Provider Attitudes to Emergency Contraception in Ghana and Burkina Faso

Mayhew, Susannah; Osei, Ivy; Bajos, Nathalie

doi:10.3917/pope.1301.0115

Cited by 5 publications

(11 citation statements)

References 47 publications

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“…A lack of understanding of the biological mechanism of action underpinning ECP was noted among many study respondents; some were not aware of the disruption of ovulation or said that ECP blocks the implantation of the fertilized ovum, or were not sure of the mechanism [ 30 , 42 - 44 ]. Some providers described ECP as an abortifacient [ 29 , 37 , 39 , 40 , 42 , 43 , 45 - 47 ]. In some studies in the review providers incorrectly believed that ECP use could result in congenital abnormalities if a woman was pregnant [ 29 , 35 , 37 , 39 , 40 , 43 ].…”

Section: Resultsmentioning

confidence: 99%

“…In some studies, providers expressed concern that ECP use might displace regular contraception use [ 25 , 30 , 35 , 37 , 39 , 47 ]. Others said they were confident that by counselling their clients they could prevent them from using ECP as a regular method.…”

Section: Resultsmentioning

confidence: 99%

“…Barriers to prescription and/or dispensing were noted in a few studies, including low consumer demand [ 26 , 36 ], and ethical, legal and religious concerns of the providers [ 34 , 36 , 43 ]. ECP were regarded by some as delivering a cost saving to the health system through reducing the abortion rate [ 41 ] and unwanted child bearing [ 32 ], as well as an opportunity to promote regular contraception [ 47 ].…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Workforce interventions to improve access to emergency contraception pills: a systematic review of current evidence in low- and middle-income countries and recommendations for improving performance

Dawson

Tran

Westley³

et al. 2015

BMC Health Serv Res

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BackgroundEmergency contraceptive pills (ECP) are one of the 13 essential commodities addressed by the UN Commission on Life-Saving Commodities for Women and Children. Although ECP have been available for 20 years, a number of barriers still limit women’s access ECP in low and middle-income countries (LMIC). The workforce who prescribe or dispense ECP are diverse reflecting the varied contexts where ECP are available across the health, commercial and justice sectors and in the community. No reviews currently exist that examine the roles and experiences of the workforce that provide ECP in LMIC.MethodWe present a narrative synthesis of research to: identify provider factors that facilitate and constraint access to ECP; assess the effectiveness of associated interventions and; explore associated health system issues in LMIC. A search of bibliographic databases, meta-indexes and websites was undertaken to retrieve peer reviewed and grey literature. Literature was screened and identified documents examined to appraise quality.ResultsThirty-seven documents were included in the review. Studies focused on formal health workers revealing knowledge gaps concerning the role of private sector and non-health providers who increasingly provide ECP. Data from the findings section in the documents were coded under 4 themes: provider knowledge; provider attitudes and beliefs; provider practice and provider training. The analysis revealed provider knowledge gaps, less than favourable attitudes and practice issues. The findings provide limited insight into products prescribed and/or dispensed, the frequency of provision, and information and advice offered to consumers. Pre and in-service training needs were noted.ConclusionAs the provision of ECPs shifts from the clinic-based health sector to increasing provision by the private sector, the limited understanding of provider performance and the practice gaps revealed in this review highlight the need to further examine provider performance to inform the development of appropriate workforce interventions. A standardized approach to assessing performance using agreed outcomes measures may serve to ensure a systematic way forward that is inclusive of the diverse workforce that deliver ECP. Recommendations are outlined to enhance the performance of providers to improve access to ECP. A framework is offered to help guide this process with indicators.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Workforce interventions to improve access to emergency contraception pills: a systematic review of current evidence in low- and middle-income countries and recommendations for improving performance

Dawson

Tran

Westley³

et al. 2015

BMC Health Serv Res

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“…Nearly all women and men had ever used a contraceptive norms around sexuality in contemporary urban Ghana, where it is now more common for single women to engage in sexual relationships; 14,15 however, to our knowledge, no studies have explored how individuals in Ghana make decisions about fertility and contraceptive use in the context of changing sexual norms and within relationships. In this study, we aim to understand the social and relational contexts in which reproductive decisions are made; we do not consider health facility-or provider-related influences (reported elsewhere 16 ), except when specifically identified by respondents as a pertinent influence.…”

Section: Resultsmentioning

confidence: 99%

Fertility Decisions and Contraceptive Use at Different Stages of Relationships: Windows of Risk Among Men and Women in Accra

Osei

Mayhew²,

Biekro³

et al. 2014

IPSRH

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“…They can influence providers' attitudes toward specific patient groups, services, and related accountability efforts. 73,74 Acts of disrespect and abuse are often explicitly or implicitly related to provider judgements about the appropriateness of patient behaviour, such as whether young, unmarried women are entitled to contraception or should be having children. 44,51,[75][76][77] The internalised discrimination described earlier can be exacerbated by the entrenched hierarchies in patient/provider interactions.…”

Section: Unpacking Community Voicesmentioning

confidence: 99%

Building a transformative agenda for accountability in SRHR: lessons learned from SRHR and accountability literatures

Boydell

Schaaf

George

et al. 2019

Sexual and Reproductive Health Matters

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Global strategies and commitments for sexual and reproductive health and rights (SRHR) underscore the need to strengthen rights-based accountability processes. Yet there are gaps between these ambitious SRHR rights frameworks and the constrained socio-political lived realities within which these frameworks are implemented. This paper addresses these gaps by reviewing the evidence on the dynamics and concerns related to operationalising accountability in the context of SRHR. It is based on a secondary analysis of a systematic review that examined the published evidence on SRHR and accountability and also draws on the broader literature on accountability for health. Key themes include the political and ideological context, enhancing community voice and health system responsiveness, and recognising the complexity of health systems. While there is a range of accountability relationships that can be leveraged in the health system, the characteristics specific to SRHR need to be considered as they colour the capabilities and conditions in which accountability efforts occur.

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Provider Attitudes to Emergency Contraception in Ghana and Burkina Faso

Cited by 5 publications

References 47 publications

Workforce interventions to improve access to emergency contraception pills: a systematic review of current evidence in low- and middle-income countries and recommendations for improving performance

Workforce interventions to improve access to emergency contraception pills: a systematic review of current evidence in low- and middle-income countries and recommendations for improving performance

Fertility Decisions and Contraceptive Use at Different Stages of Relationships: Windows of Risk Among Men and Women in Accra

Building a transformative agenda for accountability in SRHR: lessons learned from SRHR and accountability literatures

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