141st APHA Annual Meeting

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Exploring the journey of emergency contraception in Jordan

Tuesday, November 5, 2013 : 3:00 PM - 3:15 PM

Angel M. Foster, DPhil, MD, AM , Faculty of Health Sciences, University of Ottawa & Ibis Reproductive Health, Cambridge, MA
Despite Jordan's longstanding commitment to family planning service delivery for married women, dedicated emergency contraceptive pills (ECPs) have not been registered. This lack of product registration is surprising given the robust contraceptive method mix available through the public sector and the relatively strong local pharmaceutical industry. Based on fieldwork conducted over the last eight years, this paper chronicles the journey of emergency contraception (EC) in Jordan. The first act of the EC drama was influenced by research conducted in the early 2000s suggesting that there was considerable need for post-coital methods of pregnancy prevention, particularly among unmarried women in the capital. Modest attempts to introduce a dedicated product were thwarted by professional medical organizations precisely because the technology had the potential to be used by unmarried women. In the second phase, the influx of Iraqi refugees into Jordan in the mid-2000s prompted the international humanitarian relief community to call for ECP registration. However, as EC became conflated with larger debates about the status of Iraqi refugees, mobilized opposition to EC's introduction from a range of stakeholders mounted.

Yet by the end of the 2000s, married and unmarried Jordanian women alike began to request “urgent pills” or “honeymoon pills.” The third phase of the EC saga is centered in the retail pharmacy sector and is characterized by demand from women. The story of EC in Jordan offers instructive lessons of competing political, professional, and medical interests and highlights the importance of women's agency in expanding access to new reproductive health technologies.

Learning Areas:
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe the three phases of EC's journey in Jordan Identify obstacles to dedicated product registration Discuss possible strategies or expanding access to EC in Jordan

Keywords: Contraception, International Reproductive Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I hold the Echo Endowed Chair in Women's Health Research at the University of Ottawa where I am an Associate Professor in the Faculty of Health Sciences. I am also an Affiliated Scholar at Ibis Reproductive Health. I am the PI of the study and conducted the fieldwork described in this paper.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.