Oral Contraceptive Compliance in Rural Colombia: Knowledge of Users and Providers

Abstract

Errors in pill use among 341 new oral contraceptive (OC) acceptors in Magdalena Colombia were high both in daily use and in the transition from 1 cycle to the next. 58% of the women had used the pill incorrectly during a single 2-week period. Of that group 43% made errors during the cycle (such as not taking the pill every day) 47% reported making an incorrect transition from 1 cycle to the next and 10% ran out of supplies. Most of the errors reported were intentional acts such as taking the pill every other day to reduce side effects or taking the pill only around the time of sexual relations. The providers of OCs in this region--the Colombian Ministry of Healths rural health promoters--knew more about correct use than did their clients but there were serious gaps in their knowledge as well. Use-effectiveness of the pill might be dramatically improved among these rural women if 2 messages were clearly given and consistently reinforced. They must take the pill on a daily basis regardless of sexual activity or minor physical discomforts and they must adhere to the proper interval between pill cycles (which depends on whether they are on a 21-day or 28-day cycle). Clear labelling of pill packets could only serve to reinforce this message. (authors modified) (summaries in SPA FRE)