Acceptability of Norplant at a well-woman clinic in Turkey.
OBJECTIVE
To make an assessment of the acceptability and cost of subdermal implants, a new method in Turkey, in a free-choice environment.


METHODS
The records of women attending a university well-woman clinic in Istanbul, Turkey, were analyzed retrospectively. Among other contraceptives registered in the country, the women were offered subdermal contraceptive implants (Norplant) during counselling sessions. The women who chose implants were invited to attend for follow-up three times during the first 12 months and were advised to return annually thereafter. An estimation of cost was performed for Norplant, using the government price of the implant and the wage rates of public-sector staff. An estimation of cost was also performed for oral contraceptives.


RESULTS
Among the 5650 women who applied to the Clinic for contraception between 1 January 1995 and 31 December 1998, 274 women decided to use implants, giving an initial acceptance rate of 5.1%. Continuation rates were 91.8%, 71.6% and 42.5% at 12 months, 24 months and 36 months, respectively. There were no pregnancies within the study period. The only demographic characteristic that was positively related to the acceptability of Norplant was younger age. The cost of contraception with Norplant was found to be lower than that for oral contraceptives.


CONCLUSIONS
The high initial acceptance and continuation rates, combined with its high efficacy, make Norplant a valuable tool for Turkey's National Family Planning Program. Contraception with Norplant is also a cost-effective method, at least for the public sector.
Ortayli
N
N
Woman and Child Health Training and Research Unit, Medical School of Istanbul, Turkey.
Amca
B
B
Say
L
L
Bulut
A
A
D000328:Adult; D003280:Contraceptives, Oral, Synthetic / Q000191:economics; D003362:Cost-Benefit Analysis; D004343:Drug Implants; D005260:Female; D006801:Humans; D016912:Levonorgestrel / Q000191:economics; D015993:Life Tables; D016015:Logistic Models; D010342:Patient Acceptance of Health Care; D010349:Patient Compliance; D012189:Retrospective Studies; D014421:Turkey
D003280:Contraceptives, Oral, Synthetic; D004343:Drug Implants; D016912:Levonorgestrel