International Family Planning PerspectivesEmergency contraceptive pills are a postcoital contraceptive method that has been available since the 1970s. 1 Nevertheless, they are an underutilized option for preventing unwanted pregnancy, partly because knowledge of the method is often lacking, even among health care providers who typically serve as the primary gatekeepers to its access. For example, in a study of Indian paramedical workers, just 3% were familiar with the concept of emergency contraception; 2 in a survey of Turkish physicians, midwives and nurses, only 29% of those familiar with the method correctly identified the period of time after unprotected sexual intercourse in which the method was effective; 3 and in a recent survey, 39% of Kuwaiti retail pharmacists had heard of the method. 4 Furthermore, negative attitudes toward and inaccurate knowledge of the method among health care providers-including pharmacists, physicians and nursescan pose substantial barriers to women's timely access to the pills in the event of unprotected intercourse.In the English-speaking Caribbean, there is a great need for increased awareness of and access to emergency contraceptive pills. Barbados and Jamaica have high levels of sexual violence and unprotected sexual intercourse, particularly among young people. For example, 57% of pregnancies in Jamaica are unwanted or unplanned, and 20% of Jamaican women have experienced forced sexual intercourse. 5 Because abortion is highly restricted in this country, women with unplanned or unwanted pregnancies often resort to clandestine, unsafe abortions, which are a leading cause of disability and maternal mortality. 6 There are no comparable reproductive health data for Barbados. Despite the potential for emergency contraceptive pills to dramatically improve the reproductive health of women in the English-speaking Caribbean, little research has been conducted on the method in these countries, particularly in small nations such as Barbados.Emergency contraceptive pills are sold in pharmacies in both Jamaica and Barbados, but regulations regarding their provision differ. Since June 2003, Postinor-2 (a dedicated levonorgestrel product) has been available in Jamaica without a prescription, under the condition that pharmacists counsel women about the method at the time of purchase. In Barbados, Postinor-2 is also sold in pharmacies, but is legally available only by prescription. We are aware of no previous studies in Barbados on providers' knowledge of, attitudes toward or provision practices regarding the method. Because of the scarcity of information on the provision of emergency contraceptive pills in Caribbean countries, we conducted two surveys with the aim of addressing this research gap among Barbadian and Jamaican health care providers.
Jamaican and Barbadian Health Care Providers' Knowledge, Attitudes and Practices Regarding Emergency Contraceptive Pills