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

Creanga, Andreea A.; Schwandt, Hilary; Danso, Kwabena A.; Tsui, Amy O.

doi:10.1016/j.ijgo.2011.01.024

Cited by 9 publications

(11 citation statements)

References 14 publications

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“…The results from this study correspond to studies in Turkey, Philippines, Guatemala and Honduras regarding successful provision or comparable findings between ANMs and higher cadre health workers, [ 12 , 14 , 15 , 17 ], and is a positive finding for Nepal. Findings also indicate that the range of methods provided at a facility, which can be a proxy for the size and sophistication of the facility, is significantly associated with provider knowledge, similar to studies on emergency contraception in Ghana, general contraceptive provision in the United States, and others [ 29 , 30 ]. In contrast to a recent study in Pakistan, which found that a provider’s lifetime experience with IUDs is a strong predictor of knowledge, we did not find a relationship between IUD insertion experience (as measured in our study) and knowledge [ 16 ].…”

Section: Discussionsupporting

confidence: 67%

“…Covariates were chosen that can proxy for or indicate experience, and have been shown to be positively associated with family planning knowledge in previous studies. These covariates include: provider age, length of employment, volume of women served (measured through clinic volume, volume of IUDs inserted, and employment at multiple clinics), range of family planning methods offered, and past IUD training [ 27 , 29 , 30 ]. Region was chosen as a potential indicator of experience because the poor infrastructure in Nepal’s hills may result in lower client volume and resources.…”

Section: Methodsmentioning

confidence: 99%

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Knowledge and perceptions of the intrauterine device among family planning providers in Nepal: a cross-sectional analysis by cadre and sector

Chakraborty

Murphy

Paudel³

et al. 2015

BMC Health Serv Res

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BackgroundNepal has high unmet need for family planning and low use of intrauterine devices (IUDs). While clients’ attitudes toward the IUD are known in a variety of contexts, little is known about providers’ knowledge and perceptions of the IUD in developing countries. Nepal’s liberal IUD service provision policies allow the opportunity to explore provider knowledge and perceptions across cadres and sectors. This research contributes to an understanding of providers’ IUD perceptions in low-resource environments, and increases evidence for IUD task-sharing and private sector involvement.MethodsA questionnaire was administered to 345 nurses and auxiliary nurse midwives (ANMs) affiliated with the private Mahila Swastha Sewa (MSS) franchise, public sector, or private non-franchise sector. All providers had been trained in TCu 380A IUD insertion and removal. The questionnaire captured providers’ IUD experience, knowledge, and perceived barriers to recommendation. Descriptive, multivariate linear, and multinomial logistic regression was conducted, comparing providers between cadre and sector.ResultsOn average, providers answered 21.5 of 35 questions correctly, for a score of 61.4%. Providers scored the lowest on IUD medical eligibility, answering 5.9 of 14 questions correctly. Over 50% of providers were able to name the four side effects most frequently associated with the IUD; however, one-third of all providers found at least one of these side effects unacceptable. Adjusted results show that cadre does not significantly impact provider’s IUD knowledge scores or side effect perceptions. Public sector affiliation was associated with higher knowledge scores regarding personal characteristic eligibility and more negative perceptions of two normal IUD side effects. IUD knowledge is significantly associated with provider’s recent training and employment at multiple facilities, and side effect perceptions are significantly associated with client volume, range of family planning methods, and region.ConclusionsProvider knowledge and attitudes towards IUD provision are similar across cadre and sector, supporting WHO task-sharing guidelines and validating Nepal’s family planning policies. However, overall provider knowledge is low. We recommend that providers need to receive further training and support to improve knowledge, manage side effects, and recognize women in periods of high unmet need - such as post-partum or post-abortion women - as suitable candidates for IUDs.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-015-0701-y) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 67%

Section: Methodsmentioning

confidence: 99%

Knowledge and perceptions of the intrauterine device among family planning providers in Nepal: a cross-sectional analysis by cadre and sector

Chakraborty

Murphy

Paudel³

et al. 2015

BMC Health Serv Res

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“…When compared with an EC survey conducted in Turkey, where 35.3% of general practitioners (GPs) and 32.6% of nurses knew that the IUCD could be used for EC, the nurses' level of awareness of IUCD for EC was lower, while that of doctors was higher. [16] However, when compared with a survey of family planning providers in Ghana, where only 8.3% of family planning providers were aware that the IUCD could be used as EC, [17] their level of awareness was much higher. Two-thirds of the healthcare professionals could prescribe at least one EC and about half (54.3%) knew the 72-hour time limit for EC pills as in the Nigerian survey, [15] where knowledge of the indications of EC was high.…”

Section: Discussionmentioning

confidence: 93%

“…[16] However, the knowledge was higher when compared with the survey in Ghana, where only 2.5% of the providers knew that EC pills prevent or delay ovulation. [17] Knowledge on the side-effects and issuing of EC was particularly high. However, knowledge of how frequently it should be issued and the age restriction was low.…”

