Prospects for coitally-dependent hormonal contraception: perspectives from women in urban Kenya and Nigeria

Chin-Quee, Dawn S.; L’Engle, Kelly; Otterness, Conrad

doi:10.1136/jfprhc-2013-100687

Cited by 6 publications

(27 citation statements)

References 17 publications

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“…Within the study, women who have infrequent sex demonstrated a high degree of satisfaction and intent to use the method in the future. This aligns well with previous studies, which demonstrated demand and acceptability with a theoretical method (e.g., Chin‐Quee, L'Engle, and Otterness 2014; Cover et al. 2013a) and within actual study conditions (i.e., Festin et al.…”

Section: Discussionsupporting

confidence: 91%

Feasibility and Acceptability of LNG 1.5 mg as an On‐Demand Pericoital Contraceptive in Ghana

McCann,

Liang,

Ramarao

et al. 2023

Studies in Family Planning

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Globally, there is a need for more family planning method options as currently, available options do not adequately meet the needs of women, specifically those who have infrequent sex. Levonorgestrel (LNG) 1.5 mg is widely available as emergency contraception pills (ECP), and recent research has shown that certain women take it as their main form of contraception. Furthermore, limited studies have found repeat, on‐demand use safe and efficacious.This 12‐month prospective, single‐arm, interventional study in Ghana tested whether a single LNG 1.5 mg on‐demand or pericoital (“around the time of sex”) dose contraceptive was acceptable to women who have infrequent sex and if pharmacy provision was feasible. The study sample (1,890) comprised women of reproductive age recruited from urban areas, having infrequent sex (i.e., coital frequency ≤ 6× per month), and not using any other modern methods except condoms or ECP at the time of study inclusion.Results indicated that there is demand and acceptability for a pericoital pill and that pharmacy provision is feasible. Furthermore, precoital use of the pill had high levels of satisfaction and was popular with new users. Adding LNG 1.5 mg for pericoital use to the family planning method mix has the potential to address an important segment of the population currently underserved, decrease unwanted pregnancies, and increase modern contraceptive prevalence rates.

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Section: Discussionsupporting

confidence: 91%

Feasibility and Acceptability of LNG 1.5 mg as an On‐Demand Pericoital Contraceptive in Ghana

McCann,

Liang,

Ramarao

et al. 2023

Studies in Family Planning

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“…Communication messages would best respond to ECP users’ needs by encouraging the view that frequent users of ECPs are engaging in safe, responsible behaviour that will not harm their future fertility. Because the majority of ECP users are typically young 4 , 7 and may be more likely to use an on-demand contraceptive product, 26 it is particularly important that ECP communication directed towards pharmacists and drug shop staff supports repeated use among young women as a safe and responsible choice.…”

Section: Discussionmentioning

confidence: 99%

Supporting contraceptive choice in self-care: qualitative exploration of beliefs and attitudes towards emergency contraceptive pills and on-demand use in Accra, Ghana and Lusaka, Zambia

Kalamar

Bixiones

Jaworski

et al. 2022

Sexual and Reproductive Health Matters

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Supporting women to use emergency contraceptive pills (ECPs) as both a back-up and a regular, on-demand contraceptive method can increase self-managed contraceptive options and enhance reproductive autonomy, particularly for vulnerable populations. ECPs are currently regulated for use in an “emergency” situation; however, some evidence suggests that women also value this method as a regular, on-demand option used to prevent pregnancy with foresight and confidence. Beliefs and attitudes towards ECPs and their on-demand use in Accra, Ghana and Lusaka, Zambia were explored through in-depth interviews (IDIs) and focus group discussions (FGDs) with women ages 18–34 and men ages 18–30 in Accra and Lusaka. Structured interview guides and focus group discussion guides were used to explore societal and community norms, knowledge, behaviour, and attitudes. IDIs were analysed using deductive, thematic coding, and FGDs were analysed using inductive, thematic coding. Three major themes emerged: first, ECPs are a trusted method and often preferred as an easy and effective option; second, people value ECPs as an on-demand method, yet fear that repeated use could have harmful health effects; finally, anticipated stigma among users of ECPs is higher than experienced stigma, except among young women. The findings that emerged from this research suggest that the repositioning of ECPs as suitable for on-demand use would be an important step towards reducing the stigma and discrimination that is often associated with the method while expanding the range of self-care contraceptive options available to meet the differing needs of women, young women and vulnerable populations.

