Use Of Emergency Contraception Research Articles

Perception of Condoms and Emergency Contraceptive Pill Use among Students in the University of Bamenda

Background: Globally, university students fall in the youth group prone to unattended sexual risks which may lead to unwanted pregnancy and STI/HIV. In Cameroon, more than a third of maternal deaths occur among adolescent girls and young mothers. Unwanted pregnancies results from the infrequent use of modern contraceptive methods and is one of the main causes of death in this population. Condoms are barrier contraceptive that have a beauty of dual protection-against pregnancy and transmission of STI/HIV, meanwhile emergency contraceptives has just one function which is protection against unwanted pregnancy. Aim: To assess the perception of condoms and emergency contraceptive pill use among students in the university of Bamenda, Cameroon. Materials and Methods: A university-based cross-sectional study was conducted among students in the University of Bamenda, North West Region of Cameroon, a cosmopolitan area approximately about 19 km from Bamenda main town (Commercial Avenue). The study was carried out over a period of three months. Data were collected using a structured interviewer questionnaire administered through Google form. Data collected were extracted into excel sheet and analysed with SPSSv23. Results: The study included 719 students (318 males and 401 females). The rate of male and female condom use was 28.5% and 8.1% respectively. The mean age of our study populations was 24.5 ± 4.97 years with 52.7% of population between 20 to 24 years of age. Knowledge about condoms was high at 98.3%, however, 91.9% of participants have never used the female condoms before. Highest factor recorded for non-utilisation of the male and females condoms were reduction in sexual pleasure (47.4%) and lack of knowledge on usage (44.1%) respectively. 95% of students have knowledge on Emergency Contraceptive Pills (ECPs) but just an average (52.4%) have used it before. Fear of side effects (47.4%) was the main reason for not using ECPs. Conclusion: There is a very high knowledge about condom and emergency contraceptive pill among students. However, the rate of usage recorded was very low with highest source of information being the media/internet and lowest among relatives/family.

Awareness and utilization of emergency contraceptives among female undergraduates in Kano: North west Nigeria

Unintended pregnancy remains a major challenge to the reproductive health of women, especially female undergraduates. It is a cause of unsafe abortions and their attendant complications and contributes significantly to maternal mortality, which can be prevented by the use of emergency contraceptive. This is a descriptive cross-sectional study which was carried out among 374 non-medical, non-allied medical sciences, non-basic medical sciences and nonpharmaceutical sciences female undergraduates of Bayero University Kano, Northwestern Nigeria. Self-administered questionnaires were used for data collection and analyzed using SPSS Version 23.0 Software. The Chi square test was used to test for association at p<0.05The age range of the respondents was 15-45 years, with mean age of 24.98±4.96 years. Most of the respondents were between the ages of 20-29 years. More than half of the respondents (260, 69.5%) were single. The majority of the respondents (334, 89.3%) were aware of emergency contraception. There was statistically significant association between sources of information and year of study with awareness of emergency contraception (p<0.05). Respondents in this study demonstrated good awareness and knowledge of emergency contraception. Despite the conservative nature of the community where this study was conducted, there was good level of utilization of emergency contraceptives in the study population.

