Reconceptualizing Measurement of Emergency Contraceptive Use: Comparison of Approaches to Estimate the Use of Emergency Contraception

Larson, Elizabeth; Morzenti, Antonia; Guiella, Georges; Gichangi, Peter; Makumbi, Fredrick; Choi, Yoonjoung

doi:10.1111/sifp.12111

Cited by 10 publications

(14 citation statements)

References 16 publications

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“…While there is potential for the period regulation question to capture nonabortions (for instance, emergency contraceptive use), we phrased both questions within the context of actions that women may take when they become pregnant at a time when they cannot or do not want to be pregnant, in order to minimize misreporting. Additionally, among respondents, current or previous use of emergency contraception was very low (0.05 percent) (Larson et al 2020). With women's attention to menstrual regularity in the context of marital relationships, the widespread diffusion of medication abortion drugs, and growing access to pregnancy testing kits through community health workers, primary health centers, and pharmacies, we expect that we are capturing intentional actions taken to end a suspected or confirmed pregnancy, but this is an area where further investigation is warranted.…”

Section: Discussionmentioning

confidence: 98%

“…Additionally, among respondents, current or previous use of emergency contraception was very low (0.05 percent) (Larson et al. 2020). With women's attention to menstrual regularity in the context of marital relationships, the widespread diffusion of medication abortion drugs, and growing access to pregnancy testing kits through community health workers, primary health centers, and pharmacies, we expect that we are capturing intentional actions taken to end a suspected or confirmed pregnancy, but this is an area where further investigation is warranted.…”

Section: Discussionmentioning

confidence: 99%

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Induced Abortion Incidence and Safety in Rajasthan, India: Evidence that Expansion of Services is Needed

Ahmad

Shankar

Khanna

et al. 2020

Studies in Family Planning

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Despite induced abortion being broadly legal in India, up-to-date information on its frequency and safety is not readily available. Using direct and indirect methodological approaches, this study measures the one-year incidence and safety of induced abortions among women in the state of Rajasthan. The analysis utilizes data from a population-based survey of , reproductive aged women who reported on the abortion experiences of their closest female confidante in addition to themselves. We separately assess correlates of having a recent and most unsafe abortion using multivariable regression models. The confidante approach produced a one-year abortion incidence estimate of  per , women, whereas the respondent estimate is . per , women. Based on the confidante estimate, approximately , abortions occurred in Rajasthan over a year. Overall,  and  percent of respondent and confidante reported abortions were classified as most unsafe. Results suggest that abortion remains an integral component of women's fertility regulation, and that a liberal law alone is insufficient to guarantee access to safe abortion services. Existing policies on abortion in India need updating to permit task sharing in line with current recommendations to expand service delivery so that demand is met through provision of safe and accessible services.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Induced Abortion Incidence and Safety in Rajasthan, India: Evidence that Expansion of Services is Needed

Ahmad

Shankar

Khanna

et al. 2020

Studies in Family Planning

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show abstract

“…Women who want to avoid pregnancy, but are not using modern contraceptive methods, account for 77% of unintended pregnancies [ 7 ]. Emergency contraception, which is administered within a few days after sexual intercourse, can help prevent pregnancies due to non-use, failure or misuse of contraceptive, or situations of rape or coerced sex [ 10 , 11 ]. While the copper intrauterine device is considered an emergency contraceptive method; the leading option is emergency contraceptive pills (ECP), which are oral contraceptive pills for women to use as soon as possible (up to 5 days) after sexual intercourse to prevent unwanted pregnancy [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…In addition, PMA incorporated a unique ECP question: “ Have you used emergency contraception at any time in the last 12 months ?”. This question has a longer recall period than the traditional ‘current use’ ECP indicator, which underestimates the scale of ECP usage [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Contextual factors associated with contraceptive utilization and unmet need among sexually active unmarried women in Kenya: A multilevel regression analysis

