Oral contraception in the former Czech and Slovak Federal Republic: attitudes and use

Reproductive health: an international perspective

The twentieth century began with approximately 1.6 billion human beings in the world and, with an increase of 96 million people per year, will end with over 6 billion people. Unless this trend is directly confronted by the world governments and their citizens, there will be nearly 8 billion by 2025 and over 11 billion by 2050. Thus, reproductive health is and will remain an issue of critical importance for all countries to realize and study. Part of this trend is because of the many pregnancies which occur in adolescents around the world. A number of issues have developed this century contributing to the many pregnant teenagers. For example, India has one of the world's largest populations of teenagers--over 23 million, representing over 26% of the total in the world. Effective methods for contraception and sexually transmitted diseases prevention are available, but not to all sexually active humans. However, many barriers to effective contraception exist around the globe. This article discusses some of them and also reviews use of contraceptive methods in various countries. These include oral contraceptives, emergency contraceptives, injectable and implantable contraceptives, intrauterine devices, barrier contraceptives and others. Reproductive health remains a critical, universal issue for all humans in the world. We all must examine the many pitfalls to controlling the world's populations, including lack of sex education, limited access to effective contraceptives, and others. We cannot afford to let the population continue unchecked. Effective strategies are needed at this time; otherwise, the population will continue to run out of control, negatively damaging the world for the coming generations. There is need to leave a positive, and not negative legacy for the next generation.

Reproductive health in central and eastern Europe: priorities and needs

The countries in Central and Eastern Europe combine induced abortion as the method of choice for family planning with low contraceptive use (Hungary and Slovenia excepted). This widespread use of induced abortion has a negative influence on reproductive and general public health, and an effort should be made to introduce modern, effective family planning. Both information, education and communication (IEC) programmes (for the users) and training in contraceptive technology and counselling (for the providers) is badly needed, as well as a continuing supply of contraceptives. In order to design optimal programmes, more research into knowledge, attitude and practice with regard to sexuality, sexual behaviour and contraception is urgently needed. So far, little research into contraceptive behaviour and its determinants has been done in Central and Eastern Europe, but the few data that are available point towards a lack of contraceptive knowledge in both the population and amongst contraception providers. The cultural differences between Western and Eastern industrialized countries are often underestimated or ignored, but because of the special situation in the countries in Central and Eastern Europe, education programmes which were successful elsewhere in the world may not work in these countries and may require extensive adaption to local needs and customs. Alternatively, special education programmes need to be developed. Programmes, especially those addressing contraception, should be combined with a long-term commitment for support and the provision of contraceptives.

Attitudes of Czech and Slovak gynecologists toward family planning

A survey was held among 155 gynecologists of the former Czech and Slovak Federal Republic (CSFR) who visited a national gynecological congress. The sample was fairly comparable to the total group of Czech and Slovak gynecologists concerning sex, age and county. Questions were asked on personal and professional characteristics, experience with the provision of contraception, attitudes toward family planning and knowledge about contraception. Almost all gynecologists rejected abortion as a birth control method and mentioned the lack of sex education, non-use of contraception and the widespread use of traditional contraceptive methods as main reasons for the high prevalence of abortion. About 60% of the physicians thought that at least some women would rather have an abortion than use contraception. According to the physicians, special family planning services should be developed and delivered by gynecologists. Opinions on proper services for teenagers varied. Only a few physicians felt that patients should pay the full price of contraceptives. Physicians' knowledge about the pill was found to be insufficient. The physicians overestimated the knowledge of their female patients about the pill. Apart from books and journals, colleagues and pharmaceutical firms were reported as important information sources. Overall, the present survey showed that introduction of well structured pre- and postgraduate courses in family planning should be encouraged.