Reproductive Health Needs in Patients with Bleeding Disorders

Introduction: The U.S. Supreme Court's ruling to overturn Roe v. Wade may impact access to high quality reproductive healthcare for women across the United States. This includes women with bleeding disorders as well, potentially increasing the need for illegal abortions while increasing the risk of bleeding with higher rates of complications. This study aims to assess and establish the prevalence of surgical and medical abortions, including bleeding complications and utilization of emergency contraception in persons with bleeding disorders Methods: This is a retrospective cohort study conducted with deidentified data obtained from TriNetX Research Network, aggregating health records from 66 US Healthcare Organizations (>81 million patients) from 2007-2022.ICD10 codes were used to query the data. Cases were defined as females, between ages 10-45 years with Hemophilia A, Hemophilia B, Hemophilia A and B carriers, von Willebrand Disease (vWD); not in menopause. Controls were defined as females, between ages 10-45 years, who do not have Hemophilia A, Hemophilia B, vWD, not Hemophilia A and B carriers and not in menopause. The prevalence rates of any abortion, procedures for abortion, bleeding complications, medical termination with misoprostol/mifepristone, ectopic pregnancy, molar pregnancy, use of emergency contraception, use of oral contraceptive pills (OCP), intra-uterine devices (IUD), subcutaneous implants were calculated, and compared to controls. Results: We identified 19,733 cases and 23,923,130 controls. Among cases, 1941 (9.8%) patients had a documented abortion (induced/spontaneous/missed) and 76 cases (0.4%) had a medication induced abortion with misoprostol/mifepristone. Among cases, 489 patients (2.5%) had abortion listed as a procedure code. Ectopic pregnancy occurred in 354 cases (1.8%) and molar pregnancy occurred in 88 cases (0.4%). Emergency contraception with levonorgestrel 1.5mg (Plan B/ 0ther brands) was used by 73 cases (0.4%). 44 cases (0.2%) had delayed or excessive hemorrhage following induced abortion/incomplete spontaneous abortion/ectopic/molar Prevalence of use of hormonal contraception in patients with bleeding disorders include - combined OCP (9.6%), IUD (7.6%) and subcutaneous implant (0.4%). Prevalence rate of all of the above was significantly higher in patients with bleeding disorders when compared to controls (Table 1) Conclusions: Our study suggests persons with bleeding disorders have a significant need for high quality reproductive health care with emergency contraception and medical and surgical abortions being utilized at a higher rate than the general population. Though limited data, there was a trend towards increased rates of delayed or excessive hemorrhage following induced or spontaneous abortion or ectopic pregnancy in patients with bleeding disorders. Further analyses to look at all outcomes in bleeding disorder patients is ongoing from the database. A prospective registry to establish bleeding outcomes resulting from reproductive health-related procedures is urgently needed. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Temporal Changes in Counseling for and Use of Emergency Contraception.

Our objective was to evaluate changes in the prevalence of emergency contraception counseling and use after policy changes in the United States between 2011 and 2019. This was a serial cross-sectional study using the National Survey of Family Growth data set from two survey windows: 2011-2013 (4,177 women) and 2017-2019 (4,477 women). The incidence of emergency contraception counseling in the prior year did not differ between the 2011-2013 and 2017-2019 survey windows (3.3% vs 2.5%; adjusted odds ratio [aOR] 0.73, 95% CI 0.51-1.05). There was a significant increase in ever use of emergency contraception between the 2011-2013 and 2017-2019 survey windows (19.0% vs 26.1%; aOR 1.44, 95% CI 1.22-1.72). This suggests that changes facilitating access to care may have a larger effect on emergency contraception access and uptake than health care professional counseling.

Factors Responsible for the Decline Contraceptive Prevalence rate in Nepal

This study is based on the factors responsible for the decline in the use of contraceptives in Nepal since 2006. The main objective of this study is to identify potentially responsible factors contributing to the reduction of CPR in Nepal. This study is based on a secondary resource. For the purpose of this study, data and information has been collected from various sources such as demographic and health survey reports, published national and international articles and reports in related contexts. The Family Planning Program is a priority program of the Government of Nepal, established with the objective of ensuring that individuals and couples fulfill their reproductive needs and rights using quality family planning methods based on voluntarily informed choices. The use of temporary contraceptives in Nepal has not increased over the past few years and has remained stable rate since 2011 and 2016. This does not mean an overall decline in the prevalence of contraceptives because of the prevalence rate of any method of contraception has increased (53%) in 2016 from 50 percent in 2011 and 48 percent in 2006. Since 2006, the uses percentage of modern contraceptive methods has not increased, this study is focused on the causes of low or stable contraception rate. Still, the current supply of contraceptives has not able to meet the high demand of contraceptive users. The demand for contraceptives was 67 percent in 2016.The reasons for the decline in contraceptives in Nepal could be (a) Spousal Separation (especially in the reproductive age group), (b) increasing use of traditional methods, (c) legalization of abortion and (d) use of emergency contraception. Results show that 47 percent of married women discontinued the use of family planning methods because of their husband being away from home. Similarly, 9.8 percent of married women were traditional method users. After the legalization of abortion, the number of abortions has been gradually increasing over the year and the use of emergency contraceptive pills is also increasing day by day.

