use was also negatively associated with breastfeeding duration. Whilst it is commendable that the use of maternal health facilities is high in Sarawak, the inverse relationship to breastfeeding can offset its health benefits. Health policies can play a part to arrest this decline which is also related to socioeconoic development.

Matched MeSH terms: Contraception Behavior*
Nonsurgical female sterilization with quinacrine pellets: Malaysian experience

Arshat H, Ang Eng Suan, Kwa Siew Kim

Malays J Reprod Health, 1987 Dec;5(2):61-9.
PMID: 12315185
Matched MeSH terms: Contraception Behavior
Fulltext Contraceptive use among women with chronic medical conditions and factors associated with its non-use in Malaysia

Manaf RA, Ismail IZ, Latiff LA

Glob J Health Sci, 2012 Sep;4(5):91-9.
PMID: 22980381 DOI: 10.5539/gjhs.v4n5p91

INTRODUCTION: Women with chronic medical conditions are at higher risk of adverse pregnancy outcomes, which may be minimized through optimal preconception care and appropriate contraceptive use. This study aimed to describe contraceptive use among women with chronic medical conditions and factors associated with its non-use.
METHODS: This study used cross-sectional data from a family planning survey among women with chronic medical conditions conducted in three health facilities in a southern state of Malaysia. A total of 450 married women in reproductive age (18-50 year) with intact uterus, and do not plan to conceive were analysed for contraceptive use. Both univariate and multivariate analysis was conducted to identify factors associated with contraceptive non-use among the study participants.
RESULTS: A total of 312 (69.3%) of the study participants did not use contraceptive. Contraceptive non-use was highest among the diabetics (71.2%), connective tissue disease patients (68.6%) and hypertensive patients (65.3%). Only 26.3% of women with heart disease did not use contraceptive. In the multivariate analysis, contraceptive non-use was significantly more common among women who received their medical treatment in the health clinics as compared to those who received treatment in the hospital (adjusted odds ratio [OR]=1.75, 95% confidence interval [CI]: 1.09, 2.79), being in older age group of 41-50 year (adjusted OR=2.31, 95% CI: 1.19, 4.48), having children (adjusted OR=4.57, 95% CI: 1.66, 12.57) and having lower education (adjusted OR=2.87, 95% CI: 1.43, 5.77).
CONCLUSION: About two-third of women with chronic medical conditions who needed contraceptive did not use them despite the higher risk of pregnancy related complications. The high unmet need warrant an effective health promotion programme to encourage the uptake of contraceptives especially targeting women of older age group, low education and those who received their medical treatment at health clinics.
Study site: Outpatient clinic, three hospitals; 8 health clinics, Malaysia

Matched MeSH terms: Contraception Behavior/statistics & numerical data*
Fertility trends and prospects in East and South-East Asian countries and implications for policies and programmes

Leete R

Popul Res Leads, 1991.
PMID: 12285439

PIP:
Fertility trends and prospects for east and southeast Asian countries including cities in China, Taiwan, the Republic of Korea, Thailand, Indonesia, Malaysia, the Philippines, Myanmar, and Viet Nam are described. Additional discussion focuses on family planning methods, marriage patterns, fertility prospects, theories of fertility change, and policy implications for the labor supply, labor migrants, increased female participation in the labor force (LFP), human resource development, and social policy measures. Figures provide graphic descriptions of total fertility rates (TFRS) for 12 countries/areas for selected years between 1960-90, TFR for selected Chinese cities between 1955-90, the % of currently married women 15-44 years using contraception by main method for selected years and for 10 countries, actual and projected TFR and annual growth rates between 1990-2020 for Korea and Indonesia. It is noted that the 1st southeast Asian country to experience a revolution in reproductive behavior was Japan with below replacement level fertility by 1960. This was accomplished by massive postponement in age at marriage and rapid reduction in marital fertility. Fertility was controlled primarily through abortion. Thereafter every southeast Asian country experienced fertility declines. Hong Kong, Penang, Shanghai, Singapore, and Taipei and declining fertility before the major thrust of family planning (FP). Chinese fertility declines were reflected in the 1970s to the early 1980s and paralleled the longer, later, fewer campaign and policy which set ambitious targets which were strictly enforced at all levels of administration. Korea and Taiwan's declines were a result of individual decision making to restrict fertility which was encouraged by private and government programs to provide FP information and subsidized services. The context was social and economic change. Indonesia's almost replacement level fertility was achieved dramatically through the 1970s and 1980s by institutional change in ideas about families and schooling and material welfare, changes in the structure of governance, and changes in state ideology. Thailand's decline began in the 1960s and is attributed to social change, change in cultural setting, demand, and FP efforts. Modest declines characterize Malaysia and the Philippines, which have been surpassed by Myanmar and Viet Nam. The policy implications are that there are shortages in labor supply which can be remedied with labor migration, pronatalist policy, more capital intensive industries, and preparation for a changing economy.

