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
Providers 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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