Financing gaps for Pakistan's contraceptive prevalence goals: Analyses using the Guttmacher adding-it-up methodology

Access to mifepristone, misoprostol, and contraceptive medicines in eight countries in the Eastern Mediterranean Region: descriptive analyses of country-level assessments

“…Although Somalia has developed national family planning guidelines and has an updated national EML inclusive of nearly all types of contraceptives, none of these medicines are registered. In fact, Somalia has among the lowest rates of contraceptive use globally with only 8 percent of women of reproductive age using contraceptive medicines mentioned on the EML [ 9 ] Somalia also has one of the highest rates of unintended pregnancy in the region (100 per 1,000 women and girls ages 15–49 years) of which 29 percent end in abortion [ 3 ] Therefore, ensuring the safety and effectiveness of procured contraceptives is critical in efforts to reduce unintended pregnancies in Somalia as available medicines may be substandard and falsified [ 27 ]. Efforts in regulatory system strengthening in the pharmaceutical sector are critical and needed.…”

“…Although we found that procurement of all contraceptives and Mifepristone and Misoprostol in the public sector is lacking for all the assessed countries in the region, this does not necessarily indicate these medicines are not available or accessible in the private sector. For example, according to the assessments, Palestine and Iraq only procured oral contraceptives, injectable medroxyprogesterone acetate, ulipristal and copper IUD yet UNFPA reports indicate that both countries are more likely to use hormonal IUDs and injectable medroxyprogesterone than other EMR countries (e.g., Pakistan, Lebanon, Somalia, and Morocco) that procured them in the public sector [ 9 ].…”

“…Findings from Iraq and Palestine suggest that in some post-conflict and humanitarian settings, procurement by the private sector or by donors may be responsive to local needs and are critical to ensuring access to Mifepristone, Misoprostol, and contraceptive medicines. However, findings from Somalia and Libya suggest that in these humanitarian settings procurement from the public sector for various methods and types of contraceptives is insufficient as 81 percent of women of reproductive age have unmet need for contraception [ 9 ].…”

“…First, it will provide an evidence-base by identifying system-level barriers and can support policy and advocacy efforts to strengthen the pharmaceutical sector, as well as better ensure availability of Mifepristone, Misoprostol, and contraceptives to women of reproductive age at the country-level in accordance with the national law and prevailing culture. Second, Mifepristone, Misoprostol, and contraceptives are critical in promoting SRH&RR and reducing maternal mortality [8][9][10][11][12][13][14][15][16], especially in settings that persistently have high maternal mortality rates [17]. Several EMR countries also are among the list with the lowest rates of contraceptive use and highest rates of unintended pregnancy [3,[8][9][10] Third, nearly all EMR countries have abortion care policies that permit it only to preserve a woman's life or health [4,18].…”

Combined oral contraceptives and their impact on lipids, blood pressure, and body mass index in pregnant women

“…Regular check-ups and monitoring can help to minimize potential risks and ensure the continued effectiveness of the contraceptives (Vandenbroucke et al, 1996). According to a 2017 report by the United Nations Population Fund (UNFPA), the prevalence of modern contraceptive methods in Pakistan is low, with only 34% of ladies who are fertile utilizing modern contraception (Sathar et al, 2023). This is despite the fact that around 36% of Pakistan's population is comprised of women of reproductive age.…”