Emergency contraception (EC) can reduce unwanted pregnancies and potentially reduce the need for unsafe abortion. However, many questions remain on how best to provide EC services in developing countries. This study addressed this issue by testing four channels of EC provision in Lusaka, Zambia: peer counselors, clinic-based MCH/FP and outpatient (OPD) nurses, pharmacists, and community sales agents (CSAs). These were compared on frequency of use, feasibility within the current health care system, and quality of EC service provision. Data were collected through prescription cards (distributed during information sessions and redeemed for EC pills), descriptive logs of project activities, provider interviews, and mystery client interviews. Of the 1,798 prescription cards distributed by providers, 23% (421) were later redeemed for ECPs. The redeemers were all female, ranging in age from 12-45, mean age 25. Pharmacists emerged as the most commonly used source of information (54%) and supplier of ECPs (74%). Over half of the cards distributed by pharmacists were redeemed, compared to only 15% of those distributed by nurses, and less than 2% for CSAs. Although pharmacists were the most popular source of information and services, they were the most difficult to train, and, as with the other providers, did not inform EC users about transmission of sexually transmitted infections (STIs). Motivating pharmacists to educate clients about STI/HIV prevention and to sell condoms as a back-up method will serve clients' reproductive health needs and may help to convince pharmacists of the business advantages of doing so.
Learning Objectives: At the conclusion of the session, the participant will be able to: 1. Identify how ECPs can reduce unwanted pregnancy. 2. Describe the strengths and weaknesses of four different channels of information and service provision of ECPs in Lusaka, Zambia 3. Identify ways to address the weaknesses of different channels for provision of emergency contraception
Keywords: Access, Service Delivery
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.