Oral Emergency Contraception Provision in the Veterans Health Administration: a Retrospective Cohort Study

ABSTRACTBackgroundIn the USA, oral emergency contraception (EC) use to prevent unintended pregnancy is increasing. Oral EC methods include levonorgestrel (LNG) and ulipristal acetate (UPA), with increased UPA efficacy over LNG in high BMI users and those beyond 3 days post intercourse. The Veterans Health Administration (VHA) provides oral EC at low or no cost, yet prescription-level Veteran data are lacking.ObjectiveTo describe oral EC provision in VHA, including method type and Veteran user and prescriber characteristics.DesignA retrospective cohort study using VHA administrative data.ParticipantsAll VHA oral EC prescriptions from January 1, 2016, to December 31, 2020.Main MeasuresWe linked Veteran-level sociodemographic and military characteristics and provider-level data with each prescription to identify variables associated with oral EC method.Key ResultsA total of 4280 EC prescriptions (85% LNG) occurred for 3120 unique Veterans over 5 years. While prescriptions remained low annually, the proportion of UPA prescriptions increased from 12 to 19%. Compared to LNG users, UPA users were older (34% vs 25% over age 35 years, p <0.001); more likely to identify as white (57% vs 46%) and non-Hispanic (84% vs 79%) (p <0.001); and more likely to have a BMI ≥ 25 (76% vs 67%, p <0.001). UPA prescriptions originated most frequently from VA Medical Centers (87%) and women’s health clinics (76%) compared to community-based or other clinic types. In multivariable regression models, race, ethnicity, BMI ≥30, and prescriber facility type of a VA Medical Center or a women’s clinic location were predictive of UPA prescription.ConclusionsOral EC provision in VHA remains low, but UPA use is increasing. LNG prescription occurs frequently in high BMI Veterans who would benefit from increased efficacy of UPA. Interventions to expand oral EC access in VHA are essential to ensure Veterans’ ability to avert unwanted pregnancies.

Knowledge and Perception of Senior High School (SHS) Students about Emergency Contraceptive Use in the Garu and Tempane Districts

The perception and knowledge people have about family planning health services are likely to affect the kinds of decisions they are likely to make about the service. The main purpose of the study was to assess the knowledge and perception of Senior High School students about emergency contraceptive use in the Garu and Tempane Districts. A descriptive (cross-sectional) survey design adopted. A questionnaire was administered to a sample of 248 students, who served as respondents. The sample was selected using the multistage sampling procedure. The data analyses were done using frequencies, percentages, mean and standard deviation and the independent sample t-test. The results showed that students had knowledge about emergency contraceptives. The results also, provided evidence that the students had negative perception about emergency contraceptive use. Furthermore, it was evident that male and female students had similar perception about emergency contraceptive use. It was recommended that the Ghana Health Service (GHS) should intensify their sex education as part of their health education programmes for students in the Senior High Schools.

Adolescents’ knowledge, attitude and utilization of emergency contraceptive in Idjwi Island in the Democratic Republic of the Congo

Introduction: Unintended pregnancies are a major health problem and one of the main interventions to reduce unintended pregnancies and unsafe abortions is the correct use of emergency contraception (EC). The objective of this study was to assess knowledge, attitude, and utilization of EC among adolescent girls in Idjwi Island, Eastern of the Democratic Republic of the Congo. Methods: We conducted a cross-sectional survey of 353 adolescent girls aged 15-24 who were recruited and who completed a pre-established questionnaire after they were accepted into the survey. Data collected were analyzed with STATA 16 software and the comparison of variables with the Chi-square test and a significance threshold of 5%. Results: We found that 293 (83.0%) reported having ever had sexual intercourse and 220 had heard of EC. The proportion of respondents with sufficient knowledge was 59.1% (130/220) and the assessment of attitude towards the EC shows that 81.8% (180/220) of the respondents had a positive attitude towards EC. Of 293 respondents who had ever had sexual intercourse, 148 (50.5%) reported having ever used EC. Respondents with a secondary educational level (adjusted odds ratio =14.3 [7.2-28.3]) and university educational level (adjusted odds ratio =4.8 [1.8-13.0]) were more likely to use EC compared to those with a primary educational level. Conclusion: The study shows that the level of EC utilization was medium in Idjwi Island. Educational level was a major predictor of EC utilization. Therefore, it is recommended that strategies be developed to improve EC utilization by increasing the level of EC awareness among adolescent girls.