Matched MeSH terms: Contraception Behavior*
New approaches for estimating the demand for children

Lightbourne R

Popul Bull UN, 1987.
PMID: 12315520
Matched MeSH terms: Contraception Behavior*
Study of characteristics of condom-acceptors using condom as first choice and alternative method of contraception in 1981-1987 at the NPFDB, GHKL

Low Boon Song

Malays J Reprod Health, 1990 Jun;8(1):13-9.
PMID: 12316340
Matched MeSH terms: Contraception Behavior
Fulltext Knowledge, attitude and practice towards sexually transmitted diseases amongst the inmates of women shelters homes at Klang Valley

Zin NM, Ishak I, Manoharan K

BMC Public Health, 2019 Jun 13;19(Suppl 4):639.
PMID: 31196029 DOI: 10.1186/s12889-019-6863-5

BACKGROUND: Previous studies show that there is a changing trend of sexual and reproductive behaviour among youth and this requires more attention and awareness especially on sexually transmitted diseases (STD). This study was carried out to evaluate the knowledge, attitude and practice of sexually transmitted diseases among selected inmates of women shelter homes.

METHODS: A cross-sectional study was carried out by involving 60 participants whom aged in between 13 to 25 years old. The questionnaires were developed in 'Bahasa Melayu' and it has been anonymous guided questionnaires.

RESULTS: The result showed that the mean age of the participants was 17.9 years old and most of the participants have completed secondary school (91.7%). Overall, the level of knowledge of participants on STDs were classified into three groups; 'high knowledge' (33.3%), 'medium knowledge' (35.0%) and 'low knowledge' (31.7%). The majority have heard of HIV/AIDS (95%) but with respect to other STDs was less well known. Whereas, the mean score for attitude was 23.1 out total 25. Their knowledge level was not influenced by their age (p = 0.61) and socio-economic status (p = 0.85). However, their attitude was influenced by their age (p

Matched MeSH terms: Contraception Behavior/psychology
Fulltext Factors associated with crisis pregnancies in Ireland: findings from three nationally representative sexual health surveys

Bourke A, Kelleher C, Boduszek D, Morgan K

Reprod Health, 2015;12:14.
PMID: 25884222 DOI: 10.1186/s12978-015-0005-z

Findings on the demographic and sexual health characteristics associated with the experience of a crisis pregnancy are important to inform the public health policy of a country, including Ireland. Studies from other jurisdictions have suggested that certain demographic groups are at risk for unintended pregnancies and the disparity between the groups has been growing in recent years. Ireland is a country which experienced much economic and societal change in the first decade of the 21(st) century; changes which are likely to have affected demographic variables pertaining to sexual health. The current study had two aims: to investigate changes in the socioeconomic characteristics associated with crisis pregnancies over a seven year period [2003 to 2010], and to investigate the recent [2010] socioeconomic risk factors associated with crisis pregnancies in Ireland.

Matched MeSH terms: Contraception Behavior/statistics & numerical data*
Fulltext Prescription contraception use: a cross-sectional population study of psychosocial determinants

Molloy GJ, Sweeney LA, Byrne M, Hughes CM, Ingham R, Morgan K, et al.

BMJ Open, 2015 Aug 12;5(8):e007794.
PMID: 26270944 DOI: 10.1136/bmjopen-2015-007794

OBJECTIVE: Many forms of contraception are available on prescription only for example, the oral contraceptive pill (OCP) and long-acting reversible contraceptives (LARCs). In this analysis we aim to identify key determinants of prescription contraceptive use.
DESIGN: Cross-sectional population survey. Data on sociodemographic indices, concerns about the OCP and perceived barriers to access were collected.
SETTING: Data set constructed from a representative population-based telephone survey of community dwelling adults in the Republic of Ireland (RoI)
PARTICIPANTS: 1515 women aged between 18 and 45 years
MAIN OUTCOME MEASURE: Self-reported user of the OCP or LARCs (intrauterine contraception, contraceptive injections or subdermal contraceptive implants) in the previous 12 months.
RESULTS: For at least some of the previous year, 35% had used the OCP and 14% had used LARCs, while 3% had used two or more of these methods. OCP users were significantly younger, more likely to be unmarried and had higher income than non-users. Overall, 68% agreed with the statement 'that taking a break from long-term use of the contraceptive pill is a good idea' and 37% agreed with the statement that 'the OCP has dangerous side effects' and this was the strongest predictor variable of non-use of the OCP. Intrauterine contraception users were significantly older, more likely to be married and had lower income than non-users. Injections or subdermal contraceptive implant users were significantly younger, less likely to be married, had lower income and were less likely to agree that taking a break from long-term use of the pill is a good idea than non-users.
CONCLUSIONS: Prescription contraceptive use is sociodemographically patterned, with LARCs in particular being associated with lower incomes in the RoI. Concerns about the safety of the OCP remain prevalent and are important and modifiable determinants of contraceptive-related behaviour.

