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Abstracts of Studies and Comments by Participants

EC : What do healthcare providers know and think about it?
– Dr Manorama Purwar and Dr Suresh Ughade, Govt. Medical College, Nagpur

Introduction

Emergency Contraception (EC) provides a safe and effective way of preventing unwanted pregnancy when used shortly after an unprotected sexual intercourse. Despite its demonstrated efficacy, Emergency Contraception is underutilized in our country due to lack of awareness. A study was undertaken in the city of nagpur to assess the knowledge, attitude and practices about EC among obstetricians and gynaecologists.

Methods

A representative, cross-sectional, randomly selected sample of 136 consultant obstetricians and gynaecologists from Nagpur was surveyed. A structured pre-tested questionnaire including 28 open and close-ended questions-13 on knowledge and attitudes and 15 on practice aspects-was given. The data gathered were entered in a Microsoft Excel worksheet and analyzed using STATA software.

Results

An overall response rate was 58%, and it was better in consultants working in a teaching hospital. Only 30 (39%) respondents filled in complete information on each item on the questionnaire. Nearly all respondents (98%) had heard of emergency contraception, but many lacked specific knowledge about methods available, doses, timings for administration. Freshers (i.e. experience ¨ 5 years) had a better awareness about emergency contraception. A sizeable number (38%) of respondents identified two emergency contraceptive methods i.e. oral contraceptive pills and Cu-IUD, and only 17.9% could identify three methods of EC correctly. Some 22% respondents incorrectly believed that emergency contraception acts as an abortifacient and 35% erroneously expressed their ignorance about the legal status of Emergency Contraception.

A whopping proportion (41%) of respondents neither gave the brand names nor gave doses, clearly indicating the lack of knowledge amongst physicians, 29% could identify two brands correctly and 22% three brands correctly. About 76% of the respondents reported that, in the past, not a single patient visited the clinic specially to seek advice on eC. Only 24% reported that occasionally women had visited clinic for advice on eC (1-2 patients a year), suggesting very poor awareness about eC among general public.

Exactly half (50%) of the respondents were of the opinion that television could be an ideal source for promotion of EC use among the masses, while 32% respondents opined that EC pills should be provided in advance of possible unprotected intercourse.

Common side-effects of EC were well known to the obstetricians. Only 21% of respondents were correct in quoting efficacy of emergency contraception. For dispensing strategy of emergency contraception, a two-third majority opted for making emergency contraception available in the hospital, while 46% felt that emergency contraception should be made available over the counter.

Conclusions

Provider’s knowledge about emergency contraception is limited. If providers are well informed about emergency contraception, they can provide information and educate the public. There is a need to organize Information, Education and Communication (IEC) activities for general public, and Continuing Medical Education (CME) programs/workshops on EC for the providers.


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