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Strategies for Introduction of EC in India : Expert Viewpoints

FOGSI participation for cause of Emergency Contraception
– Dr Kamini Rao, President, FOGSI

An estimated 40 to 60 million women seek termination of pregnancy every year. In developing countries, it is unfortunate that a large percentage of induced abortions are performed by unqualified personnel under unsafe conditions. Unsafe abortion is considered to be one of the most neglected problems of healthcare in developing countries. There is no doubt that any woman would prefer to prevent an unwanted pregnancy rather than have an abortion or carry the pregnancy to term. In addition to the regular methods of contraception, post-coital contraception provides a back-up for individuals at risk of an unplanned pregnancy.

In India, awareness about emergency contraception is low, not only among the public but also among healthcare providers. Studies show not only lack of awareness among couples regarding the available methods of family planning but also lack of willingness to use the available methods as well as a lacunae in the capabilities of the reproductive healthcare system in delivering the services.

The name itself sounds rather alarming – ‘emergency’ and ‘contraception’. Why are we talking about morality and about animal experiments and so many other things? Drugs have already been used in varied doses. We have to talk about women who are in such a need, and I think one has to understand that human behaviour cannot be computerized.

Role of FOGSI in Emergency Contraception Introduction

The Federation of Obstetric and Gynaecological Societies of India (FOGSI), the vanguard of Obstetrics and Gynaecology in India is an organization comprising 150 Obstetrics and Gynaecological societies from all parts of India with a total strength of over 14000 members. It is possibly one of the largest medical federations worldwide, which serves as a vehicle not only for the dissemination of knowledge, but is also the prime organization for the care of the mother and child in our country.

The aim of the FOGSI has always been in the area of academic excellence. Over the last few years, FOGSI has always ventured out into various social and health issues particularly in the areas of RCH programme. FOGSI has a role to play in :

• serving as an important source of information regarding emergency contraception.

• setting guidelines for appropriate delivery.

• increasing awareness by conducting CME Programs, Training Programs and Orientation Programs.

• publicizing the available methods of contraception through meetings, workshops and group discussions.

• using the media of radio and television to create awareness and ensure wide and appropriate use of EC.

• inducing pharmaceutical companies to share the responsibility of increasing awareness among potential users and providers.

• continued education of all health workers at the grassroot and FRU levels on contraceptive choices.

• co-ordinating with ANMs for arranging health education programs.

• organizing CME programs and workshops in the District General Hospitals and Taluk Hospitals.

• updating knowledge, skills and practices of all health functionaries for effective delivery of contraceptive services.

• maintaining information on performance and providing feedback.

• involving private doctors to complement the existing services in government hospitals.

The successful implementation of any project depends on the orientation and technical skills provided to the medical and paramedical staff. FOGSI has standardized training modules which have been pre-tested. With the help of these modules, FOGSI can assist in the planning and implementation of training, as well as in encouraging community participation.

The theme subject for FOGSI this year is ‘Safe abortion saves life’. As the name itself suggests, we are trying to give women undergoing abortion a safe abortion, and what better place than to have these centres as post-abortion clinics for counselling for EC. Prof Mittal has conducted a study which has shown that EC use increases the subsequent use of oral contraceptives. It is a woman in need, who gets the timely help, that she will stick to pills later on and will not complain for minor problems of nausea and vomiting.

We may not advertise EC like we would advertise a biscuit company or coffee, but certainly in centres where people seek help, like in post-partum or family planning centres, posters can be put up and EC can be provided in their basket of services.

We look forward to having each and every FOGSI member participating and trying to get 100% knowledge on EC, so that he/she will be able to help the patients and society and help undergraduate and postgraduate learning to spread the message of EC.

We have four zonal conferences this year, apart from the annual conference, and one of the subjects in these zonal conferences is going to be EC. This will bring about a lot of awareness among all our FOGSI members. We are also requesting every society to have a MTP workshop in this year. This programme can also have a component of EC thrown in. Our members are also going to speak to various women’s organizations on this subject, as well as encourage articles on the subject on the FOGSI website. We are also looking at the doctors being deputed as consultants to first referral units to spread the message about judicious use of EC. It is important that all of us collectively go ahead because women’s health and population–stabilization is a very important issue for our country.

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