Emergency contraception: knowledge and attitudes of Turkish nursing and midwifery students.

OBJECTIVES: To assess the knowledge and attitudes of emergency contraception (EC) among nursing and midwifery students of a university in the Eastern-Mediterranean region of Turkey. METHODS: The survey was conducted among 210 nursing and midwifery students. RESULTS: One hundred and twenty-five participants (59.5%) knew at least one method of EC. One hundred and fourteen participants (54.3%) had heard about emergency contraceptive pills (ECPs), but only 17 (8.1%) knew what they contained. Rates of hearing about ECPs were statistically higher in third and fourth classes than first and second classes, and in midwifery students than in nursing students (P < 0.001). In spite of their very unsatisfactory level of knowledge, 166 students (79.0%) thought that ECPs should be sold in pharmacies. CONCLUSION: The nursing and midwifery students we assessed have a very insufficient knowledge of EC. Probably therefore, many are prejudiced against it. They should be much better acquainted with this modality of contraception since, after graduation, they will play an important role in the dissemination of information about EC in the population.     

Knowledge, practices, and attitudes regarding emergency contraception among students at a university in Ghana

Objectives

To investigate the knowledge, practices, and attitudes among students at a university in Ghana regarding emergency contraception (EC).

Methods

An anonymous, self-administered, 39-item questionnaire was sent to 3200 students. The sample size was stratified and 2292 students were randomly selected.

Results

Of the 71.6% of students who responded, 51.4% had heard of EC. Among those, 19.4% thought EC consisted of contraceptive pills, 19.1% of “morning-after pills,” and 12.8% of an intrauterine device. Only 4.2% had ever used EC but 73.9% wished it were provided on campus. Of all the respondents, 90.9% called for the establishment of a reproductive health counseling center on campus.

Conclusion

Student knowledge and use of EC were poor, and there is urgent need for reproductive counseling and EC services on campus.     

Emergency contraception use by Irish teenagers

Objective?To audit teenagers attending a family planning clinic requesting emergency contraception.

Methods?A non-judgemental, relaxed, confidential interview was carried out.

Results?Many young Irish women become sexually active at a young age. Many teenagers appear to have problems using condoms correctly while others are taking chances by not using any method of contraception.

Conclusions?These findings have important implications for those drawing up a sexual health strategy for young people.     

Emergency contraception in Cuba with 10 mg of mifepristone

Background?Mifepristone in a dose of 10 mg is an effective emergency contraceptive when administered up to 120 hours after unprotected coitus.

Methods?Between May 2003 and February 2005, we conducted in Cuba a single-arm trial to evaluate the effectiveness of 10 mg mifepristone for emergency contraception up to 6 days after unprotected coitus. A total of 635 women who requested emergency contraception after a single act of unprotected intercourse were included in the study.

Results?After treatment there were 7/635 (1.1%) pregnancies (95% CI 0.4–2.3%). Pregnancy that might have occurred was prevented in 88.0% of the cases (95% CI 77.1–95.1%). The most common side effects reported by participants were fatigue (10.7%), dizziness (6.1%) and nausea (4.9%); vomiting was only reported by 0.6%. In 38/635 (6.0%) women menstruation was delayed more than 7 days.

Conclusions?Mifepristone 10 mg administered is an effective emergency contraceptive with an acceptable profile of side effects up to five days, but greater studies are necessary to verify its efficacy up to 6 days after unprotected intercourse.     

Knowledge and attitudes towards emergency contraception of health-care providers in a region with a high birth rate

Objective?To assess the knowledge of, attitude towards and practices of emergency contraception among health-care providers at a university hospital located in a region with a high birth rate.

Methods?The survey was conducted among 214 health-care providers working at a university hospital located in eastern Turkey.

Results?Two hundred participants completed the questionnaire. Of the respondents, 26.0% said that they did not know anything about emergency contraception, while the remaining 74.0% said that they knew about at least one of the methods of emergency contraception. But among these, the knowledge of 38.5% of the participants about emergency contraception was accurate and that of 61.5% was inaccurate. Thirty-four percent of the respondents stated that they had previously required personally to use emergency contraceptive methods. The most commonly used emergency contraceptive methods were oral contraceptives (69.1%) and intrauterine device (14.7%). None of the respondents knew anything about mifepristone and levonorgestrel.

Conclusion?There is a knowledge deficit among health-care providers who play a significant role in the dissemination of the information about emergency contraception.     

