Initiation of effective postpartum contraceptive use in public hospitals in Guatemala Inicio de un método anticonceptivo eficaz durante el puerperio en hospitales públicos de Guatemala

• Main Authors: Edgar Kestler, Maria del Rosario Orozco, Silvia Palma, Roberto Flores
• Format: Article in Journal/Newspaper
• Language: English; Spanish; Portuguese
• Published: Pan American Health Organization 2011
• Subjects: Período de posparto; conducta anticonceptiva; servicios de planificación familiar; Guatemala; Postpartum period; contraception behavior; family planning services; Medicine; R; Arctic medicine. Tropical medicine; RC955-962; Public aspects of medicine; RA1-1270; Arctic; Baja
• Online Access: https://doaj.org/article/63001fc2251c41db9bc92531c2c44ace

OBJECTIVE: Low frequency of effective contraceptive use remains a challenging problem. This article examines the frequency of effective postpartum contraception and the methods used before discharge in public hospitals in Guatemala. It also discusses the need to implement best practices in providing family-planning and contraceptive services. METHODS: In March 2006, a surveillance system was implemented to collect data on the initiation of effective contraceptive methods. Postpartum women were monitored in 34 public hospitals. Univariate and bivariate analyses were performed, and a chi-square test for linear trends was used to compare female surgical sterilization rates after vaginal delivery and cesarean section. RESULTS: Between 1 March 2006 and 31 December 2008, of the 218 656 women who had a postpartum event, 31% received an effective contraceptive method before hospital discharge. The frequency of initiation of effective postpartum methods varied across hospitals. Hospital results were consistent with national data on women of reproductive age. Among women who underwent surgical sterilization, differences between those who had delivered vaginally and those who had a cesarean section were statistically significant. CONCLUSIONS: The overall frequency of initiation of effective postpartum contraceptive use is low in public hospitals in Guatemala. It is higher, however, in hospitals at lower health care levels with strong community ties. Routine data collection revealed specific areas for improvement, particularly the need to enhance health providers' knowledge of medical eligibility criteria for effective contraceptive use postpartum. The priority is to promote the provision of highquality family-planning and contraceptive services in Guatemala's public health system. OBJETIVO: La baja frecuencia del uso de métodos anticonceptivos eficaces sigue siendo un arduo problema. En este artículo se analiza la frecuencia con que se adopta un método de anticoncepción eficaz durante el puerperio y los diferentes métodos ...