Section: Discussionmentioning

confidence: 99%

Knowledge, attitudes and practices of health professionals in public health institutions on emergency contraception in Pietermaritzburg, KwaZulu-Natal Province, South Africa

Sibanda

Titus²

2017

S Afr J OG

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RESEARCHBackground. Although emergency contraception (EC) is widely available, its use is surrounded by many controversies. Overall, it seems to be underutilised worldwide. Objectives. To determine healthcare professionals᾽ knowledge, attitudes and perceptions regarding EC, and how frequently they encounter, educate and issue it to patients. Methods. A questionnaire-based survey of doctors and nurses (volunteers) working in obstetrics and gynaecology was conducted in 3 public hospitals and 17 clinics in Pietermaritzburg, KwaZulu-Natal Province, South Africa. Data were analysed using SPSS. Results. Sixty-seven (25%) doctors and 201 (75%) nurses participated in the survey. Awareness of the three ECs available in the public sector overall was 56.4%, and 62.7% of participants could prescribe one EC correctly. Only 39.6% knew that EC pills prevent ovulation. Seventy-six percent thought that the use of EC could lead to high-risk sexual behaviour, high risk of transmission of HIV and non-use of other forms of contraception. Only 7.8% saw patients seeking EC often, 5.6% issued it often and 23.5% educated patients about it often. Conclusion. Participants were familiar with EC, but lacked accurate and detailed knowledge about its mechanism of action and had misperceptions on its social impact. They seldom prescribed it. It is estimated that about 41.0% of the 208 million pregnancies that occurred worldwide in 2008 were unintended.[1] East and Central Africa have the highest rates of unintended pregnancies and about 14 million unintended pregnancies are estimated to occur in subSaharan Africa annually. [1,2] Unintended pregnancies are resolved differently by women. Globally, there were an estimated 42 million induced abortions in 2003, of which 48% were unsafe and 97% of the unsafe abortions were performed in developing countries.[3] The World Health Organization (WHO) estimated that 21.6 million unsafe abortions occurred worldwide in 2008, an increase from 19.7 million in 2003, [4] with Eastern and Central Africa having the highest rates.[5] Unsafe abortions have a negative impact on maternal morbidity and mortality. A reduction in unintended pregnancies may result in a reduction of unsafe abortions, hence lowering maternal mortality.In situations where there is unprotected sexual intercourse or contraceptive method failure, emergency contraception (EC) may be used to prevent unintended pregnancies. Although EC is widely available in many countries, its use has been marred with controversies and misperceptions, especially concerning its mode of action, impact on behaviour and safety. EC pills prevent pregnancy by inhibiting or delaying ovulation, but they cannot disrupt an established pregnancy. However, an analysis of 1 077 articles in 113 newspapers between 1992 and 2002 showed that 44.5% of them included at least one instance of confusion between EC and medical abortion, with 31.0% of the articles inaccurately portraying the mode of action of EC as medical abortion.[6] The use of EC varies in different countries, and o...

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“…This measure of awareness rather than knowledge may lead to the false sense that efforts to educate the population on methods are not needed. In addition, providers in Ghana30 31 and elsewhere in Africa32 33 may perpetuate some of the misinformation that women reported.…”

Section: Discussionmentioning

confidence: 99%

Misperceptions, misinformation and myths about modern contraceptive use in Ghana

Hindin

McGough²,

Adanu

2013

J Fam Plann Reprod Health Care

109

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Objective Ghana, like the rest of West Africa, has very low contraceptive prevalence and is one of a few nations that reports declines in contraceptive use over time based on two of the most recent national surveys. Fear of side effects is a leading cause of non-use of contraception, based on national surveys. The objective of this study was to gain a more holistic understanding of why Ghanaian women are not using contraception. Methods We used focus groups with vignettes to elicit normative beliefs about contraception. We recruited 91 women from three different clinics within Legon Hospital in Accra, Ghana: the antenatal clinic, the student clinic and the child welfare clinic. Focus groups were homogeneous with regard to age group and union status. Results We found that women were most concerned with the menstrual irregularities caused by hormonal methods. In addition, women believed strongly that the hospital was the best place to get contraception as blood tests were needed to match women with the appropriate method. Knowledge of how methods worked and of basic reproductive biology was low. Conclusions Poor knowledge of how to use modern methods combined with myths and misinformation should be the targets of programmes to increase modern contraceptive prevalence in Ghana.

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

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

Cited by 9 publications

References 14 publications

Knowledge and perceptions of the intrauterine device among family planning providers in Nepal: a cross-sectional analysis by cadre and sector

Knowledge and perceptions of the intrauterine device among family planning providers in Nepal: a cross-sectional analysis by cadre and sector

Knowledge, attitudes and practices of health professionals in public health institutions on emergency contraception in Pietermaritzburg, KwaZulu-Natal Province, South Africa

Misperceptions, misinformation and myths about modern contraceptive use in Ghana

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