Turkish adolescents' knowledge on and attitude toward emergency contraception

ObjectiveAdolescents tend to be at risk for unwanted pregnancies, so detecting their level of knowledge on emergency contraception and providing them information is important to prevent such pregnancies. Hence, in two faculties at Gazi University, this study aimed to detect freshman students' level and need of knowledge on emergency contraception and to evaluate their attitude towards emergency contraception.Materials and MethodsThe study was performed with freshman students of the Occupational Education Faculty and the Technical Education Faculty. A questionnaire including questions about demographic properties, obstetrical history, status of contraceptive use, level of knowledge and opinions on emergency contraception was administered to the students. Data was analyzed statistically with the computer program EPI Info 6.0.ResultsA total number of 385 adolescents were included in the studys; 157 of whom were males (40.8%) and 228 of whom were females (59.2%). To the question “is there any way to prevent a possible pregnancy after an unprotected sexual intercourse?”, 166 students replied “yes” (50.5%), 39 “no” (11.9%) and 124 “I do not know” (37.7%). Of 166 students replying “yes,” 114 (68.7%) listed a possible contraceptive method. The mostly cited method was “morning after pills” (n = 62; 54.4%), followed by curettage (n = 15; 13.2%). Among all students, 158 (49.8%) informed us that they were aware of the presence of “morning after pills” whereas 159 (50.2%) claimed they were not. Eighty-six male students (70.5%) and 115 female students (72%) emphasized that they would use emergency contraception upon necessity.ConclusionHalf of the participants were familiar with various options to prevent pregnancy after an unprotected sexual intercourse episode, but they lacked specific knowledge about possible methods and ways to use them. Thus, it is essential that information about emergency contraception be included in adolescents' educational programs and that adolescents be provided with easily accessible medical services.     

Emergency contraception in South Africa: A literature review

Objectives Since emergency contraception (EC) products became available over the counter in South Africa in 2000 a number of studies have emerged. This paper reviews the growing body of literature on EC in that country.

Methods Standard computer database searches identified published articles and reports on EC in South Africa.

Results The level of awareness of EC is fairly low, especially among public sector clients. Most studies suggest that very few people have even heard of it. Several studies also indicate that provider knowledge of and attitude towards EC vary greatly. While many providers are aware of the indications and efficacy of the method, not all health care professionals are sufficiently knowledgeable and misperceptions persist. The limited knowledge of EC among health professionals may, in turn, prevent them from discussing it with clients.

Conclusion The existing literature suggests that the greater availability of EC is not sufficient to increase uptake and that interventions are needed to ensure that women become aware of this option.     

Past and present midwifery education in Turkey

Among criteria relating to the level of development in a country are health indicators such as total fertility, maternal mortality, infant mortality, and rates of life expectancy at birth. These have a close relationship with the quality of health-care services, especially those provided by midwives. An improvement in midwifery services can be achieved to a great extent by standardised and high-quality midwifery education. Until recently, midwifery education has not been standardised in Turkey. Although improvements have been made, more needs to be accomplished. In this paper, we report the development of midwifery education in Turkey from a historical perspective, dealing with past and present applications, and make recommendations to overcome existing problems.     

Emergency contraception and impact on abortion rates

Emergency contraception (EC) is a drug or a device that is taken after sexual intercourse to prevent unintended pregnancy. The most effective EC is the copper-bearing intrauterine device (Cu-IUD), but oral EC methods are more commonly used and include a single dose of either levonorgestrel (1.5 mg) or ulipristal acetate (30 mg). Although all EC methods are extremely safe, access to EC is often limited due to prevailing misconceptions over how EC works. Although EC can prevent unintended pregnancy for an individual woman, it has failed to make an impact on abortion rates at a population level. This may be because it is not used after every episode of unprotected sex and because existing oral EC methods are only effective if used before ovulation. Future strategies around EC should focus on maximising uptake of Cu-IUD, facilitating initiation of effective regular contraception after EC and developing a more effective oral EC.     

Emergency contraception in Senegal: Challenges and opportunities

Abstract

Objectives This paper highlights lessons from introductory efforts and presents new data on community, provider and key opinion leader perspectives to support expanded use of emergency contraception (EC) in Senegal.

Sources of information The paper draws on four data sources: (i) a literature review; (ii) a secondary analysis of a household survey conducted by the Urban Reproductive Health Initiative; (iii) in-depth interviews with key opinion leaders; and (iv) a quantitative survey of healthcare providers from a range of service delivery points.