Contextual factors associated with contraceptive utilization and unmet need among sexually active unmarried women in Kenya: A multilevel regression analysis.

Unmarried women who report less recent sexual intercourse (>30 days from survey enumeration) are largely excluded from global health monitoring and evaluation efforts. This study investigated level and contextual factors in modern contraceptive utilization and unmet need within this overlooked female subpopulation in Kenya from 2014 to 2019. This study analyzed data from the Performance Monitoring and Accountability (PMA) survey in Kenya, a nationally representative survey of female respondents, to understand the level and contextual factors for family planning utilization and unmet need within female subgroups including married, unmarried sexually active (defined as sexual intercourse within 30 days of survey enumeration), and unmarried with less recent sexual intercourse (defined as sexual intercourse 1-12 months prior to survey enumeration). The analysis included multilevel regression modeling to assess correlates on outcomes of modern contraceptive prevalence rate (mCPR), unmet need, and recent emergency contractive pill (ECP) use, which is a unique PMA question: "Have you used emergency contraception at any time in the last 12 months?". Cumulatively, the surveys enumerated 19,161 women and this weighted analysis included 12,574 women aged 15-49 from three female subgroups: 9,860 married women (78.4%), 1,020 unmarried sexually active women (8.1%), and 1,694 unmarried women with less recent sexual intercourse (13.5%). In 2019, while controlling for covariates, unmarried women with less recent sexual intercourse exhibited statistically significant differences (p-value<0.02) in current mCPR, mCPR at last sexual intercourse, unmet need for modern contraceptives, and recent ECP use. As compared to an unmarried woman with less recent sexual intercourse (i.e., reported sex 1-12 months prior to survey), the odds of an unmarried sexually active woman (i.e., reported sex within last 30 days of survey) currently using modern contraceptives was 2.28 (95% CI: 1.64, 3.18), using modern contraceptives at last sexual intercourse was 1.44 (95% CI: 1.06, 1.95), and having an unmet need for modern contraceptives was 2.01 (95% CI: 1.29, 3.13) while controlling for covariates. The odds of a married woman using ECP during the last 12 months was 0.60 (95% CI: 0.44, 0.82) as compared to an unmarried woman with less recent sexual intercourse. In 2019, unmarried women with less recent sexual intercourse reported the highest rate of ECP use during the last 12 months at 13.5%, which was similar for unmarried sexually active women at 13.3%. Since 2014, summary measures of unmet need and total demand for modern contraceptives increased for unmarried women with less recent sexual intercourse, but declined for the other female subgroups. In Kenya, unmarried women with less recent sexual intercourse exhibited significantly different contraceptive utilization, unmet need, and recent emergency contraceptive use. Moreover, changes over time in key family planning indicators were asymmetrical by female subgroup. This study identifies an important monitoring gap regarding unmarried women with less recent sexual intercourse. Evidence dissemination by the global measurement community for these unmarried women is exceedingly scarce; therefore, developing an inclusive research agenda and actionable information about these marginalized women is needed to enable targeted planning and equitable service delivery.

Trends in Emergency Contraceptive Use Among Adolescents and Young Adults, 2006–2017

PurposeIn 2013, age restrictions for adolescents on over-the-counter access were removed for “Plan B One-Step”, a single oral medication option for emergency contraception use. Restrictions on generic options of the emergency contraceptive pill (ECP) were removed in 2014. MethodsNational Survey of Family Growth data were used to assess the prevalence of ever use of ECPs among sexually experienced female adolescents and young adults (AYA) aged 15–24 years (2015–2017 sample), and trends in indicators of ECP use and acquisition (2006–2017 samples). Prevalence estimates were obtained by age subgroups for 15–17, 18–19, and 20–24 years. Statistical significance was determined using an alpha of .05 and 95% confidence intervals calculated around the point estimates. ResultsThe weighted estimate of sexually experienced female AYA in the United States ranged from 13.3 million in 2006–2008 to 12.7 million in 2015–2017. The prevalence of ever ECP use was 18.2% (95% CI 15.7–21.1) and 31.8% (95% CI 26.9–37.1) in 2006–2008 and 2015–2017, respectively. Ever use in 2015–2017 varied by age group, number of lifetime opposite-sex partners and abortions, and experience of nonconsensual sex. In 2008–2010, 46.1% (95% CI 36.0–56.5) of respondents last obtained ECPs at community health or family planning clinics, and 31.8% (95% CI 22.9–42.2) last obtained ECPs at a pharmacy compared to 18.1% (95% CI 12.0–26.4) and 70.1% (95% CI 60.6–78.1) respectively in 2015–2017. Prevalence of provider counseling about emergency contraception in female AYA regardless of prior sexual experience in the past 12 months remained at or below 5% from 2006 to 2017. ConclusionIncreasing access to ECPs over-the-counter may have contributed to notable increases in reported ever use of ECPs and in the receipts from a pharmacy among AYA between 2006 and 2017. AYA may benefit if pharmacists and healthcare providers increase reproductive health counseling.

