Emergency contraception provider and client perspectives in Lusaka

Abstract

Objective is to explore issues of accessibility, administration, transition to regular family planning, training and management of side effects as applied to emergency contraceptive pills. Subjects were 52 Health care providers -18 doctors practicing Obstetrics and Gynaecology and 34 nurse family planning providers. Five groups of up to 15 university students formed focus group discussions, 400 Clients who underwent termination of pregnancy. Knowledge of the existence of emergency contraception, how to access it, its administration, handling side effects and acceptance as contraceptive need by clients and by health providers were the main outcome measures. Fifty-one out of 52 health care providers had heard about ECP, 75% offered emergency contraception as part of their family planning services. Most of those who did not offer it lacked adequate information and a few felt that it was an abortificient. Most University Students lacked information on emergency contraception. The services were available at their clinic as well as the counseling centre but the students were not free to utilise them. Clients who had termination of pregnancy were mostly lacking in adequate information as well. Twenty-seven percent had experienced method failure whilst 44.8% of all clients said they could have tried to use emergency contraceptive pill if they had known about it. For emergency contraception to have an impact on reduction of unwanted pregnancies more health care providers need to be trained in provision of emergency contraception services. Women need more education on when and how to use emergency contraception as well as its safety, effectively, side effects and where to obtain it from. Its only when women have the knowledge on emergency contraception the health providers would be comfortable to give advance distributions of the pill. Community distribution workers need special training in order to provide services in remote areas.