Dixit Anvita, Khan M E, Bhatnagar Isha
Reproductive Health Program, Population Council, New Delhi, India.
Indian J Community Med. 2015 Jan-Mar;40(1):49-55. doi: 10.4103/0970-0218.149271.
Emergency Contraception Pill (ECP) is an essential intervention to prevent unwanted pregnancies. However, its use has remained low due to various barriers including reservations among medical fraternity.
This paper presents findings on barriers to ECP's easy access for potential users from (i) a cross-sectional survey of providers' attitudes, beliefs, and practices and interviews with key opinion leaders, (ii) three consultations organized by Population Council with policymakers and public health experts, and (iii) evidence from scientific literature.
The major barriers to easy access of ECP include misconceptions and reservations of providers (disapproval of ECP provision by CHWs, opposition to its being an OTC product, and myths, misconceptions, and moral judgments about its users) including influential gynecologists.
For mainstreaming ECP, the paper recommends educational campaign focusing on gynecologists and CHWs, relaxing restrictive policy on advertisement of ECP, involving press media and strengthening supply chain to ensure its regular supply to ASHA (CHW).
紧急避孕药是预防意外怀孕的一项重要干预措施。然而,由于包括医学界存在保留意见在内的各种障碍,其使用率一直较低。
本文介绍了关于紧急避孕药潜在使用者难以方便获取该药的障碍的研究结果,这些结果来自:(i)对提供者的态度、信念和做法的横断面调查以及对关键意见领袖的访谈;(ii)人口理事会与政策制定者和公共卫生专家组织的三次磋商;(iii)科学文献中的证据。
紧急避孕药难以方便获取的主要障碍包括提供者的误解和保留意见(社区卫生工作者不赞成提供紧急避孕药、反对其成为非处方药产品以及对使用者的误解、错误观念和道德评判),包括有影响力的妇科医生。
为使紧急避孕药成为主流,本文建议开展针对妇科医生和社区卫生工作者的教育活动,放宽对紧急避孕药广告的限制性政策,让新闻媒体参与进来,并加强供应链以确保其定期供应给辅助社会工作者(社区卫生工作者)。