Determinants of emergency contraceptive pill use in Bangladesh

Objective: To examine the determinants of emergency contraceptive pill use in Bangladesh. Methods: Data for this cross-sectional study came from 2017-2018 Bangladesh Demographic and Health Survey. Characteristics of 906 reproductive age women who were potential candidates for using emergency contraceptive pill were analysed in this study. Data were analysed using univariate and multivariate analyses. Stepwise binary logistic regression was employed as multivariate analysis. Results: Only 10.9% candidates were found to ever use emergency contraceptive pill. The odds of using emergency contraceptive pill for women visited by family planning field worker was significantly higher than that for those who were not visited by family planning field worker [odds ratio (OR) 1.94; 95% confidence interval (CI) 1.19–3.17; P=0.008], while the odds of using emergency contraceptive pill for women with high socioeconomic status was higher than that for those with low socioeconomic status (OR 3.10; 95% CI 1.61–5.97; P=0.001). Additionally, having some media access was linked to an increase in the odds of using emergency contraceptive pill (OR 3.01; 95% CI 1.33–6.83; P=0.008). Women empowerment related factors did not show any significant effect on emergency contraceptive pill use. Conclusions: The findings indicate that family planning programme has a great opportunity of playing an important role in increasing emergency contraceptive pill use in Bangladesh by increasing the knowledge and awareness of women about emergency contraceptive pill.

KNOWLEDGE, ATTITUDE AND BARRIERS TO THE UTILIZATION OF EMERGENCY CONTRACEPTIVES AMONG FEMALE STUDENTS OF THE UNIVERSITY FOR DEVELOPMENT STUDIES: A CROSS-SECTIONAL STUDY

Unintended and unwanted pregnancy is a public health threat among young women and girls in developing countries including Ghana. Despite all the public health interventions, the effectiveness of the use of emergency contraceptives (ECs) to avert unintended pregnancies is still low in Ghana. Little is known about the knowledge, attitude, and barriers to ECs utilization in Ghana. Therefore, the objective of the study was to investigate the knowledge, attitudes, and barriers to the utilization of ECs among female students of the University for Development Studies, Tamale. A total of 309 female students of reproductive age were selected using a simple random approach. A descriptive cross-sectional study design was used for the study. Also, a semi-structured questionnaire was used to collect data on knowledge, attitudes, and barriers to the utilization of ECs. Frequency and percentage distribution of the sociodemographic factors, and behavioral and attitude variables of EC variables were computed using the SPSS software (version 20). Overall, the majority (65.0%) of the participants showed sufficient knowledge of ECs. Also, 54.0% of the respondents had a good attitude toward EC. An assessment of the reasons for not using any form of ECs revealed that some of them wanted pregnancy (26.6%), lacked knowledge about ECs (18.1%), and partner refusal (4.3%). Also, religious beliefs (37.2%) were barriers to the utilization of ECs. In conclusion, the study found a high level of knowledge and a good attitude toward ECs among the study participants. However, partner refusal and religious beliefs were mentioned as barriers to the utilization of ECs. Therefore, we recommend that the health authorities in charge of reproductive health education should liaise with religious leaders as they could partner in the creation of awareness of EC.&#x0D; &#x0D; Keywords: Emergency Contraceptive, Knowledge, Attitude, Barriers, utilization.

Impact of COVID-19 on the Use of Emergency Contraceptives in Ghana: An Interrupted Time Series Analysis.