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“…Papers reported on research conducted in 16 countries across five WHO regions: nine countries in Africa, including Benin [ 29 ], the Democratic Republic of Congo (DRC) [ 35 ], Ethiopia [ 26 , 31 ], Ghana [ 11 , 33 , 36 , 38 , 39 ], Kenya [ 12 , 27 , 28 , 30 ], Nigeria [ 27 , 28 , 30 , 32 ], Somalia [ 34 ], Uganda [ 37 ] and Zambia [ 39 ]; three countries in the Americas, including the US [ 42 , 44 ], Brazil [ 40 , 43 , 45 ] and Argentina [ 41 ]; two countries in South East Asia, including India [ 46 , 48 , 49 ] and Nepal [ 47 ]; one country in Eastern Mediterranean, in Iran [ 50 ]; and two countries in Europe, in Spain [ 52 ] and Serbia [ 51 ]. One paper reported on data from multiple international settings [ 10 ]; no research was identified from the Western Pacific.…”

Section: Resultsmentioning

confidence: 99%

“…The reviewed papers used qualitative ( n = 12) [ 26 , 31 , 32 , 34 – 37 , 39 , 40 , 42 , 44 , 49 ], quantitative survey ( n = 14) [ 27 – 30 , 33 , 38 , 41 , 43 , 45 – 48 , 50 , 51 ], intervention or trial ( n = 3) [ 10 – 12 ] and surveillance ( n = 1) [ 52 ] approaches. Twenty four papers reported on the perspectives of end users (e.g., younger women, women of reproductive age, university students, male sexual partners) [ 10 – 12 , 26 – 39 , 41 – 44 , 49 , 52 ], nine papers on service providers (e.g., pharmacists, GPs, clinicians, midwives, community health workers) [ 26 , 34 , 40 , 45 – 48 , 50 , 51 ], and four on other stakeholders (e.g., donors, policy makers, NGO workers) [ 26 , 34 , 37 , 46 ].…”

Section: Resultsmentioning

confidence: 99%

Acceptability of an on-demand pericoital oral contraceptive pill: a systematic scoping review

Bell,

Gibbs,

Winskell

et al. 2024

Reprod Health

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Background Access to an on-demand pericoital oral contraceptive pill – used to prevent pregnancy within a defined window around sexual intercourse – could offer women more reproductive agency. A contraceptive with this indication is not currently available in any market. This review aims to understand international user appeal for an on-demand pericoital oral contraceptive pill. Methods Systematic scoping review, comprising 30 peer-reviewed papers published between 2014–2023. Results Data from 30 papers reporting on research from 16 countries across five World Health Organisation regions suggests widespread user appeal for on-demand oral contraceptive pills that can be used peri- or post-coitally, especially among women who are younger, more educated or who have less frequent sex. Women of varying age, wealth, employment or relationship status, and with different prior experience of using modern contraceptives, were also interested. Women identified clear rationale for use and preference of these types of product: close alignment with women’s sexual lives that comprised unplanned, spontaneous or occasional sex; perceived convenience and effectiveness; discreet use of pills to negotiate contextual circumstances that constrained their reproductive agency. Factors inhibiting use included knowledge barriers and attitudes of service providers, a lack of knowledge and misinformation among end-users, women’s dislike of menstrual side effects and myths related to the effects of hormone content on future fertility. Conclusions Introduction of an on-demand pericoital oral contraceptive pill could expand contraceptive choice for diverse women experiencing unmet need for modern contraception and constrained sexual and reproductive agency. Priorities for future research include: broadening the geographical scope of evidence to include SE Asia and the Pacific, and international rural and peri-urban settings; documenting the perspectives of adolescents and unmarried young people; identifying opportunities for innovation in the supply channels to enhance appropriate, affordable access to on-demand oral contraceptives; and unpacking how to bring new pericoital contraceptives to the market in a variety of international settings.

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Prospects for coitally-dependent hormonal contraception: perspectives from women in urban Kenya and Nigeria

Cited by 6 publications

References 17 publications

Feasibility and Acceptability of LNG 1.5 mg as an On‐Demand Pericoital Contraceptive in Ghana

Feasibility and Acceptability of LNG 1.5 mg as an On‐Demand Pericoital Contraceptive in Ghana

Supporting contraceptive choice in self-care: qualitative exploration of beliefs and attitudes towards emergency contraceptive pills and on-demand use in Accra, Ghana and Lusaka, Zambia

Acceptability of an on-demand pericoital oral contraceptive pill: a systematic scoping review

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