Women find contraceptives hazardous

Women find contraceptives hazardous

JAKARTA (JP): Many women using long term contraceptives --
like IUDs -- are having health problems and could be dropping out
of the family planning program, a leading doctor says.

Azrul Azwar, the chairman of the Indonesian Medical
Association, said his survey also found complaints about
discomfort among women who use long term contraceptives.

The most often cited health complaints were bleeding and
irregular menstruation, he said.

Although many of these women may have switched to short term
contraceptives, Azrul did not rule out the possibility that some
have dropped out of the family planning program.

"If that is the case, it would jeopardize the government's
family planning program," he told The Jakarta Post yesterday.

Azrul, who wrote a dissertation on the subject for his
doctorate last month, said the solution is for family planning
doctors and extension workers to provide better service.

"The quality of service for long-term contraceptive users is
crucial because it affects a woman's health," said Azrul, who
also sits on the executive board of the Indonesian Association
for Secure Contraception.

He said efforts to improve service have not been satisfactory.

According to a 1995 survey by the National Coordinating Family
Planning Board, 22 percent of the 23 million Indonesian women in
the program used IUDs, another 8 percent used implants and 6
percent were sterilized.

The pill and injections are still the most popular
contraceptive methods, each accounting for 32 percent of the
total.

Azrul warned that unless something is done to improve medical
service, the medical profession and the government could face
legal problems.

With Indonesians now becoming more assertive about their legal
rights, the medical profession could face expensive malpractice
suits, he said.

Azrul's assertion was supported by a survey by the family
planning board which shows increasing health complaints among
long-term contraceptive users.

The survey showed that in 1990/1991, as many as 55 percent of
the participants complained. The figure rose to nearly 60 percent
the following year, and to 62 percent in 1992/1993. Complaints of
discomfort averaged 28 percent.

Azrul's thesis said family planning doctors and extension
workers should be more involved in the surveys and planning long
term contraceptive services.

The services involve a continuing process that depends on
facilities, standards and skill, he said.

Family planning doctors and nurses should learn quality
control, he said. Hospitals directors and their entire staff
should also be trained in running the long term contraceptive
programs, including the rights and obligations of their
establishments.

Azrul said most hospitals neglect quality control, including
the provision of services for long term contraceptive users.

Lack of pressure from the government and the public, who
remain ignorant of their rights, allows hospitals to ignore
quality. (31)