The Coronavirus disease pandemic has disrupted reproductive health services including decline in the use of pre-coital contraceptives. However, evidence of its impact on the use of emergency contraceptives, often, post-coital methods, is limited in the emerging literature, hence this study. Data on total number of emergency contraceptive users from January 2018 to February 2020 (pre-pandemic) and March to December 2020 (during the pandemic) were extracted from the Ghana Health Service District Health Information Management System. Interrupted Time Series analysis was used to estimate the impact of the pandemic on the trend of emergency contraceptive use, adjusting for serial autocorrelation and seasonality. The results showed a gradual upward trend in emergency contraceptive use before the pandemic, increasing at a rate of about 67 (95% CI 37.6–96.8; p = 0.001) users per month. However, the pandemic caused a sudden spike in the use of emergency contraceptives. The pandemic and its related restrictions had an immediate effect on the use of emergency contraceptives, increasing significantly by about 1939 users (95% CI 1096.6–2781.2; p = 0.001) in March 2020. Following March 2020, the number of emergency contraceptive users continued to increase by about 385 users per month (95% CI 272.9–496.4; p = 0.001). The evidence shows that use of emergency contraceptives, often used as post-coital methods for unprotected sex was not negatively impacted by the pandemic. In fact, it is the opposite. Hence, in planning for similar situations attention should be given to the distribution of post-coital contraceptive methods.

Knowledge, Attitude, and Practice towards Emergency Contraceptives use Among Negelle Health Sciience College Female Students, South Eastern, Ethiopia: a Descriptive Cross-Sectional Study, 2021

Background: Emergency contraceptives is the only method women cause to prevent pregnancy after they have had unprotected sexual intercourse. About 7.2% of women will be sexually assaulted by a stranger and depending on the region; 23-36% of women will experience unwanted sex from an intimate partner. Objective: To ascertain knowledge, attitude and practice towards emergency contraceptive use among female students in Negelle college of health sciences. Methods: A descriptive cross sectional study design was carried out July 29 /2021 to September 31/2021.Data was collected through employing semi-structured self-administered questioner, and then the collected data was cleared, coded and analyzed by statistical packages for social sciences 26.0 version statistical software. Descriptive statistics were used for variables using statistical parameters of frequencies, and percentages, and were presented in table format. Factors with a bivariate test value ≤ 0.05 were included. Results: The study was conducted on total sample of 152 participants, among the respondents, majority 131(86.2%) of them age was &gt;20 years old. Above half 92(60.5%) of the study subjects was heard the cornerstones merit of contraceptives was to prevent pregnancy.82(53.9) respondents were agree about when having unintended sexual intercourse, they take ECPs.60 (39.5%) of the study subjects were agree about fear of side effects hinder them from not using ECPs.85(56.0%) were used EC pills after unprotected sexual intercourse. Age greater than twenty years and unmarred female students was predictors to have good knowledge about EC pills. Conclusion and recommendations: A majority of this study subjects were came from urban area, and majority of the study subjects were bought EC from pharmacy from pharmacy and shop. Knowledge, attitude and practice towards EC among female students were high. Health care workers should have to escalate awareness of the usage of emergency contraceptive methods among female students.

Knowledge and Patterns of Use of Emergency Oral Contraception among Portuguese Female Users of Healthcare Services.

The lack of knowledge about the existence, effectiveness, and supply of emergency contraception as well as access to it, its effective duration and the lack of recognition of the need for its use can prevent women from using it. The aim of this study was to ascertain the attitudes, experience, level of knowledge and information sources about emergency contraception of Portuguese female users of healthcare services. We conducted a multicentre, cross-sectional, observational study among 280 Portuguese women users of health care services through an original and anonymous questionnaire composed of 30 questions. The mean age of the women who replied to the questionnaire was 33.83 ± 8.76 years. Of the observed sample, 27.7% used EC, 50% of whom with no counselling. Despite 92.1% of women claiming knowledge about emergency contraception, only 31.2% of these answered 8 - 10 questions correctly (14 in total). The media were the most frequent source of information (63.4%). Most participants (67.5%) considered that emergency contraception is associated with severe adverse reactions. Furthermore, 76% did not know the time range of effectiveness after unprotected sexual intercourse. Youngest age (p = 0.038), higher education level (p < 0.001), increasing parity (p = 0.051) and previous use of emergency contraception (p = 0.011) were identified as the determinant sociodemographic factors for a higher level of knowledge about emergency contraception. The use of emergency contraception after counselling by healthcare professionals was lower than reported in the literature. This study showed that female users of healthcare services were aware of the existence of emergency contraception, but they demonstrated a low level of knowledge about it, especially regarding the correct period of use, place of acquisition and safety issues.

