Contraceptive implant study not complete yet

JAKARTA (JP): The National Family Planning Board has delayed the introduction of one-pellet implants called Implanon pending the result of further study by the University of Indonesia.

"The study by the university's School of Medicine is not complete yet," Elizabeth Kuji, of the board's contraceptives bureau, said on Thursday.

Implanon, a contraceptive for a period of up to three years, was originally planned to be launched late last year as an alternative to Norplant, a six-pellet implant designed as a five- year birth control method.

Norplant is now used by some 1.5 million out of 20 million women using contraceptives in Indonesia since its official use in the national family planning program in 1987.

"After the study is completed we still have to seek approval from the Ministry of Health," Kuji told The Jakarta Post.

She was responding to questions on the plan of the National Family Planning Board (BKKBN) to introduce a new type of implant with two pellets from Finland, which was raised on Wednesday in a hearing at the House of Representatives.

The Board's deputy, Loet Affandi, assured members of the Commission VIII which oversees health issues that the government would not rush the introduction of the new contraceptive.

"The government is not reckless in selecting contraceptives," he said in response to a question from Khofifah, a member of the commission who expressed concern for the safety of women regarding the use of the new implant.

"We request BKKBN place emphasis on the safety of women in introducing this new method," Khofifah said.

Kuji said the implants with fewer pellets will be more practical for those who want two to three years of birth control.

The BKKBN officials said "relatively few" complaints have been reported related to the use of Norplant, a hormonal contraceptive like the pill and injections.

Kuji said that irregular menstruation is one of the complaints of implant users, which must be reported.

Loss or addition of weight are other effects. "Reports of headaches may only be psychological and can be treated through counseling," she said.

Researchers said some of the problems regarding contraceptive usage often originate from the lack of information given by medical and non-medical staff and field officers who administer implants and other contraceptives.

Very often, they neglect basic requirements on applying birth control methods, such as prior examination of a woman's physical condition and counseling.

Implants, for instance, are not recommended for women with hypertension, the researchers said.

Endah Triwiati of the Center of Women Studies at the University of Indonesia said a study conducted last year on reproductive health revealed that "there were no follow-up examinations" on women using various birth control methods.

The study, which she said is near completion, involved 100 respondents in rural and urban areas including North Sukabumi and Lembang in West Java and Jagakarsa in South Jakarta.

"Respondents had little information on birth control choices. Those who reported complaints such as dizziness continued using contraceptives because they were afraid of getting pregnant," Triwiati said.

"None of the couples used condoms; the women are in a low bargaining position," she added.

The Kalyanamitra Foundation is also planning studies on women using Norplant.

"Studies are necessary, due to the government's preference for contraceptives designed for longer periods of birth control and less frequent needs for examination, compared to other methods," said Ita Fatia Nadia of the Foundation.

She referred to a 1992 study on the use of Norplant in West Sumatra, conducted by the Andalas University of Padang for BKKBN, which also revealed shortcomings in the staff authorized to administer contraceptives.

It was found that among 156 doctors, midwives and field officers, 62 percent attended trainings on inserting implants but only 49 percent learned how to remove them.

And only 8.5 percent knew that Norplant is no longer effective after five years, according to the survey. (anr)