Urban Health Initiative's Experiences with Emergency Contraceptive Pill (ECP)

Background

Contribution of ECP to total CPR is low in India. Reported ever-use remains under 1%.

Interventions

• Trained 100 Counselors, 9000 Community Workers who reached 756192 women 

• Referred clients to government hospitals/workers and pharmacies for ECP

• Developed job aids that included the ECP

• Supported availability of free supply and visibility of products in sales outlet

Data-source

• House-hold survey at baseline and midterm in 6 cities

• Sales data/stock-registers 

• Discussions with public/private doctors, chemists and community workers.

Results

• Use of ECP increased from 0.2% to 0.4%
• Janani-a partner, increased sales from 100 to 13,842 ECPs within one year 

Discussions with providers/community workers

• There are a wide variety of brands to choose from. Community knows about OCP, Weekly OCP, MA pill and ECP

• EC pills were sometimes confused with MA pills

• Younger and educated women are more aware

• Women hide ECP use and disclose only if they miss their periods

• The use was more in clients with infrequent intercourse

• Some women preferred MA pills used only once they miss periods compared to ECP, taken after every unprotected sex

• Cost was not a deterrent as women wanted to prevent unplanned pregnancy

Lessons

• Commercial sector is the primary source for ECPs in India, not government providers

• ECP counseling and distribution through government sector is sub-optimal

• ECP use can be expanded by increasing awareness of these products by responsible and accurate mass-media advertising

• In India, it is seen as particularly important to prevent unsafe abortions that kill an estimated 20,000 women every year

• Men make most calls to helplines requesting information on ECPs