Analysis of data Knowledge of EC among women is low in urban areas, with only 20% of women having heard of the method and 4% having ever used it. There were serious gaps in providers’ technical knowledge about EC; only 57% knew its mode of action and 34% were aware of the need for timely use (within 120 h). Moreover, nearly half reported reluctance to provide EC to married women and even fewer were willing to provide it to youths, particularly to adolescent girls. Responses from key opinion leaders were mixed, demonstrating ambivalence about EC and how it could be offered.

Conclusion In Senegal, the current positive political climate for family planning provides a good opportunity for strengthening EC programming to address knowledge and attitudinal barriers among providers, key opinion leaders and communities.

Chinese Abstract

摘要 ：目的,这篇文章的亮点来自导言,尽力展示并且提供了社区、提供者及关键意见领袖支持紧急避孕药在塞内加尔的广泛使用的新数据。

资料来源 这篇文章的资料来源于四个数据：（1）文献综述;（2）一篇由城市生殖健康倡议进行的入户调查的二级分析。（3）一个和关键意见领袖的深度的采访。（4）很多医疗保健服务提供方从乡镇机构得到的量化调查结果。

数据分析 在城市地区的妇女对紧急避孕药的了解很少,仅有20%的女性听说过这种方法而只有4%的女性使用过。供应者提供的紧急避孕药的技术知识存在缺口,只有57%的人知道其作用方式,34%的人知道要在120小时内及时地使用。此外,据报道几乎有一半的情况愿意向已婚女性提供紧急避孕药,极少愿意提供给青年人尤其是青春期的女孩。关键意见领袖的反应是不确定的,对于紧急避孕药及该如何提供存在着矛盾。

结论 在塞内加尔,当前计划生育积极的政治气候对于加强紧急避孕药的规划、对药物的供应者,关键意见领袖和社区介绍药品的知识和态度上的障碍提供了很好的机会,。     

Emergency contraception in the context of marriage in Upper Egypt

Objective

To explore the degree of knowledge, perception, and practice of emergency contraception (EC) within marital relations in Egypt.

Methods

The present study was a pilot cross-sectional survey. Eligible participants were randomly selected from 4 governorates in Upper Egypt. A questionnaire was designed by the investigators and administered to an unselected sample of healthcare providers and potential users of EC. The questionnaire collected information in 4 domains: demographics; knowledge about EC; attitudes toward EC; and practice of EC in Egypt.

Results

In total, 240 healthcare providers and 60 potential users of EC completed the questionnaire. Approximately 85% of healthcare providers and 30% of potential users had heard about EC. A similar proportion of study participants said that EC methods are needed. Only 32.7% of healthcare providers and very few potential users had actually used EC.

Conclusion

There is a need for EC in Egypt. However, a big gap in knowledge leads to nonuse or incorrect use of EC and negative attitude toward it. If health service planners and policy makers could fill this gap, a considerable decline in the prevalence of unwanted pregnancy may be achieved by using EC.     

Knowledge about emergency contraception among family-planning providers in urban Ghana

Objective

To assess the theoretical and practical knowledge about emergency contraception (EC) among family-planning (FP) providers in Ghana and to examine the association between FP providers’ theoretical and practical knowledge.

Methods

Data on 600 FP providers were collected through a census of facilities offering FP services in Kumasi, Ghana, in 2008. Nested linear multivariate regression analysis was used to identify sociodemographic, facility-related, and work-related variables associated with FP providers’ theoretical and practical knowledge about EC.

Results

On average, FP providers gave 4.1 correct answers to the 11 questions assessing theoretical knowledge and 5.6 correct answers to the 8 questions assessing their practical ability to provide EC. The FP providers seemed to learn provision-related aspects through practice without having a particularly good theoretical knowledge on EC as a contraceptive method. The health sector in which FP providers worked, their education and having received EC-specific training, the number of services offered, and the number of women seen during a week were all significant correlates of both theoretical and practical knowledge about EC. The 2 knowledge domains were significantly and positively associated.

Conclusion

There is need to improve knowledge about EC among FP providers in Ghana through in-service training.     

Knowledge of and Interest in the Copper Intrauterine Device Among Women Seeking Emergency Contraception

Objective

Emergency contraception (EC) includes hormonal pills (levonorgestrel or ulipristal acetate) and the copper IUD (Cu-IUD). The Cu-IUD is more effective for EC than hormonal pills but remains underused, possibly because of lack of knowledge or interest. The objective of this study was to examine knowledge of and interest in the Cu-IUD for EC among Canadian women seeking EC.