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Publication Open Access Factors Associated with Contraceptive Practice among Hmong Hill Tribe Women in Nan Province(2016) Punpaporn Srirai; Somsak Suthutvoravut; พรรณปพร ศรีหร่าย; สมศักดิ์ สุทัศน์วรวุฒิ; Mahidol University. Faculty of Medicine Ramathibodi Hospital. Department of Obstetrics and GynecologyBackground: Hill tribe women in Thailand still have high crude birth rate with low rate of contraceptive use. This leads to poor quality of life and poor societal development. Objective: To study the rate and factors associated with contraceptive practice among Hmong hill tribe women in Nan Province, Thailand. Methods: This research is a cross sectional survey study. Data was collected by self-administered questionnaire from 284 married Hmong hill tribe women aged 15-44 years old. Results: We noted 56% of the Hmong hill tribe women of reproductive age used contraceptives; 41.6% used modern methods, while 14.4% used traditional methods. By univariate analysis, the factors significantly associated with contraceptive practice included age, income, easy accessibility to the contraceptive services, cheap contraceptive service, receiving advice from health personnel, satisfaction of contraceptive services, ever attended education class of contraception and ability to advice other people about contraception. When multiple logistic regression analysis was applied, age, easy accessibility to the contraceptive services and satisfaction with contraceptive services were independently associated with contraceptive use. Conclusions: Rate of contraceptive practice among Hmong hill tribe women of reproductive age in Nan Province was still low and significantly associated with accessibility, understanding and attitude toward contraception and satisfaction with service which enable them to advise others people about contraception. Thus, contraceptive service should be actively improved and developed which included education and promotion of knowledge of contraception to the Hmong Hill tribe women.Publication Open Access Factors Associated With the Use of Subdermal Etonogestrel Implants Among Postpartum Primipara Adolescents(2018) Watcharee Rueankhong; Somsak Suthutvoravut; Jirat Tangthitiwong; วัชรี เรือนคง; สมศักดิ์ สุทัศน์วรวุฒิ; จิรัตน์ ตั้งฐิตวงศ์; Mahidol University. Faculty of Medicine Ramathibodi Hospital. Department of Obstetrics and Gynecology; Health Promotion Center 13Background: In Thailand, there has been a high incidence of adolescent pregnancy which leads to major public health and socioeconomic problems such as unplanned pregnancy, induced abortion and negative impacts on the health of the mothers and newborns. Contraception among adolescents is so important that it can prevent those problem, especially subdermal etonogestrel implant which are recommended to be effective and suitable for adolescents. Objective: To study the rate of use and factors associated with the use of subdermal etonogestrel implants among postpartum primipara adolescents in Saraburi province. Methods: This study is an observational descriptive research. The population were 106 primipara adolescents at 4 - 6 weeks postpartum period at three hospitals in Saraburi province (ie, Saraburi Hospital, Pra-putabat Hospital, and Banmoh Hospital). Data was collected by interviewing postpartum primipara adolescents from March 21, 2016, to June 30, 2016. Data was analyzed by descriptive statistics which included frequency, percentage, mean and stranded deviation. Test of hypothesis was done by chi-square test, Fisher’s exact test and multiple logistic regression analysis with the significant level at P < 0.05. Results: Among 106 postpartum primipara adolescents, 93.4% used contraceptives (31.1% used subdermal etonogestrel implant; 62.3% used other reversible contraceptions [eg, depot medroxyprogesterone acetate injection, oral contraceptions and condoms]), and 6.6% used no contraception. By univariate analysis, factors significantly associated with the use of implant among primipara adolescents included age of primipara adolescents, age of husband, expense, convenience of use, side effects, application pain, duration of contraception and medical personnel’s recommendation. When multiple logistic regression analysis was applied, only four factors were significantly associated with the use of implant. The most significant factor was medical personnel’s recommendation. The other significant factors were expense, age of husband and duration of contraception. Conclusion: Most of primipara adolescents at 4 - 6 weeks postpartum period in Saraburi province used contraceptives. Subdermal etonogestrel implants was the second most common contraceptive used. The most important factor for the use of implant was medical personnel’s advice which emphasized on the use of implants in order to prevent unplanned pregnancy among adolescents.