Assessing the availability and accessibility of emergency contraceptive pills in Uganda: A multi-methods study with Congolese refugees

Abstract

ObjectivesWe aimed to document the availability and explore the accessibility of emergency contraceptive pills for Congolese refugees living in both camp and urban settings in Uganda. MethodsIn 2017, we conducted a multi-methods assessment in both the Nakivale Refugee Settlement and Uganda’s capital of Kampala. Our study included a review of the published literature and institutional reports and statistics, 11 key informant interviews, 4 focus group discussions (FGDs) with married (N = 16) and unmarried (N = 20) Congolese women, and 21 in-person in-depth interviews with refugee women. We analyzed these data for content and themes using deductive and inductive techniques and triangulated our findings. ResultsOur findings show that the availability of emergency contraception in the Nakivale Refugee Settlement is inconsistent and theft of product by health center personnel is a significant problem. Congolese women living in Kampala reported that the cost of emergency contraceptive pills is prohibitive. Most of our refugee participants living in both settings lacked accurate knowledge about post-coital contraception and several reported using a range of other drugs to prevent pregnancy after sex. ConclusionEmergency contraception has long been incorporated into the standards of care for sexual and reproductive health in humanitarian settings. However, results from our study indicate that Congolese women face a range of challenges accessing emergency contraception in Uganda. Strengthening supply chain management, examining and addressing the dynamics underlying product theft, and increasing awareness of effective post-coital methods are priorities for expanding reliable access. ImplicationsInconsistent availability and lack of accessibility of emergency contraception has significant implications for refugee and displaced populations. Supporting efforts to ensure that humanitarian stakeholders in Uganda are adhering to global standards of care is critical.