Implants will help reduce baby deaths, says doctor

By DOROTHY MARK
CONTRACEPTIVES such as implants are the most effective approach to reducing maternal mortality, Madang-based gynaecologist Dr John Bolnga says.
Bolnga made presentation at the 54th medical symposium in Madang yesterday on how the implants were effective in family planning.
He said PNG had a high maternal mortality ratio (MMR) in the Asia-Pacific region with a low contraceptive prevalence of 36.5 per cent and high unmet family planning needs.
Bolnga said the institutional MMR had been hovering around 300 per 100,000 LB and a PNMR of 33/1000 births.
“As you can see from one of our correspondences with Lancet GH, we have made progress with our MMR despite the geographical remoteness of the rural population. But it still remains a struggle every day,” he said.
“Therefore, as we all know that family planning, particularly long-acting contraceptives such as implants, is the most effective approach to reducing the maternal mortality,” Bolnga said.
Bolnga said World Health Organisation estimated that unintended pregnancies maybe reduced by 50 per cent and maternal deaths from unsafe abortion would be decrease by 90 per cent in the next decade with improved access to contraceptives.
He said the contraceptive implant was hormone-based and highly effective family planning method approved in more than 60 countries and used by millions of women around the world.
“The typical implant is a small flexible tube measuring about 40mm (like match stick) in length and is inserted under the skin (typically in the upper arm),” Bolnga said.
“It prevents pregnancy for up to four-five years by releasing progesterone hormones that prevent ovulation and thickens cervical mucus hindering sperm entry,” he said.
Bolnga said in PNG the most common version introduced in 2012 was the two-rod levonorgestrel implant or Jadelle as commonly known.
Implant has been employed fragmentally via local health and non-governmental services since 2012 but with no proper clinical background data, follow-up and therefore its uptake, continuation and acceptability in the community remain unknown.
Bolnga said recently Gupta et al surveyed 860 women 12 months after insertion in Karkar Island in Madang and saw that there were good uptake, continuation rates and less side effects reported.
“Implant is now a very commonly sought family planning method right across the country,” he said.
“However, despite its popularity, more recently a lot of patients have reported to Modilon General
Hospital seeking to have their implants removed for different reasons and because we do not have any data as yet in the country and very less information is
available in the region for reasons for early contraceptive implant removal, we conducted this study,” Bolnga said.