Practical training of health care providers in insertion of contraceptive implants: findings from two Brazilian centres

BACKGROUND AND OBJECTIVES

Lack of information and myths or inadequate training of health care providers in the guidance and management of contraceptives could negatively affect choice and eventually continuation rates. Our objectives were to evaluate the impact of clinical and theoretical training of health care professionals on insertion and removal of etonogestrel (ENG)-implant regarding this contraceptive, including pre- and post-training knowledge about insertion and removal techniques, clinical characteristics, side effects and outcomes.

MATERIAL AND METHODS

We conducted a cross-sectional study in which a questionnaire was sent to health care providers after they received clinical training in the management of ENG-implant.

RESULTS

After training, 78.2% of the 139 participants initiated to offer and inserted up to 5 implants/month and 17.6% between 6 to 10/month. None of the interviewees reported having difficulty with insertions after training, and 87.9% reported feeling very confident for removal.

CONCLUSION

Theoretical and practical training appeared important to prepare health care professionals, clarify doubts and promote higher rates of use of contraceptive implants in Brazil, contributing to reduce the rates of unintended pregnancies.

MONENSINA SÓDICA NO CONSUMO E DIGESTIBILDADE APARENTE DAS FIBRAS EM DETERGENTE NEUTRO E ÁCIDO DA DIETA EM OVINOS

Objetivou-se avaliar os efeitos da adição da monensina sódica na dieta de ovinos sobre o consumoe os coeficientes de digestibilidade aparente da fibra em detergente neutro (FDN) e ácido (FDA) num ensaio dedigestibilidade “in vivo”, utilizando-se 16 ovelhas, não prenhes e não lactantes, mestiças, com peso e desviopadrão médios de 55,11 ± 3,11 kg, em delineamento inteiramente ao acaso, com quatro tratamentos (0; 25; 50 e75 mg de monensina/animal/dia). Os animais foram alimentados à vontade, com dietas à base de cana-deaçúcar,farelo de soja, grão de milho moído e mistura mineral como dieta básica. Houve efeito significativo dosníveis de monensina sobre os consumos das fibras em detergentes neutro e ácido da dieta. Os coeficientes dedigestibilidade aparente da FDN e da FDA não diferiram estatisticamente entre os tratamentos. Os níveis demonensina sódica utilizados diminuíram os consumos e os coeficientes de digestibilidade aparente daFDNe daFDA.