***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Past efforts to promote  family planning in Pakistan have been disappointing , but between 1990 - 91 and 2000 - 01 contraceptive use has more than doubled . This rise has coincided with a concerted effort on the part of the Pakistani government to increase access to contraceptive services , particularly in rural areas . The Lady Health Worker Programme ( LHWP ) , initiated under the Ministry of Health in the early 1990s , aim ed at integrating family planning into the doorstep provision of primary health care . This paper presents findings from the first national evaluation of this Programme . Data are analyzed from a r and om sample survey of 4277 women living in households served by the LHWP and those living in control areas .  Logistic regression analysis was performed to determine the effect of the Programme on the uptake of modern reversible contraceptive methods  , controlling for other independent variables . The data provide strong evidence that the LHWP has succeeded in increasing modern contraceptive use among rural women . Women served by Lady Health Workers are significantly more likely to use a modern reversible method  than women in communities not served by the Programme ( OR=1.50 , 95 % CI=1.04 - 2.16 , p=0.031 ) , even after controlling for various household and individual characteristics . The model of providing doorstep services through community-based female workers should remain central to achieving universal access to safe family planning methods  by the end of the decade -- the long-term objective of Pakistan 's most recent population policy adopted in 2002 This pilot study conducted in Muzaffarnagar district in the state of Uttar Pradesh , India , demonstrates the potential for using traditional medical practitioners in the delivery of  family planning services after a brief training period . Practitioners participated continuously in the program for an intervention period of two years during which their services were accepted by the community . The impact of their involvement was reflected in increased knowledge of permanent as well as reversible contraceptive methods and in higher contraceptive use rates , especially of reversible methods adopted by women younger than 25 years ( from 8 percent to 37 percent ) , in the intervention villages , as compared with increased knowledge and use ( from 13 percent to 25 percent ) of permanent methods alone in the control villages In response to the concept that a good postpartum program should begin prenatally , this study was design ed to determine whether the provision of expert contraceptive counseling during the antenatal period would have an impact on contraceptive uptake , patterns of contraceptive usage , and pregnancy rates during the first year after childbirth . Over 500 women attending antenatal clinics in each of three centers ( Edinburgh , Scotl and ; Shanghai , People 's Republic of China ; Cape Town , South Africa ) were r and omized to receive expert contraceptive advice ( participants , n = 771 ) or the st and ard advice routinely given in that setting  ( controls , n = 866 ) . Follow-up was by postal or interviewer-administered question naires at 16 and 52 weeks after childbirth . There were no significant differences in the prevalence of contraceptive use at one year ( over 79 % in all centers ) between participants and controls . In Edinburgh , participants were more likely to undergo sterilization ( p < 0.01 ) than controls , otherwise there were no differences among Edinburgh , Shanghai , or Cape Town in either the methods of contraception chosen or in the methods used over time . Contraceptive counseling delivered antenatally appeared to have no impact on the pregnancy rate during the first year after childbirth . In Shanghai , over 11 % of women in both groups underwent termination of pregnancy in the year of follow-up . In conclusion , although women in all centers said they found the opportunity to discuss contraception antenatally was useful , it had very little effect on contraceptive use or on subsequent pregnancy rates Objectives To assess the profile of  long-acting reversible contraceptives ( LARCs ) users in Europe . Methods A r and om sample of women aged 15–49 years in 14 European countries ( Germany , France , UK , Spain , Italy , Russian Federation , Estonia , Latvia , Lithuania , Austria , Czech Republic , Denmark , Norway , and Sweden ) underwent web-based or computer-aided face-to-face interviews in June 2006 . In this paper data pertaining to a subgroup of women using  LARCs are presented . Results A total of 11,490 women participated in the full study . Of these , 1,188 ( 10 % ) women were LARC ( hormonal implant , injectables , levonorgestrel-releasing intrauterine system [ LNG-IUS ] , copper intrauterine device [ Cu-IUD ] ) users . The age of the  LARC users exceeded 30 years for 57–91 % of them . Furthermore , more than half of them found convenience an extremely important factor when selecting the LARC as a contraceptive method . As compared to those wearing a Cu-IUD , women using hormonal LARCs experienced fewer physical and emotional symptoms that appeared or worsened during menstruation . Conclusions LARCs have their place in the contraceptive market in Europe . The most popular LARCs among European women were the LNG-IUS and the Cu-IUD ; both were mainly used by women who had children and had no wish to have more in the future BACKGROUND The study was conducted to determine the impact of counseling and educational leaflets on contraceptive practice s of couples . STUDY DESIGN R and omization of 600 women was done in two groups matched for age , parity and socioeconomic status at the Department of Obstetrics and Gynaecology , Shifa Foundation Community Health Centre , Shifa International Hospital , Islamabad , Pakistan . In Group A , the intervention group was exposed to contraceptive counseling and educational leaflets in the postnatal ward after delivery , whereas in Group B , the nonintervention group was not given any formal contraceptive advice . Later on , both groups were assessed regarding their contraceptive practice s. RESULTS At their follow-up visit ( 8 - 12 weeks ) postpartum , 19 ( 6.3 % ) women in the nonintervention group had started contraceptive use , whereas 153 ( 50.8 % ) had decided to start contraception in the next 6 months , and 129 ( 42.8 % ) women were still undecided . The main contraceptive user was the male partner ( n=117 , 38.8 % ) , and the most common method used was coitus interruptus ( n=62 , 36.3 % ) . In the intervention group , 170 women ( 56.9 % ) had started using contraceptives , whereas 129 ( 43.1 % ) had decided to start contraceptive use in the next 6 months . The predominant contraceptive user was the females ( n=212 - 70.9 % ) , and the most popular method chosen was oral contraceptive pills ( n=111 , 37.1 % ) . CONCLUSION There is a definite increase in contraceptive uptake in women provided with educational leaflets and counseling session with a shift toward use of more reliable contraceptive methods BACKGROUND Brazilian women who have undergone abortion use contraceptive methods ; however , their use of contraceptive methods is inconsistent and /or inappropriate . STUDY DESIGN This r and omized trial evaluated the effectiveness of a personalized counseling on contraceptive acceptability and its use for postabortion women in the northeast of Brazil . It was conducted in July 2008 to September 2009 , enrolling 246 women r and omly distributed in intervention ( n=123 ) and control ( n=123 ) groups . An intention-to-treat analysis was performed . RESULTS In the follow-up , 98.4 % women in the intervention group were using contraceptive methods compared with 70.6 % women in the control group ( p<.001 ) . The probability of adherence and of the use of any kind of contraceptive method 6 months after the abortion was 41 % greater in the intervention group . CONCLUSIONS The strategy on individualized contraceptive counseling increased the acceptance and the use of contraceptive methods and increased the adequate use of the methods Objective Despite the availability of free contraception from family planning clinics , the rate of unwanted pregnancy in Iran is still high . The effectiveness of other methods for contraceptive supply should , therefore , be evaluated . The aim of this study was to determine the effects of community-based distribution ( CBD ) on contraceptive usage in Iran . Methods This controlled field trial study involved 297 individuals ( 100 subjects in the CBD group and 197 subjects in the control group ) from four major remote areas of Hamedan , Iran . Stratified r and om sampling was used . Results Data analysis suggested that using CBD has four major effects : ( 1 ) it increases the level of contraceptive knowledge ( p<0.0001 ) , ( 2 ) it enhances correct contraceptive choice by couples ( p<0.0001 ) , ( 3 ) it improves contraceptive usage ( p<0.0001 ) and ( 4 ) it improves contraceptive continuation rates ( p<0.0001 ) . Conclusions CBD facilitates better knowledge , proper choice , and correct and continuous usage of contraception . This method should , therefore , be adopted for family planning services in remote areas of Iran The impact of antenatal counselling on  couples '  knowledge and practice of contraception was investigated . An interview question naire was used before and after conducting counselling sessions with 200 pregnant women and 100 spouses . The participants were followed up immediately after delivery and 3 months later . Both the control and study groups displayed a lack of knowledge of contraception . Counselling sessions improved the couples ' knowledge and practice in the study group . Involving husb and s in family planning counselling sessions led to joint decisions being made and encouraged women 's use of contraception . The majority of couples retained most of the information given . Integrating family planning counselling into antenatal care in all facilities and involving the husb and are recommended OBJECTIVE Early postpartum home visiting is universal in many Western countries . Studies from developing countries on the effects of home visits are rare . In Syria , where the postpartum period is rather ignored , this study aim ed to assess whether a community-based intervention of postnatal home visits has an effect on maternal postpartum morbidities ; infant morbidity ; uptake of postpartum care ; use of contraceptive methods ; and on selected neonatal health practice s. DESIGN A r and omized controlled trial was carried out in Damascus . Three groups of new mothers were r and omly allocated to receive either 4 postnatal home visits ( A ) , one visit ( B ) , or no visit ( C ) . SAMPLE A total of 876 women were allocated and followed up . INTERVENTION Registered midwives with special training made a one or a series of home visits providing information , educating , and supporting women . RESULTS A significantly higher proportion of mothers in Groups A and B reported exclusively breastfeeding their infants ( 28.5 % and 30 % , respectively ) as compared with Group C ( 20 % ) , who received no visits . There were no reported differences between groups in other outcomes . CONCLUSIONS While postpartum home visits significantly increased exclusive breastfeeding , other outcomes did not change . Further studies framed in a nonbiomedical context are needed . Other innovative approaches to improve postnatal care in Syria are needed 
    Output:
    
Community-based interventions and antenatal contraceptive counselling improved uptake of copper-IUD  in studies mainly conducted in developing counties .