Family planning in Sik

Family planning.

Date: 7/7/09
By: Ketua Jururawat Masyarakat- Nur Aziah Ismail
Blogged by: Mark Paul

Aim of family planning is to space out pregnancies.

Benefits to mother: prevent maternal depletion syndrome, provide sufficient time for mother’s body to replenish stores; able to provide sufficient attention and care to each child.some mothers have heart disease or autoimmune diseases such as SLE, which require longer spacing as pregnancy worsens the disease and can lead to maternal death.
Will not be a burden to mothers if pregnancies are spaced out.

Benefit to child: able to get sufficient attention and care from mother. Prevents IUGR and small for gestational age (SGA).

Main age group of users in Sik: women/mothers of 20-35 years old.

How: staff nurses and the community nurses ( jururawat masyarakat) give the mothers counseling about family planning and contraception during antenatal period and also postnatal period.The counseling is given to the mothers and their husbands.They even hold small talks to the couples, to educate them about family planning. It is done from time to time. The ultimate choice of to use contraception or types of contraception used lies on the couple’s decision.

Methods: male condoms- are commonly used method. Couple comes to KKIA twice a month, each visit they get 12 condoms, that is 24 condoms per month.
oral contraceptive pills- combined and progesterone only pills- COCP, POP. In terms on medication, COCP is the most common among pills, depo-provera IM injectios and Multiload copper IUCD.

COCP used in Sik are Regivedon, Marvelon. Starts 42 days after delivery or when menstrual cycle starts. Not used if candidate have risk factors or history of heart disease, thromboembolism, breast and ovarian cancer.

POP used is Noriday- commonly used if mother is still breastfeeding. Starts by 0-6 months after delivery; COCP causes non-lactation..

Both COCP & POP are available in all KK and KD is Sik. Can be started by staff nurses, community nurses, MOs, FMS. Before starting them on pills, an extensive history is taken regarding the heart diseases, breast problems, thromboembolism.

Depo provera injections via IM lasts for 3 months, also available in all KK & KD in Sik. Can be administered by staff nurses, community nurses, MOs, FMS.

IUCD is only available in KK Jeniang (because FMS is stationed there) and KKIA Sik (by MO or FMS only). Can’t be administered by nurses.
The IUCD used here is Multiload copper IUCD, its market value is rm 250. Mirena is RM500, therefore it is not used. Suitable for women who tend to forget.
IUCD lasts for 3 years. It is inserted 42 days after delivery or 5 days after mensus begin. First, US scan is done to measure the cervix length, based on that measurement, the applicator length is adjusted too. Upon insertion, US scan is done again to determine if it is correctly placed. A review is done 6 weeks later using US scan. After that, annual review is done. It is only removed when 3 years period expired or when mother plan to get pregnant.

All methods are provided free by KK & KKIA & KD.

For women who is having heart disease, renal failure, SLE and others, which pregnancy worsens the disorders, they will require Norplant or Implanon, lasts for 5 years, to be done in LPPKN clinic in Sungai Petani and Baling. The couple bear the costs.

JM Suraya says family planning is very well accepted by the people of Sik and she says it is working well.

The financial allocation is provided by finance unit of PKD, the Sister buys the stocks from either the supplier, or via government tender. From KKIA Sik, she distribute them to the other KK and KD.

Unfortunately, there is no NGO operating in this field in Sik.