Oral contraception in Bangladesh

In rural Bangladesh, the continuation rate of oral contraceptives (OCs) is the lowest among all methods except for condoms, and the pregnancy rate for OC users is comparable to that for users of traditional methods, which lies halfway between that for foam and condom users (high) and Depo-Provera and IUD users (low). To determine why postpartum amenorrheic OC acceptors have shorter pregnancy intervals than postamenorrheic OC acceptors who were matched on time of acceptance as well as on age and parity, subintervals of the pregnancy interval are examined. Results reveal significantly shorter duration of use by amenorrheic acceptors. This short duration of use overrides their significantly longer duration to pregnancy since discontinuation, to give overall shorter duration to pregnancy since last birth.

Contraceptive users in rural Bangladesh: a time trend analysis

An examination of the characteristics of contraceptive acceptors in a family planning program in rural Bangladesh revealed trends of declining age and number of living children among new acceptors. A time series analysis of the age-specific acceptance rates confirmed the observation, indicating that over time the program succeeded in attracting younger and low-parity women. The high use prevalence rates resulted in fertility levels that were 25 percent lower in the program area than in the comparison area. The decline in the fertility levels during the first program year was mainly due to a large decline in fertility among women over age 35, but in the second year, the contribution made by women 30-35 years old was substantial.

Coital frequency and sexual abstinence in rural Bangladesh

The paper analyses results of a survey of sexual and reproductive behaviour in a sample of 2301 currently married women aged less than 50 years. The survey was conducted in 22 villages of the ICDDR, B field station in Bangladesh. Admittedly, the sample is not representative as co-operation could not be obtained from about one-third of eligible women. The results suggest higher coital frequencies among Hindu than among Muslim respondents. There appears to be a clear age and marriage duration pattern with coital frequencies declining rapidly to a plateau after about 5 years of marriage and among women aged 25 and over, followed by another steep decline at durations of marriage over 20 years and age 40 and more. Generally, recently married, young, non-breast-feeding, non-contracepting and pregnant respondents reported higher coital frequencies than their peers of opposite characteristics. Post-partum abstinence among both Muslims and Hindus was comparatively short, generally not exceeding 3 months.

The effect on fecundity of pill acceptance during postpartum amenorrhea in rural Bangladesh

The length of the interval from last live birth to the subsequent pregnancy was studied for 121 contraceptive pill acceptors who were in postpartum amenorrhea at the time of acceptance and 121 matched nonacceptors in a prospective study in Matlab, Bangladesh. Half of the pill acceptors discontinued use within seven months, and as a group the pill acceptors had a significantly shorter interval to the next pregnancy than the matched nonacceptors. These findings suggest that unless continuation rates can be improved, it is better not to encourage women in rural Bangladesh to start the contraceptive pill during postpartum amenorrhea.

Experience with Lippes loop and copper-T intrauterine devices in rural Bangladesh

Experience with IUD use among rural Bangladeshi women within two programmatic efforts demonstrates that the Copper-T IUD suited the needs of younger, lower-parity women better than Lippes Loop. The differential performance by the device was especially marked within the program that offered a broad selection of contraceptive methods and occurred mainly because of lower rates of expulsion and lower rates of discontinuation for bleeding and pain among the Copper-T users. Nevertheless, the easy availability of a wide choice of methods during the second program successfully encouraged dissatisfied IUD discontinuers to try other methods of contraception.

The demographic impact of the family planning--health services project in Matlab, Bangladesh

This paper evaluates the demographic impact of the Family Planning-Health Services Project in Matlab Thana of rural Bangladesh. The project was begun by the International Centre for Diarrhoeal Disease Research, Bangladesh in October 1977. Contraceptive services--including pills, condoms, IUDs, sterilization, and injectables--are supplemented by oral rehydration, tetanus toxoid, and other services. About 33 percent of eligible couples are using contraception. Impact is evaluated by direct measurement of birth rates in the treatment and comparison areas. An overall fertility decline of about 25 percent is observed, concentrated among older women. The impact is two-to-three times that of an earlier project that included fewer methods and used lesser trained workers. The study shows that intensive family planning efforts can affect fertility in the absence of socioeconomic changes.

Peritoneal biopsy for diagnosis of abdominal tuberculosis

Eighty-eight patients with abdominal tuberculosis were studied for the diagnostic value of peritoneal biopsy. Peritoneum for biopsy was obtained during laparotomy in 41 cases and by making a small incision in the right iliac fossa, under local anaesthesia, in 47 cases. In 80% histopathological examination revealed caseation or giant cells and epithelioid cell infiltration. In 20% non-specific inflammatory changes were present. Thus, histopathological examination of the peritoneum was helpful in the diagnosis of abdominal tuberculosis in all the 88 patients.