Knowledge and Use of Emergency Contraception in PMA2020 Surveys

Publication date: 2017

Performance Monitoring and Accountability 2020 (PMA2020) conducts surveys on family planning indicators. Launched in 2013, surveys have been conducted in 10 countries to date. PMA2020 uses a multi-stage cluster design, stratifying by urban-rural, major regions and districts and surveys households, individual females aged 15-49, and health facilities. Every new country conducts surveys semi-annually in the first two years for each project country and annually thereafter. Data from eight African countries were analyzed to determine trends in emergency contraceptive (EC) knowledge and use. Different countries have different numbers of rounds of data available; the round is indicated when results are presented. COUNTRIES AND REGIONS SURVEYED Burkina Faso . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Whole country DRC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Kinshasa Ethiopia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Whole country Ghana . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Whole country Kenya. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Whole country Niger . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Niamey Nigeria . . . . . . . . . . . . . . . . . . . . . . . . . . Lagos and Kaduna states Uganda . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Whole country STANDARD QUESTIONS CAPTURING EMERGENCY CONTRACEPTION IN PMA2020 SURVEYS Question/Variable Definition Outcome Have you ever heard of emergency contraception? Knowledge or awareness of EC Are you/your partner currently doing something or using any method to delay or avoid getting pregnant? Which method or methods are you using? (Select all methods mentioned) Current use of EC In the last 12 months, have you ever done something or used a method to delay or avoid getting pregnant? Which method did you use most recently? (Select the most effective method) Recent use of EC (Use in past 12 months & current use) Which method did you first use to delay or avoid getting pregnant? Use of EC as first contraceptive method Knowledge of EC Levels of knowledge about EC vary considerably across the different countries, being highest in Kenya and Ghana, and lowest in Burkina Faso, the Democratic Republic of Congo and Niger (Figure 1). In general, women who are older than 25 have greater levels of awareness than those aged 15-24, as do women with higher levels of education (not shown). Knowledge and Use of Emergency Contraception in PMA2020 Surveys EC POLICIES, ACCESS & AWARENESS OCTOBER 2017 PMA2020 surveys provide valuable new information on knowledge and use of emergency contraception. Knowledge varies by country, but use remains low in all areas surveyed. Figure 1: Knowledge of EC Percentage of all women aged 15-49 who have ever heard of ECP, by country Percent of ECP Knowledge Not captured in Ethiopia. 23% Niger R4 23% DR Congo R3 23% Burkina Faso R1 29% Nigeria R4 38% Uganda R3 52% Ghana R2 67% Kenya R3 Figure 2: Use of EC as the First Method Percentage of unmarried women aged 15-49 who have ever used a contraceptive method who used EC as first method, Round 1 Percent of ECP Knowledge 1.1% Burkina Faso 0% Uganda 0% Niger 1.4% Ethiopia 1.9% DR Congo 4.4% Ghana 8.3% Kenya 13.5% Nigeria Use of EC EC is an underutilized method and use of EC is rare in most countries, according to PMA data. Use of EC among all women, across all countries, is under 1% for both current use and recent use. Women who are sexually-active and unmarried have higher levels of EC use than women who are currently married/in union. Unmarried women were more likely to report that they used EC as their first family planning method, compared to currently married women. Access to EC Women in Ghana, Kenya, and Uganda were surveyed on where they accessed EC and other modern methods of contraception. In all three countries, EC was much more Figure 3: Sources of Family Planning Methods (Ghana) Distribution of women aged 15-49 using a method of contraception in the past 12 months, by source of access ■ public ■ pharmacy/store ■ private ■ other other modern methods emergency contraception likely to be obtained in a pharmacy or store, whereas other modern methods were more likely to be obtained at a health facility. For instance, in Ghana, 94% of EC users reported purchasing it at a pharmacy or store, compared to only 31% of other modern methods. Fees or payment was also more common to obtain EC than other modern methods, and women were more likely to report that they made the decision to use the method alone. Conclusion Women in Kenya and Ghana were the most likely in all the countries to report that they were aware of EC. Knowledge is still low in the other countries surveyed. Unmarried women in Nigeria were the most likely to report that they used EC as a first method. The PMA2020 questionnaire does not give an accurate measurement of lifetime use of EC. Addition of such a question would allow for more comparison of use over time. Notes Data were used by permission of PMA2020. PMA2020.org Analysis by Tulane University. 45 Broadway, Suite 320 • New York, NY 10006 • USA +1 646 677 8108 • www.emergencycontraception.org ICEC is hosted by Management Sciences for Health Copyright © 2017 International Consortium for Emergency Contraception . All rights reserved .

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