Prevalence and determinants of ectopic pregnancy in Ethiopia: Systematic review and meta-analysis

Background: Ectopic pregnancy is a life-threatening obstetric emergency, and is a major health problem for women of fertile age. Therefore, the aim of this systematic review and meta-analysis was to estimate the prevalence, determinant factors, and outcomes of ectopic pregnancy among fertile age women in Ethiopia. Method: International databases (MEDLINE/Pub Med, Hinari, Scopus, Google scholar, African journals, and literatures were searched and nine eligible cross sectional and two case control studies were included in this systematic review and meta-analysis. Eggers test and funnel plot were computed to check publication bias across the studies. Publication bias was computed using a funnel plot and eggers test. Heterogeneity of the studies was checked using Cochrane Q-test and I2 statistic. Results: The pooled prevalence of ectopic pregnancy in Ethiopia was 3.61% (95%CI: 2.24–4.98, I2 = 89.2.0%, p &lt; 0.001). Having cesarean section scar (AOR = 7.44, 95%CI: 5.48–10.09), single marital status (AOR = 5.71, 95%CI: 4.76–6.85), history of sexually transmitted infection (AOR = 4.68, 95%CI: 3.04–7.19), history of abortion (AOR = 3.89, 95%CI: 3.35–4.52), history of ectopic pregnancy (AOR = 5.74, 95%CI: 3.81–8.65), and emergency contraceptive use (AOR = 8.72, 95%CI: 2.90–26.20) were the determinant factors for the occurrence of ectopic pregnancy. Conclusion: This systematic review and meta-analysis showed that the prevalence of ectopic pregnancy was high in Ethiopia. Thus, educating women to limit the number of sexual partners, smoking cessation, using a condom during sex helps prevent sexually transmitted infections and the risk of pelvic inflammatory disease is crucial.

Dispensing and practice use patterns, facilitators and barriers for uptake of ulipristal acetate emergency contraception in British Columbia: a mixed-methods study.

Background:Ulipristal acetate 30 mg became available as prescription-only emergency contraception in British Columbia, Canada, in September 2015, as an addition to over-the-counter levonorgestrel emergency contraception. In this study, we determined dispensing and practice use patterns for ulipristal acetate, as well as facilitators of and barriers to emergency contraception for physicians, pharmacists and patients in BC.Methods:In the quantitative component of this mixed-methods study, we examined ulipristal acetate use from September 2015 to December 2018 using a database that captures all outpatient prescription dispensations in BC (PharmaNet) and another capturing market sales numbers for all oral emergency contraception in BC (IQVIA). We analyzed the quantitative data descriptively. We conducted semistructured interviews from August to November 2019, exploring barriers and facilitators affecting the use of ulipristal acetate. We performed iterative qualitative data collection and thematic analysis guided by Michie’s Theoretical Domains Framework.Results:Over the 3-year study period, 318 patients filled 368 prescriptions for ulipristal acetate. Use of this agent increased between 2015 and 2018. However, levonorgestrel use by sales (range 118 897–129 478 units/yr) was substantially higher than use of ulipristal acetate (range 128–389 units/yr). In the 39 interviews we conducted, from the perspectives of 12 patients, 12 community pharmacists, and 15 prescribers, we identified the following themes and respective theoretical domains as barriers to access: low awareness of ulipristal acetate (knowledge), beliefs and experiences related to shame and stigma (beliefs about consequences), and multiple health system barriers (reinforcement).Interpretation:Use of ulipristal acetate in BC was low compared with use of levonorgestrel emergency contraception; lack of knowledge, beliefs about consequences and health system barriers may be important impediments to expanding use of ulipristal acetate. These findings illuminate potential factors to explain low use of this agent and point to the need for additional strategies to support implementation.

Characterization of the Use of Emergency Contraception from Sentinel Pharmacies in a Region of Southern Europe.

