Kuala Muda District Office - Day 3

Having finished the third day of the posting, here is a brief review of what we have discovered.

Today, we were sent to Klinik Kesihatan Bakar Arang to learn about the procedures involved in Family Planning Unit of the public health system. We reached the clinic at about 9 a.m. upon which we were welcomed by Staff Nurse Suria, who is technically the person in charge of the Family Planning Unit.

Generally, patients requiring family planning assistance are mostly already mothers and they normally seek consultation on the same day when they bring in their newborn babies for the first month follow up. Upon completing their post natal follow up, they will then proceed to the Family Planning room, as they would have registered for it while registering for post natal follow up. However, as for the Family Planning assistance, they will be asked to fill up a form with their details at registration. This process differs slightly for those who are walking in solely for family planning assistance, where they register directly under Family Planning Unit and the rest of the procedures are the same.





Family Planning Unit / Room

Form to be filled up by patients at registration

At the Family Planning Unit, they will be advised on various contraceptive methods according to their preferences and will be sent home. So far, these procedures are managed by the nurses only. However, for those requiring Intrauterine Contraceptive Device (IUCD), they will be referred to a doctor who will then fix the device for the patient. Besides prescribing medictions or devices to the patients, the nurses also advise the patients to have a gap of two years before having the next child as far as possible.

Various methods of contraception

'Rigevidon'

'Noriday'

'Regulon'

Some details about

the contraceptives

WHO Medical Eligibility Criteria Wheel
for contraceptive use

Conditions to be considered

before prescribing contraceptives

Following this, they will be asked to come for follow ups monthly to assess their tolerance towards whatever methods of contraceptive practised and also to keep track of any side effects due to the contraceptive methods. Patients are also advised for Pap Smear screening after six months, as part of the procedure. As for the cost for the Family Planning assistance by the clinic, it is free of charge for everyone.

Pap Smear Test Kit

Moving on to the statistics of drugs or methods used, it is said that the drugs 'Noriday' and 'Rigevidon' are the most commonly prescribed drugs compared to the other list of available drugs shown above. Besides, we were also told that the drug 'Marvelon' is no more prescribed for reasons which the nurses themselves claim not to know.

The nurses also said that the drug 'Noriday' is the drug of choice for breastfeeding mothers and is given over a course of six months.

As for the differences in preferences of methods of contraception among different races, it is noticed that the Malays and Indians prefer using pills or injections, with Indians having greater affinity for injections, whereas the Chinese prefer condoms.

Although the whole process is a very simple one and easily accessible to patients, the nurses are strict in prescribing any form of contraception to those who are married but not planning to have a child yet unless permitted by the doctor. However, a big 'NO' with no further considerations is usually the answer for those who are not married and requesting contraceptives.

With that, I would like to wrap up this post, with satisfaction over newer discoveries we have come across for today's posting.

-Vinodharan Nagaretnam-