From 1987 to 1997, approximately four million Indonesian women had a Norplant insertion. Concerns have been raised about the timely removal of the implant within a few days of the user's request or at the end of the recommended five years of use and about the possibility of a large and rapidly increasing backlog of removal cases developing. This study of 2,979 Indonesian women in 14 provinces, all of whom had had Norplant inserted five or more years before they were interviewed, reveals that 66 percent had obtained removal by the end of the fifth year of use and 90 percent had done so by the end of the sixth year of use. The data from this study strongly suggest that no large backlog of removal cases exists, particularly after the sixth year of use. The major reason for the underreporting of removals is probably clients' use of nurse/midwives, of caregivers in the private sector, and of mass safari camps, because records from each of these sources are poor or nonexistent.

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This handbook has several objectives and uses. First, it is designed to help HIV/AIDS researchers develop and write a detailed operations research proposal. An appropriate use of the handbook is as a resource in workshops or courses on research design and proposal development. Thus, the organization of the handbook follows that of a research proposal, starting with identifying, defining, and justifying a research problem, and ending with how to prepare a budget. Although the handbook is not an academic textbook on research methods, it does provide a review of many key concepts and important methods essential for conducting HIV/AIDS field research studies. These features can also help HIV/AIDS program administrators and managers as well as health policymakers understand the process of operations research and the uses of research findings to improve HIV/AIDS service delivery. Most examples were drawn from HIV/AIDS operations research studies conducted in Africa, Asia, and Latin America by the Horizons program, a global HIV/AIDS operations research program funded by USAID and implemented by the Population Council.

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