PMA2020 surveys provide valuable new information on knowledge and use of emergency contraception. This issue brief analyses the levels of knowledge, use of, and access to EC in seven different African countries. Results show that knowledge of EC varies by country but that use remains low in all areas surveyed.
This section contains fact sheets, blog posts, technical statements, clinical guidelines, journal articles and publications focusing on policies and access. Several publications focus on sexual assault and humanitarian settings. For more information on specific themes, please visit the EC Issues Pages. Many of our publications are available in multiple languages.
In an effort to draw more attention to emergency contraception access around the world, Elizabeth Westley and Monica Kerrigan authored a blog post on Devex’s website. In it, the authors discuss the unfinished agenda for EC access and point out that although EC remains the only contraceptive method that is effective after sexual intercourse, it is one of the most underutilized, underfunded, and unheard of tools to broaden access and choice for millions of women and youth globally.
A new blog post, authored by Elizabeth Westley and Melissa Garcia, details ICEC’s recent strategy to increase awareness of EC by promoting EC-related storylines in “entertainment for education” media projects. These projects, which are produced by our partners Population Media Center and ONG RAES and include engaging television and radio soap operas, provide innovative and unique opportunities to reach wide audiences in the countries where ICEC has focused work (Democratic Republic of the Congo, Senegal, and Nigeria).
National Essential Medicines Lists (EMLs) include medicines that fulfill primary health needs of a country’s population, as determined by its government. This fact sheet provides information regarding the inclusion or non-inclusion of emergency contraceptive pills (ECPs) in all available country EMLs. In addition, it lists which ECP regimens are indicated among those EMLs that include ECPs.
This document, co-authored by ICEC and the Inter-Agency Working Group on Reproductive Health in Crises, provides information about EC for health care providers in crisis settings. It discusses information about EC, such as the timeframe during which it can be taken and safety concerns, and provides a chart outlining the different regimens of oral contraceptive pills that can be taken to make EC when a dedicated EC product is not available.
EC is a vital option for women and girls in crisis-affected settings. Women living in crisis settings, such as countries or regions affected by conflicts and natural disasters, face particular challenges that make access to EC essential. Regular contraceptive supplies can be disrupted when a crisis strikes, while sexual assault and transactional sex can often rise; both of these factors result in an increased need for EC. Moreover, the especially harsh living conditions in most crisis-affected settings make pregnancy and childbirth even more difficult and life-threatening. This document, co-authored by ICEC and the Inter-Agency Working Group on Reproductive Health in Crises, provides information for policymakers, decision-makers, and program managers about EC in crisis-affected settings, including how to ensure that women in crisis-affected settings have access to EC.
This paper presents a narrative synthesis of research to: identify provider factors that facilitate and constraint access to ECP; assess the effectiveness of associated interventions and; explore associated health system issues in LMIC. The analysis revealed provider knowledge gaps, less than favorable attitudes, and practice issues. The findings provide limited insight into products prescribed and/or dispensed, the frequency of provision, and information and advice offered to consumers. As the provision of ECPs shifts from the clinic-based health sector to increasing provision by the private sector, the limited understanding of provider performance and the practice gaps revealed in this review highlight the need to further examine provider performance to inform the development of appropriate workforce interventions. Authors: Angela Dawson, Nguyen-Toan Tran, Elizabeth Westley, Viviana Mangiaterra, and Mario Festin
ICEC’s Emergency Contraceptive Pills Medical and Service Delivery Guidelines were adapted in 2013 by the Latin American Consortium for Emergency Contraception (CLAE) and the Latin American Federation of Societies of Obstetrics and Gynecology (FLASOG) to reflect the cultural and political environment in the region. The guidelines address EC pill regimens including levonorgestrel and ulipristal acetate, and also the Yuzpe method, which is still the only choice available in many communities in Latin America and the Caribbean. In 2015 this version of the guidelines were translated into Portuguese by the Rede Brasileira de Promoção de Informações e Disponibilização da Contracepção de Emergência (REDECE), and reviewed and endorsed by the Federação Brasileira das Sociedades de Ginecologia e Obstetrícia (FEBRASGO), the Associação de Obstetrícia e Ginecologia do Estado de São Paulo (SOGESP) and the Sociedade Brasileira de Reprodução Humana (SBRH).
While emergency contraceptive pills are labeled for single use, medical evidence suggests that they can safely be used multiple times in a cycle. Because ECPs work by delaying ovulation, they will not provide protection from pregnancy if unprotected intercourse occurs after ECPs have been used. Women who want to avoid pregnancy can take ECPs multiple times in each cycle with assurance that such use is safe; however, long-term or on-going methods are more effective at preventing pregnancy, and only condoms can prevent transmission of sexually transmitted infections. This fact sheet reflects the latest version of the World Health Organization’s Medical Eligibility Criteria (MEC), released in 2015.
This publication reviews new developments in emergency contraception research, including women’s weight and EC effectiveness, repeat use of EC, and the need for EC as part of comprehensive post-rape care. Clinicians can play an important role in making EC information and services available to women by providing accurate information about EC generally and the specific options that may be most effective for each woman, including levonorgestrel, ulipristal acetate and the copper IUD. Authors: Elizabeth Westley, Sarah Rich, and Hilary Lawton
This study examined knowledge and use of emergency contraception in 45 countries using population-based survey data. In every country surveyed but Colombia, fewer than 50% of women have ever heard of EC and fewer than 6% have ever used it. In general, the more educated women were or the wealthier they were, the more likely they were to have known about or used emergency contraception. Authors: Tia Palermo, Jennifer Bleck, and Elizabeth Westley