ABSTRACT
Injectable Contraceptive NET OEN (200mg) given every 60+ – 7 days was studied at urban post-partum centres and primary health centres attached to medical college under Reorientation of Medical Education (ROME) scheme to identify the logistics requirements and its acceptability in the existing programme conditions in the country. The total of 2449 women’s were observed for 11691 women-months of use at 42 post-partum centres and 531 women’s were observed for 3180 women-months of use at primary health centres selected by 11 medical colleges. The methods failure rate was observed to be 2.1 per 100 users at post-partum centres and 1.7 per 100 users at primary health centres. Detection of pregnancy was mainly on clinical judgement and all such cases were recommended to undergo Medical Termination of Pregnancy (MTP). Majority of the discontinuation as expected were due to menstrual irregularities; 41.2 per 100 user at post-partum centres and 34.6 per 100 users at the primary health centres. Continuation rates at the end of 1 year were 22.9 per 100 users at post-partum centres and 29.3 per 100 users at primary health centres. The rates observed in this study were much less than those observed in clinical trials. The possible reasons could be that the participating centres were not familiar with this new technology and the importance of motivation and counselling was not taken in the right perspective. Continuation rates were better at primary health centres; this could be because of the fact that the ANMs have better rapport with the women and thus have more frequent contacts. Percent loss to follow up was high 24.1 at post-partum centres and 15.1 at primary health centres. Proper counselling and motivational skills and follow-up strategies on the part of providers could significantly improve the continuation rate of this new technology if this is introduced in the National Family Welfare Programme (NFWP).