Matched MeSH terms: Contraception Behavior/psychology*; Contraception Behavior/statistics & numerical data*
Fulltext Unmet needs for contraception in married women in a tribal area of India

Patil SS, Abdul Rashid K, Narayan KA

Malaysian Journal of Public Health Medicine, 2010;10(2):44-51.
MyJurnal

Background and Objectives: Unmet need for contraception is the gap between women's reproductive intentions and their contraceptive behavior. This community based interventional study was carried out to determine the unmet needs for contraception, the reasons for this and to assess the impact of interventional measures on acceptance of contraception.
Subjects and Methods: This study was conducted in 52 villages in the state of Maharashtra, India, among 363 married women selected by cluster sampling. Data was collected using an interview guide. An intervention was done for the women who had an unmet need and an assessment of the change was done subsequently. Data was analyzed by using SPSS.
Results The prevalence of contraceptive usage was 59.2% and the prevalence of unmet need for contraception was 44% (160). The unmet need for spacing births was 53.8%, 38.7% for limiting births and 7.5% women were dissatisfied with the current contraceptive method. The reasons ranged from side effects to contraceptives to source of obtaining contraceptives. Age of the respondents, education and number of living children showed statistically significant association with unmet needs. Post intervention, the contraceptive prevalence rate increased significantly 85.7% and there was a significant reduction in the unmet needs for spacing and limiting births, equally there was a significant reduction of dissatisfaction with using contraception.
Conclusion: Improvement in the use of contraception and addressing the unmet need for contraception requires community involvement and ongoing, sustained efforts by health workers to ensure quality care to the beneficiaries.

Matched MeSH terms: Contraception Behavior
[Fertility trends and socioeconomic development in the Philippines]

Nebenfuhr E

Demogr Inf, 1991;?(?):48-52, 154.
PMID: 12343124

PIP:
In the Philippines the number of children per woman is envisioned to be 2 by the year 2000 to reach simple replacement level. The crude birth rate had dropped from 43.6% in 1960 to 32.3% during 1980-85 corresponding to 4.2 children/woman. However, the corresponding rates for Thailand and Malaysia were 28% and 32.1%, respectively. The total fertility rate (TFR) was still a high 4.7% in 1988. In 1980 TFR was 3 in Manila, but 3/4 of the provinces still had TFR of 5-6.8 in 1985. Yet the World Fertility Survey of 1970 indicated that the total married fertility rate had decreased from 9.6 in 1970 to 9.1 in 1977. Married women had an average of 4.5 children in 1968 and still 4 children in 1983. Only 1/2 of married women aged 15-45 used contraception. In 1983, only 26.2% of all fertile married women used effective contraception. 63% of Moslim women, 70% of Catholics and Protestants, and 83% of members of the Church of Christ advocate modern contraceptives. From 1967 the National Population Outreach Program of the state sent out family planning advisers to unserviced areas. In 1983 only 37% of married women knew about such a service within their locality, and in 1988 a World Bank investigation showed that 67% could not afford contraceptives. The education, employment, income, urbanization of the household as well as medical care of women and children strongly influenced reproduction. The lifting of living standards and improvement of the condition of women is a central tenet of Philippine family planning policy. A multiple regression analysis of the World Fertility Survey proved that professional women tended to have smaller family size, however, most women worked out of economic necessity not because of avocation. The higher the urban family income, the lower marital fertility; but the reverse is true in rural areas where traditionally large families have had more income, and children have provided future material security. In 1983 1/3 of women with children over 18 received regular financial remittances from them. Thus, appropriate family planning program evaluation has to be concerned with the relationships of fertility and rural areas, the economic development of the community, and the physical access to a family planning clinic.

Matched MeSH terms: Contraception Behavior*

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