Numerous studies have been published suggesting that emergency contraception (EC) is used repeatedly, but a lack of information regarding the profile of users makes it difficult to evaluate actual consumer habits. The aim of this study was to obtain information regarding the profile of users who obtain EC and other factors that might play a role, and to provide criteria to evaluate and improve the strategies of current contraceptive programs. This was an observational one-year study based on surveillance data on the provision of EC to women of reproductive age in 60 community pharmacies in Catalonia, Spain. In total, 941 notifications of dispensation of EC in Catalonia were received. A total of 44.2% of users said it was not the first time that they had taken the medication (repeat user). The percentage of users who used condoms was lower in repeat users compared to first-time users (56.7% vs. 64.4%, p < 0.05). A total of 25.7% of users stated that they did not use any barrier contraceptive method. The use of natural methods in repeat users was 53.8% in the subgroup who requested the medication after 48 h, significantly higher than in users who obtained the medication within the first 24 h (p < 0.05). A high percentage of repeat users with risky sexual behaviors were detected, suggesting that new measures must be implemented to provide information for this method, together with educational and preventive strategies.

Dynamics of Emergency Contraceptive Use in Accra, Ghana.

Recent data suggest increasing rates of emergency contraception (EC) use in Ghana, particularly in urban areas. In 2018, we collected survey data from 3,703 sexually experienced women aged 16-44 years living in low-income settlements of Accra. We estimated the prevalence of lifetime and current EC use. Multivariate logistic regression was used to assess factors associated with current use of EC. Retrospective monthly calendar data on contraceptive use were analyzed to identify patterns of EC use, including repeat and continuous use, and uptake of other contraceptive methods in the months following EC use. Nearly 15 percent of women had ever used EC. About half of recent EC users (52 percent) used EC for at least four months cumulatively within a 12-month window. There was no evidence of adoption of other modern methods in the months after using EC. Our results suggest that EC is a common method for pregnancy prevention in Accra, particularly among young, unmarried, highly educated women. Counseling on effective EC use and strategies that promote equitable access should be prioritized.

Men's knowledge, attitude, and barriers towards emergency contraception: A facility based cross-sectional study at King Saud University Medical City.

BackgroundMale partners have a considerable role in influencing women’s contraceptive decision making to reduce the chance of unintended pregnancy. Most studies are focused on women’s knowledge and barriers for emergency contraception (EC) use. There is limited research on this topic from the male perspective. This study aimed to gather baseline data on men’s knowledge, attitudes and barriers about EC.MethodsDescriptive analytic cross-sectional study was conducted from Dec 2019 –May 2020 at the King Khalid University Hospital (KKUH); a teaching facility with general and subspecialty medical services in King Saud University Medical City (KSUMC), Riyadh, Saudi Arabia. Data were collected using a structured pretested questionnaire and analyzed using SPSS version 23.0. Descriptive statistics and Chi square tests were used. Multivariate logistic regression analysis was used to find significant predictors for EC awareness and use. A p value < 0.05 was considered statistically significant.ResultsA total of 461 participants completed the questionnaire (response rate 86%). The majority (82%) of the participants were unaware of EC; with only 18% having some knowledge. Knowledgeable men had positive attitudes (73.5%) about EC as compared to non- knowledgeable ones (55.0%). Factors found to be associated with less knowledge of EC were cultural [0.46, 95%CI 0.22. 0.96] and religious unacceptability [OR 0.51, 95%CI 0.29, 0.89)]. Higher level of education [OR 1.83, 95%CI 0.94, 3.53] was associated with more knowledge regarding EC. The study showed that correct information about using contraceptives within 3 days of unprotected sex [OR 4.96, 95%CI 1.81, 13.60]; availability without prescription [OR 5.06, 95%CI 1.68, 15.30], EC advertisement [OR 4.84, 95%CI 0.96, 24.27] and receipt of information from family/friends [OR 18.50, 95%CI 5.19, 65.93] were factors that contributed to men using EC.ConclusionThe current knowledge of EC among men is limited. Social determinants affect these levels of knowledge, as well as the usage of EC. Factors that were associated with the use of ECPs were correct knowledge, advertisement, availability and receipt of information from family/friends. The findings highlight the need to educate men on this important topic to avoid unintended pregnancy, keeping in view cultural and social values. Future qualitative studies are needed to understand the male perspective.