Nemser

Addofoh²

2022

PLoS ONE

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Background Unmarried women who report less recent sexual intercourse (>30 days from survey enumeration) are largely excluded from global health monitoring and evaluation efforts. This study investigated level and contextual factors in modern contraceptive utilization and unmet need within this overlooked female subpopulation in Kenya from 2014 to 2019. Methods This study analyzed data from the Performance Monitoring and Accountability (PMA) survey in Kenya, a nationally representative survey of female respondents, to understand the level and contextual factors for family planning utilization and unmet need within female subgroups including married, unmarried sexually active (defined as sexual intercourse within 30 days of survey enumeration), and unmarried with less recent sexual intercourse (defined as sexual intercourse 1–12 months prior to survey enumeration). The analysis included multilevel regression modeling to assess correlates on outcomes of modern contraceptive prevalence rate (mCPR), unmet need, and recent emergency contractive pill (ECP) use, which is a unique PMA question: “Have you used emergency contraception at any time in the last 12 months?”. Results Cumulatively, the surveys enumerated 19,161 women and this weighted analysis included 12,574 women aged 15–49 from three female subgroups: 9,860 married women (78.4%), 1,020 unmarried sexually active women (8.1%), and 1,694 unmarried women with less recent sexual intercourse (13.5%). In 2019, while controlling for covariates, unmarried women with less recent sexual intercourse exhibited statistically significant differences (p-value<0.02) in current mCPR, mCPR at last sexual intercourse, unmet need for modern contraceptives, and recent ECP use. As compared to an unmarried woman with less recent sexual intercourse (i.e., reported sex 1–12 months prior to survey), the odds of an unmarried sexually active woman (i.e., reported sex within last 30 days of survey) currently using modern contraceptives was 2.28 (95% CI: 1.64, 3.18), using modern contraceptives at last sexual intercourse was 1.44 (95% CI: 1.06, 1.95), and having an unmet need for modern contraceptives was 2.01 (95% CI: 1.29, 3.13) while controlling for covariates. The odds of a married woman using ECP during the last 12 months was 0.60 (95% CI: 0.44, 0.82) as compared to an unmarried woman with less recent sexual intercourse. In 2019, unmarried women with less recent sexual intercourse reported the highest rate of ECP use during the last 12 months at 13.5%, which was similar for unmarried sexually active women at 13.3%. Since 2014, summary measures of unmet need and total demand for modern contraceptives increased for unmarried women with less recent sexual intercourse, but declined for the other female subgroups. Conclusion In Kenya, unmarried women with less recent sexual intercourse exhibited significantly different contraceptive utilization, unmet need, and recent emergency contraceptive use. Moreover, changes over time in key family planning indicators were asymmetrical by female subgroup. This study identifies an important monitoring gap regarding unmarried women with less recent sexual intercourse. Evidence dissemination by the global measurement community for these unmarried women is exceedingly scarce; therefore, developing an inclusive research agenda and actionable information about these marginalized women is needed to enable targeted planning and equitable service delivery.

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“…Emergency contraception has a number of advantages over intentional termination of pregnancy. The United Nations Commission on Life-Saving Commodities for Women and Children listed emergency contraception as one of its 13 "overlooked life-saving commodities" that could save lives of 6 million women and children (United Nations International Children's Emergency Fund, 2012) [10,11]. Young adolescent girls often decide to use oral emergency contraception and it is extremely important to provide health education to this population at appropriate opportunities [12].…”

Section: Introductionmentioning

confidence: 99%

Knowledge and attitudes towards emergency contraception among adolescents

2021

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Introduction. Emergency or postcoital contraception is a method of contraception that is used within 72 hours after unprotected intercourse. It is very important that adolescents consider emergency contraception with awareness. It is not a regular method of contraception. The aim of this study was to examine the knowledge and attitudes of adolescents towards the use of emergency contraception. Material and Methods. The research was a cross-sectional study that used a specially designed questionnaire for adolescents intended to assess their knowledge about emergency contraception methods. The study included an intentional sample of 108 students attending the Medical High School ?Dr. Misa Pantic? in Valjevo. Participation in the study was voluntary and anonymous. Results. The largest number of students was informed about the indications for emergency contraception (80%, c2 = 0.004); the respondents agreed that emergency contraception is not a regular method of contraception and should be used in cases of sexual abuse (c2 = 0.019). Most of the respondents believe that they need additional education (N = 95, c2 = 0.032) regarding emergency contraception methods. Conclusion. The analysis of the results showed that the adolescents who participated in the study need additional education about the methods of emergency contraception. It is necessary to improve the strategies of health education of adolescents on this topic.

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Reconceptualizing Measurement of Emergency Contraceptive Use: Comparison of Approaches to Estimate the Use of Emergency Contraception

Cited by 10 publications

References 16 publications

Induced Abortion Incidence and Safety in Rajasthan, India: Evidence that Expansion of Services is Needed

Induced Abortion Incidence and Safety in Rajasthan, India: Evidence that Expansion of Services is Needed

Contextual factors associated with contraceptive utilization and unmet need among sexually active unmarried women in Kenya: A multilevel regression analysis

Knowledge and attitudes towards emergency contraception among adolescents

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