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Jessica Malter
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International Perspectives on Sexual and Reproductive Health

TWO DECADES AFTER EMERGENCY CONTRACEPTIVE PILLS BECAME AVAILABLE, FEW WOMEN USE THEM

In many developing countries, most women have never heard of or used emergency contraceptive pills, according to “Knowledge and Use of Emergency Contraception: A Multicountry Analysis,” by Tia Palermo of Stony Brook University. Although the method can help women avoid unplanned pregnancies, in every country surveyed but Colombia, fewer than 50% of women have ever heard of it 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.

The researchers analyzed national survey data from 2000–2010 of women aged 15–49 in 45 countries in four regions.Women’s knowledge and use of the method varied widely within each region. In Latin America and the Caribbean, for example, Colombia had the highest proportions of women who knew about the method (66%) and had used it (12%), while Haiti had the lowest (13% and 0.4%, respectively).

Wide ranges in knowledge and use were also seen in the other three regions. In Africa, women’s awareness of emergency contraception ranged from 2% in Chad to 40% in Kenya and use ranged from less than 0.1% in Chad to 4% in Ghana. In Asia, awareness ranged from 3% of women in Timor-Leste to 29% in the Maldives, and use ranged from a low of 0.1% (Cambodia, Nepal and Timor-Leste) to 0.9% (Pakistan). In Eastern Europe and West Asia, Ukraine had the highest rates of awareness and use (49% and 6%, respectively), while Azerbaijan had the lowest (5% and 0.5%).

According to the authors, rates of emergency contraception use in the countries studied tended to be much lower than in countries where the method has been on the market longer, such as France and the United States (17% and 11%, respectively). The exceptionally high levels of knowledge and use found in Colombia, reflect, among other things, a commercial sector that makes nine brands of emergency contraceptive pills easily available.

The authors recommend that family planning programs place a greater focus on disseminating information about emergency contraception, especially to women with lower income and less education. They also recommend that governments, donors and NGOs ensure that a range of contraceptive methods, including emergency contraception, are available at public health facilities.

Knowledge and Use of Emergency Contraception: A Multicountry Analysis,” by Tia Palermo of State University of New York, is currently available online in International Perspectives on Sexual and Reproductive Health.

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