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PLoS One. 2014 Oct 6;9(10):e109315. doi: 10.1371/journal.pone.0109315. eCollection 2014.

Improving access to emergency contraception pills through strengthening service delivery and demand generation: a systematic review of current evidence in low and middle-income countries.

Author information

1
World Health Organization Collaborating Centre for Nursing, Midwifery and Health Development, Faculty of Health, University of Technology, Sydney (UTS), Sydney, New South Wales, Australia.
2
School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
3
International Consortium for Emergency Contraception, New York, New York, United States of America.
4
RMNCH and HSS Technical Advice & Partnerships Department, The Global Fund to Fight AIDS, