ABSTRACT
Emergency contraception (EC) is used post-coitally and offers women an important second chance to prevent pregnancy. Approximately 10 years ago, Mexico became one of the earliest countries working to expand EC access. Partners came together to pursue a synergistic four-pronged strategy, including product registration, health care provider training and orientation, awareness raising among the general public, and policy change. By 2006, five EC products were registered and sold in Mexico, EC was widely available through pharmacies and included in the public sector contraceptive options, and knowledge of the method had increased substantially.
Subject(s)
Contraception, Postcoital/statistics & numerical data , Cooperative Behavior , Health Services Accessibility , Family Planning Services , Female , Health Care Surveys , Hotlines , Humans , Mexico , Pilot ProjectsABSTRACT
Emergency contraception (EC) is safe and has the potential to prevent unwanted pregnancies. However, use remains low in most settings, due to a range of barriers to access. This paper reviews key issues related to EC and describes recommendations reached during the Women's Health Alliance pre-Congress workshop, held in advance of the FIGO 2006 World Congress. The working group concluded that national societies of obstetrics and gynecology can play an important role in increasing access to this unique contraceptive method.
Subject(s)
Contraception, Postcoital , Health Services Accessibility , Women's Health Services/supply & distribution , Contraceptive Agents, Female/administration & dosage , Contraceptive Agents, Female/supply & distribution , Female , Global Health , Humans , Levonorgestrel/administration & dosage , Levonorgestrel/supply & distribution , Physician's Role , Societies, MedicalABSTRACT
OBJECTIVE: To identify information and service delivery needs for obstetric/gynecologic uses of misoprostol in developing countries. METHODS: The study included a survey of reproductive health providers in 23 countries and a qualitative study of misoprostol use in four developing countries. Researchers used purposive sampling methods for the survey and qualitative study and conducted a descriptive statistical analysis of survey data and computer-assisted text-based content analysis of qualitative data. RESULTS: In some developing countries, women frequently access misoprostol through pharmacies and self-medicate to induce early abortion. Some clinicians expressed concern about this use of misoprostol, but many stated that its availability had reduced serious complications resulting from unsafe abortions. CONCLUSION: Although misoprostol is routinely used for a range of off-label obstetric/gynecologic indications, evidence-based, up-to-date information about safety, effectiveness, and appropriate regimens is not widely available. This information is requested by providers, including pharmacists. Women need information and guidance about its use.
Subject(s)
Abortifacient Agents, Nonsteroidal/therapeutic use , Developing Countries , Misoprostol/therapeutic use , Adolescent , Adult , Counseling , Female , Humans , Practice Patterns, Physicians'ABSTRACT
Currently, emergency contraception is seldom used in Kenya. As part of a larger study designed to provide insight into the possible roles for the method in Kenya, we assessed the knowledge of and attitudes towards emergency contraception in two groups of potential users, and we focus on these data specifically in this paper. We interviewed clustered samples of clients at ten family planning clinics in Nairobi (n = 282) and conducted four focus group discussions with students at two universities in Kenya (n = 42). Results show that despite relatively low levels of awareness and widespread misinformation, when the method was explained, both clients and students expressed considerable interest, but also expressed some health and other concerns.
Subject(s)
Attitude to Health , Contraceptives, Postcoital , Health Knowledge, Attitudes, Practice , Students/psychology , Universities , Women/psychology , Adult , Attitude to Health/ethnology , Educational Status , Female , Focus Groups , Humans , Kenya , Male , Surveys and Questionnaires , Urban PopulationABSTRACT
Emergency contraception, sometimes referred to as "morning after" or postcoital contraception, provides a second chance for women who experience contraceptive failure or do not use a method, as well as for women who experience unplanned intercourse, including coerced sex or rape. The two primary methods of emergency contraception are postcoital use of a higher dose of oral contraceptive pills and insertion of an intrauterine device (IUD). Both can significantly reduce a woman's chance of becoming pregnant (75% and 99% respectively). Knowledge of emergency contraception is crucial, since women must know they can prevent pregnancy after intercourse in order to seek out treatment. While rates of unwanted pregnancy vary in different countries and among population groups, the need for emergency contraception is critical worldwide, However, the availability of emergency contraception differs widely. It is most extensively used in Europe, but is still a new method in other countries, including the United States.
