Impact of the contraceptive implant on maternal and neonatal morbidity and mortality in rural Papua New Guinea: a retrospective observational cohort study

Gupta, Saurabh; Ramsay, Philippa; Mola, Glen; McGeechan, Kevin; Bolnga, John; Kelly‐Hanku, Angela; Black, Kirsten

doi:10.1016/j.contraception.2019.03.042

Cited by 11 publications

(19 citation statements)

References 14 publications

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“…Karkar Island is a rural community off the coast of Madang town, Madang Province on the north coast of PNG, and is a two hour boat ride from the mainland. In 2016 the population was estimated at 60,000 with 31,200 females (52%), of whom 51% were in the reproductive age range of 15-49 years [11,23]. Less than one in three (29%) of women of reproductive aged were using modern contraceptives in 2016 [11,12].…”

Section: Research Settingmentioning

confidence: 99%

“…Less than one in three (29%) of women of reproductive aged were using modern contraceptives in 2016 [11,12]. Amongst those using a modern method, 40% were using implants, 31% were using injectables, 31% were using the oral contraceptive pill and the remainder were using condoms, had had a tubal ligation or their husband had had a vasectomy [11,12].. Implant uptake amongst women on the island since 2016 has been minimal [23].…”

Section: Research Settingmentioning

confidence: 99%

“…There are 52 villages on the island of which 41 (79%) are along the island's 84 km coastline [11,23]. Villages are connected by a continuous road which is subject to flooding.…”

Section: Research Settingmentioning

confidence: 99%

“…The hospital and health centres are continuously staffed by nurses, midwives, doctors and community health workers whilst staffing at aid posts is inconstant. Family planning counselling and services should theoretically be available from all sites [23].…”

Section: Research Settingmentioning

confidence: 99%

“…Each village on Karkar Island is headed by one or two leaders, a church representative and four to five family elders, all of who are typically men [11,23]. Social ranking is determined by age, gender and land asset with village heads responsible for maintaining order within and between villages, including resolving family and marital disputes where necessary [11,12].…”

Section: Research Settingmentioning

confidence: 99%

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Community attitudes and gendered influences on decision making around contraceptive implant use in rural Papua New Guinea

et al. 2020

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Background: Despite targeted interventions to improve contraceptive implant acceptability and uptake in rural Papua New Guinea (PNG), ongoing use of this method remains limited. Previous literature has suggested community attitudes and intrinsic factors within the decision-making process may be negatively impacting on implant uptake, however these elements have not previously been studied in detail in this context. We set out to explore community attitudes towards the contraceptive implant and the pathways to decision making around implant use in a rural community on Karkar Island, PNG. Methods: We conducted 10 focus-group (FGD) and 23 in-depth interviews (IDI) using semi-structured topic guides. Key sampling characteristics included age, exposure or non-exposure to implants, marital status, education and willingness to participate in discussion. Four FGDs were held with women, four with men and two with mixed gender. IDIs were carried out with five women (current implant users, former implant users, implant never users), five men, five religious leaders (Catholic and non-Catholic), four village leaders and four health workers. Two indepth interviews (four participants) were analysed as dyads and the remaining participant responses were analysed individually. Results: Men were supportive of their wives using family planning but there was a community-wide lack of familiarity about the contraceptive implant which influenced its low uptake. Men perceived family planning to be 'women's business' but remained strongly influential in the decision making processes around method use. Young men were more receptive to biomedical information than older men and had a greater tendency towards wanting to use implants. Older men preferred to be guided by prominent community members for decisions concerning implants whilst young men were more likely to engage with health services directly.

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Section: Research Settingmentioning

confidence: 99%

Section: Research Settingmentioning

confidence: 99%

“…There are 52 villages on the island of which 41 (79%) are along the island's 84 km coastline [11,23]. Villages are connected by a continuous road which is subject to flooding.…”

Section: Research Settingmentioning

confidence: 99%

Section: Research Settingmentioning

confidence: 99%

Section: Research Settingmentioning

confidence: 99%

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Community attitudes and gendered influences on decision making around contraceptive implant use in rural Papua New Guinea

et al. 2020

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A cross-sectional study of factors associated with immediate postpartum uptake of contraceptive implants in Papua New Guinea

et al. 2023

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A scoping review of maternal near miss assessment in Australia, New Zealand, South‐East Asia and the South Pacific region: How, what, why and where to?

Jayaratnam

Franklin

Costa

2021

Aust NZ J Obst Gynaeco

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Background: Severe maternal morbidity or maternal near miss (MNM) events can have significant consequences for individuals, their families and society and the study of these events may inform practices to reduce future adverse pregnancy outcomes. Aims:To review the scope of MNM studies undertaken in Australia, New Zealand, South-East Asia and the South Pacific region. Materials and Methods:A systematic search of four online databases (MEDLINE, EMBASE, SCOPUS and CINAHL) and the World Health Organization Library was conducted to identify all relevant studies published between 1 January 2011 and 31 December 2020. The studies were reviewed and included if they assessed MNM using a composite outcome or a predefined set of indicators. Results:The literature search yielded 143 articles of which 49 are included in this review. There were substantial differences in the monitoring approach to MNM in the Australasian region. Overall rates of MNM in the region ranged from two to 100/1000 births and the most common aetiologies identified were direct obstetric causes such as postpartum haemorrhage, pre-eclampsia and sepsis. Multidisciplinary review indicated a substantial number of MNM cases were preventable or amenable to improved management, mostly from a provider perspective.Conclusions: Assessment of MNM is an important part of the evaluation of maternity care provision. Reaching a consensus on indicators and how best to collect information will allow a more discerning assessment of MNM including longerterm health outcomes, aspects of preventability and financial implications for health services.

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Impact of the contraceptive implant on maternal and neonatal morbidity and mortality in rural Papua New Guinea: a retrospective observational cohort study

Cited by 11 publications

References 14 publications

Community attitudes and gendered influences on decision making around contraceptive implant use in rural Papua New Guinea

Community attitudes and gendered influences on decision making around contraceptive implant use in rural Papua New Guinea

A cross-sectional study of factors associated with immediate postpartum uptake of contraceptive implants in Papua New Guinea

A scoping review of maternal near miss assessment in Australia, New Zealand, South‐East Asia and the South Pacific region: How, what, why and where to?

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