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Call for rethink on best contraception
LARCs may be the answer to reducing unintended pregnancies, AHHA argues.
Despite the widespread use of contraceptives, unintended pregnancies remain a significant health issue that needs to be addressed by both clinicians and patients, the Australian Healthcare & Hospitals Association( AHHA) says.
Its chief executive, Alison Verhoeven, said long-acting reversible contraceptive methods( LARCs) could be the answer, and to discuss this possibility, the AHHA held a workshop and released a consensus statement on the topic.
“ When we talk of LARCs we mean progestogen-only implant and hormonal and copper intrauterine devices( IUDs),” Verhoeven said.
“ The uptake of LARCs is low in Australia— yet clinical and other experts, both here and internationally, recommend them as the most effective reversible contraceptive, within the context of informed choice. The release of the contraceptive pill in 1961 led to huge changes in women’ s lives as they assumed control over
their reproductive future. The pill continues to be used widely— estimates for the primary contraceptive method for Australian women are that 33 per cent use oral contraceptives, 30 per cent condoms, and 19 per cent sterilisation.
“ But despite this, unintended pregnancy remains a significant health issue. Around 60 per cent of Australian women who have had an unintended pregnancy were using contraception— most notably the pill( 43 per cent) and condoms( 22 per cent). The problem with the pill was usually a missed dose.
“ Although they will not suit everyone, LARCs are a more effective, less user-dependent method of contraception.”
Verhoeven said there was still some way to go before LARCs could be used as a genuine contraception alternative, and healthcare providers needed to take great care to help consumers understand their options.
“ There are several barriers to best-practice contraceptive management for women in Australia, ranging from lack of knowledge and support systems among consumers and professionals to financial barriers,” she said.“ Participants at our workshop felt that all levels of government across the health, social and education sectors, as well as consumers, health professionals, and professional colleges and associations, had roles and responsibilities in reducing unintended pregnancies.
“ As a first step, women must be supported to make an informed choice about contraception. This starts from secondary school age onwards, through mechanisms such as education programs in schools and national clinical guidelines.
“ Then, changes to financing and models of care are needed to ensure equitable access to LARCs. This includes MBS items for insertions and removals that adequately reflect the cost of providing the service, as well as taking into account the public health benefit.”
Verhoeven said training programs in implant and IUD insertion and removal needed to be made readily available for health professionals. ■
USC nursing students Antonija Monckton, Laura Keldoulis, Emma Kendall and Amanda Keldoulis.
Nursing students head to Java village
International placement program will challenge students to think on their feet.
The University of the Sunshine Coast’ s first accredited international nursing placement will see students take their medical skills to rural villages in Indonesia.
One of 20 students selected for the trip, midwifery and nursing student Emma Kendall, said she hoped to be able to grow as a professional when she takes on the three-week clinical placement in Java.
Kendall hopes to make a lasting impact on rural villagers from the Indonesian island of Java when she takes part in the university’ s first accredited international nursing placement.
“ With limited resources, we will have to think both on our feet and outside the box, and find ways to safely improvise in some situations,” she said.“ I hope by helping to educate villagers about the prevention and management of health conditions, we can leave a lasting impression on those we visit.”
The group will be accompanied by USC senior lecturer in nursing Dr Debbie Massey and lecturer in nursing Matt Mason.
Mason said USC’ s first overseas nursing experience will allow students to gain credit towards their degree, while making a longterm, sustainable contribution to rural communities.
“ The students will spend time in three Javanese villages near the historical World Heritage-listed city of Yogyakarta, where they will overcome cultural, language and social barriers to gain a different perspective on nursing care and health education,” he said.
Students will provide everything from house calls to basic wound care and injury management to health assessments.
They will also conduct health education workshops for local schools, health workers and community members. ■
6 | nursingreview. com. au