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Objective To determine the intrauterine contraceptive device (IUD) discontinuation rate and its causes and related factors among women attending UNRWA health centres in Jordan. MethodsThe study cohort comprised 371 women who had an IUD inserted during 1997 and who were interviewed during their visits to the health centres in the period January-March 2003. The main outcome measure was IUD discontinuation. ResultsThe incidence of IUD discontinuation in the first year following insertion was 17.5%. Approximately 32% of the study sample continued using their devices after 5 years. The average duration of IUD use was 36 months. Of the 371 women, 39.6% discontinued IUD use because of a desire to conceive, 18.6% because of side effects, 4.9% because they were sexually inactive and 1.6% because of opposition from the woman's family. The most common side effects reported as reasons for discontinuation were bleeding, infection and pain. Discontinuation was inversely related to current age, marital age and number of living children. Outside camp residents, previous contraceptive users and women with obstetric complications were significantly less likely to discontinue IUD use. ConclusionsThe crude cumulative rate of IUD discontinuation was 17.5% during the first year, suggesting a need to tackle the problem of discontinuation through effective educational strategies on the process of fertility and contraception. The most common reason for voluntary IUD removal was the women's desire to conceive. This suggests that improved counselling and good selection of candidates before IUD insertion is required. G A desire to conceive and side effects are the main reasons for IUD discontinuation.

This article reports the results of the first household survey ever conducted in Jordan Badia to include questions on knowledge, attitude, and practices (KAP) among 15–49 currently married women in Jordan Badia toward family planning. The Jordan Badia is the eastern part of Jordan populated by Bedouins who make up about 7 to 9 percent of the 4.8 million total population of Jordan. Using convenience sampling procedure, a total of 450 respondents, 50 from each of nine villages, were selected for participation. The mean age of the study population was 30.9 years and the women's age at marriage ranged from 13 to 35 years, with a mean age at first marriage of 16.8 years. More than 37 percent of the women were illiterate. Over 91 percent of the women know about family planning, but proportions of ever-users or currently-users of contraception are found to be 35.7 percent and 31.7 percent respectively. The social support network, including the husbands, mothers, and mothers-in-law, was explored. Husbands' support for family planning was significantly higher (p < 0.001, Chi Square test, df = 2) than the support of both the mothers and mothers-in-law. In view of the limited data-based literature in the area of family planning, findings of this survey can assist in the formulation of culturally appropriate population policy and viable family planning programs for this Bedouin community. Based on the results of this KAP survey, appropriate recommendations aiming at increasing the demand for family planning services among women in Jordan Badia are provided.

Socio-demographic characteristics of this group of adolescents with epilepsy are compatible with the results of the work of others such as Elwes [Neurosurg Psychiatr 54 (1991) 200], in the North East of England and Hauser from the Mayo clinic in his descriptive study of the epidemiology of epilepsy.

Children in Central Asia and the Middle East bear disproportionate environmental threats to health, of which the most widespread and serious result from poverty, malnutrition, lack of access to safe drinking water and food, and exposures to toxic chemicals. Their psychological health is threatened in several parts of this region by internal wars and strife. Many, or even most, children are regularly exposed to environmental tobacco smoke. In many of these countries, children constitute very high percentages of the population. Because children constitute the future, it is critical that these threats to their health be addressed and reduced to the greatest extent possible through both provision of safe and adequate drinking water and nutrition and reduction of exposures to environmental contaminants.