Repeat use of emergency contraceptive pills: A study of urban women in Kenya and Nigeria

Background

Anecdotal accounts and some research suggest that dedicated EC products are being used more frequently than intended. However, observations or even interviews with pharmacy-based ECP users over a limited time period cannot corroborate claims of repeat use, as frequent ECP users tend to be oversampled in point-of-service settings.

Methods

To obtain as diverse a sample of EC users as possible without conducting resource-intensive household surveys, women 18-49 years old from high, middle, and low income neighborhoods were intercepted and interviewed at high-traffic shopping areas in Nairobi, Kenya and Lagos, Nigeria. Data collection focused on the characteristics of women who use EC, patterns and extent of EC use, their contraceptive method mix, and attitudes about EC and other contraceptive methods.

Results

Average frequency of EC use over six months was higher among Nigerian than Kenyan women (4.6 vs. 2.1), but the context of use was similar. In Kenya, there was greater use of condoms, pills, and injectables as a main contraceptive method than in Nigeria. Nigerian women were more likely to name ECPs as their main method of contraception (41% vs. 15%) than Kenyans and their attitudes towards EC use were in line with this finding.

Conclusions

Results suggest that understanding repeat use is not dependent solely on the number of times a woman uses EC, but on the context of use as well. Moreover, overall contraceptive prevalence may play a role in the frequency of EC use.