Supporting contraceptive choice in self-care: qualitative exploration of beliefs and attitudes towards emergency contraceptive pills and on-demand use in Accra, Ghana and Lusaka, Zambia. Issue 3 (1st January 2022)

• Record Type: Journal Article
• Authors: Kalamar, Amanda; Bixiones, Christine; Jaworski, Grace; Lerma, Klaira; Mwansa, Melvin; Lawerh, Rachel; Adjei, Selase
• Is Part Of: Sexual & reproductive health matters. Volume 29:Issue 3(2021)
• Publication Date: 2022-01-01
• Subjects: emergency contraception -- on-demand -- self-care -- stigma -- adolescents -- self-managed care; Sexual health -- Periodicals; Reproductive health -- Periodicals; Women's health services -- Periodicals; Women's rights -- Periodicals; Women's rights; Women's health services; Sexual health; Reproductive health; Sexual Health; Reproductive Health; Women's Health; Women's Rights; Electronic journals; Periodicals; Periodical; 613.9
• DOI: 10.1080/26410397.2022.2045065
• Languages: English
• ISSNs: 2641-0397

Abstract

ABSTRACT: Supporting women to use emergency contraceptive pills (ECPs) as both a back-up and a regular, on-demand contraceptive method can increase self-managed contraceptive options and enhance reproductive autonomy, particularly for vulnerable populations. ECPs are currently regulated for use in an "emergency" situation; however, some evidence suggests that women also value this method as a regular, on-demand option used to prevent pregnancy with foresight and confidence. Beliefs and attitudes towards ECPs and their on-demand use in Accra, Ghana and Lusaka, Zambia were explored through in-depth interviews (IDIs) and focus group discussions (FGDs) with women ages 18–34 and men ages 18–30 in Accra and Lusaka. Structured interview guides and focus group discussion guides were used to explore societal and community norms, knowledge, behaviour, and attitudes. IDIs were analysed using deductive, thematic coding, and FGDs were analysed using inductive, thematic coding. Three major themes emerged: first, ECPs are a trusted method and often preferred as an easy and effective option; second, people value ECPs as an on-demand method, yet fear that repeated use could have harmful health effects; finally, anticipated stigma among users of ECPs is higher than experienced stigma, except among young women. The findings that emerged from this research suggest that the repositioning of ECPs as suitable for on-demand use would be an important step towards reducing the stigma and discrimination that is often associated with the method while expanding the range of self-care contraceptive options available to meet the differing needs of women, young women and vulnerable populations.