An Intervention Study Of Contraceptive Generalization In Floating Population

[BACKGROUNDS] In recent years,the number of floating population has increasedsharply.It has promoted the progress of social and economy,while it has broughtgreat problem to family planning management and service.The majority of thefloating population are young,poor-educated and reproductively active.And theircontraceptive knowledge are relatively poor,which has resulted in their lack ofconsciousness and capability in the choice of contraception.When the floatingpopulation has changed its reproductive will and has more needs in reproductivehealth and contraception,we have to study effective generalization of suitablecontraception.In a stable and low reproductive level,it is important to providefloating population better reproductive health service.[OBJECTIVES] A series of intervention have been implemented according to theexamination of reproductive will,contraceptive knowledge,contraceptive applicationand service demands from floating population to find the possible effective ways toimprove subjects' contraceptive knowledge,their practice of informed choice and thecapability of self-choice.Thereby explore an appropriate model to generalize effectivecontraceptives in floating population is quite necessary.[METHODS] An comprehensive intervention has been implemented in MinhangDistrict,Shanghai.Four factories,four construction sites and four entertainmentplaces with similar scale were chosen.Then they were randomly assigned tointervention group and control group.In the intervention group,a series ofintervention measures including qualified advocation,management,education,propaganda,integrated sexulity and reproductive health counseling,professionalservice,following up and referred if necessary were implemented,while routinefamily planning work was conducted for clients in the control group.By questionnairesurvey,focus group discussion among floating population,FP managers,serviceproviders and indepth interview among policy makers,the researchers have evaluatedthe impacts of intervention on subjets' knowledge,practice,needs of contraceptiveand the influence factors and found the advantages and disadvantages of familyplanning management and service among floating population.Then an effectivecontraceptive model can be explored in floating population.[RESULTS] 1.General information All together,2001 subjects were enrolled in the baselinesurvey,and among whom 989 were in the control group and 1012 in the interventiongroup.There were 1791 subjects who were investigated in evaluation survey with 881in the control group and 910 in the intervention group.The follow-up rate was89.51%.2.The demography and floating characteristics of subjects Mean age of themigrants was 29.50(±8.336) years.About 22.33% of them were between 25～30 years,and 59.82% of them were female.About 78.61% of them were married or withsexual experience.54.17% of them had middle school education.There were nosignificant difference between intervention group and control group in age,work site,education experience and registered residence.Subject lived in every place for morethan half a year and the cumulative time for their living in Shanghai has been longerthan half a year.Their main way of migration was to move with whole family,whichoccupied about 70%.3.The subjects' willings of reproductive About 65.53% of the subjects expect 2children and 26.05% of them expected 1 child.Only 5.37% of them expect more than3 children.Most of the subjects had no significantly gender tendency for children.About 64.93% of them expected the number of girls from the number of boys was 0.Only 1.86% of the subjects expected the number of girls from the number of boys wasmore than 2. And the rest the number of girls from the number of boys was 1 or -1.4.The subjects' poor contraceptive knowledge They understood condom best.And the next was the knowledge of oral prophylactic and sterilization.But all scoresfor the contraceptive were less than 60 score.Only 10.24% of the subjects had a totalscore of more than 60 for nine contraceptives.Only 31.83% of them had a score ofmore than 60 for the contraceptive they used now.5.The high proportion of the subjects who currently use contraceptive,but onlysmall part of them chose contraceptive by themselves About 94.96% of thesubjects used contraceptive.But only 21.04% of them chose the method bythemselves.The main contraceptive they used was IUD (51.00%).And the next wascondom (24.96%).6.The effective intervention to improve the subjects' contraceptive knowledge remarkably The intervention group and control one had no significant difference incontraceptive knowledge score in baseline survey.However they were significantlydifferent as the intervention implemented.The media of the total score of the controlwas only 27.78 and the intervention group was 59.26 during the evaluation survey.They were significantly different.Median of the different value of two survey of theintervention group was 27.22,of the control group was 6.852,which was significantlydifferent (p＜0.0001).7.The effective intervention to promote the subjects' practice to seekreproductive health counseling During the study,29.64% of the subjects inintervention group have got face-to-face counseling service,while only 11.45% of thecontrol group had the service.There were significant difference between them [OR:2.802,95% CI:(2.190-3.584)].And marital status,education,work site and censusregister were potential impact factors.The migrants whom were unmarried,poor-educated,worked in the place of entertainment and came from the east of Chinahad more probability to seek counseling service compared with them who weremarried,high-educated,worked in the place of construction and camed from the restof China.8.The significant associations among knowledge,practice and the willings ofreproductive The analysis of the association between subjects' knowledge,practiceand requirement and reproductive will show that improve of subjective' contraceptiveknowledge could promote their capability of self-choice of contraceptive.Thus theycould make decision for the appropriate contraceptive for themselves or they couldseek counseling to meet their personal needs.Then the use rate and effective rate ofcontraceptive could be increased.9.A number of advantages and disadvantages that might influence theimplementation of appropriate contraceptive related services The advantagesincluded:support of policy,well-running of FP network,professional FP serviceworkers and increased consciousness of reproductive health of the floating population.The disadvantages of included:insufficient service providers,inadequate education ofknowledge,lack of consciousness and skill of individual service and the clients' poorunderstanding of the information.[CONCLUSIONS] Intervention activities increased people's knowledge of contraceptive,promoted their practice and met their needs on reproduction health.Thus they could make self-choice of appropriate contraceptive.Then suitablecontraceptive could be generalized in floating population.The long-term effects of theintervention for the generalization of suitable contraceptive in floating populationshould be further evaluated.