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“Prophylactic” versus “on demand”: A critical analysis of Emergency Contraceptive Pill (ECP) distribution

M. E. Khan, PhD1, Sharif Mohammed Ismail Hossain, MBBS MPH2, and Moshiur Rahman2. (1) Asia & Near East Region, Population Council, House CES (B) 21, Road 118, Gulshan, Dhaka, Bangladesh, 8802-8821227, mekhan@pcindia.org, (2) Popualtion Council, House #CES(B) 21, Road #118, Gulshan, Dhaka, Bangladesh

This operations research tested relative effectiveness of two alternatives service delivery models for providing ECP. In the first study group (On-demand), all family planning clients except IUD, Norplant and sterilization acceptors were received counseling and a brochure on ECP. They were asked to come back at the clinic for ECP supplies, if needed. In the second group (prophylactic), the women received same information and services but in addition they were provided two packets of ECP to use during emergency. The third group was control group, without any intervention. To examine the impact of educational efforts and service delivery strategies it used a multi-factorial, control group longitudinal survey design. Among the two delivery models tested, model providing ECP as prophylactic was much more successful in meeting needs of ECP of the clients and its proper use than the model which provided ECP on-demand after unprotected intercourse has occurred. In prophylactic group, 75 percent of the clients in need, reported use of ECP as against 47 percent in on demand group. Logistic regression showed that the chance of ECP use was more than 5 times higher in the prophylactic area than in the on-demand area. The multivariate analysis further revealed that programmatic variables were the key factors in determining use of ECP. It included provision of ECP as prophylactic (odd ration 5.3), strong educational support, measured in terms of provision and reading of ECP brochure (odd ratio 4.7) and user- ship of contraceptive method when unprotected intercourse occurred (odd ratio 5.9).

Learning Objectives:

  • At the end of the presentation the participants of this session will be able to

    Keywords: Access and Services, Health Care Delivery

    Presenting author's disclosure statement:
    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.

    Emergency Contraception: Challenges and Opportunites as Availabitiy Increases

    The 132nd Annual Meeting (November 6-10, 2004) of APHA