Oluwatosin(
Tosin) Onibokun, MD
Resident in OB/GYN, BWH/MGH
Combined Residency Program
PGY 3
While
at the University College Hospital (UCH), I had a chance to observe clinical
work at the family planning clinic.
Hallway at the Family planning clinic at the University College Hospital (UCH) |
I was impressed by the major role the nurses played in the counseling and provision of contraception to women. Contrary to the norm in the United States, insertions of reversible long acting contraception were managed by the nurses at the family planning clinic (including placement and removal of contraceptive implants and intrauterine devices) with doctors available for back up as needed (which appeared to rarely happen).I think the training and empowerment of nurses in this area is very laudable and the right step towards expanding
Posters in family planning clinic promoting promoting contraception use as a form of child spacing |
Of
note, all reversible long-acting contraception ( IUDs and implants) provided at
the family planning clinic at UCH are fully funded by the Nigerian Urban Reproductive
Health Initiative (NURHI), which is a project funded by the Bill and Melinda
Gates Foundation with the goal to eliminate the supply and demand barriers to
contraceptive use in Nigeria, a very laudable and inspiring goal. The patients
only pay a nominal fee to pay for the cost of syringes, needles and local
anesthesia. This highlights to me the
role of philanthropy in making an immense significant impact in the lives of
people and nations.
I
think the available funding explains why I saw more implantable contraception
devices inserted into patients than I initially expected given their relatively
high cost in the United States.
On
the other hand, it was also interesting to note that the public awareness
campaigns regarding contraception (with the exception of condoms) is skewed
towards helping married women ensure adequate spacing between children and less
as a way to prevent unwanted pregnancies in young unmarried women who are
sexually active. This skew can be noted in the pictures that advertise
contraception use. However, I think it
is important to modify this rhetoric so that young women, married or not and
parous or not, can have equitable access to effective contraception.
In
summary, it was a great learning experience to observe the efforts at improving
access to contraception in a Nigerian setting, a cause I hope to continue to be
involved in as an OB/GYN.
Oluwatosin(
Tosin) Onibokun,
OB/GYN
Resident PGY 3
BWH/MGH
Combine Residency Program
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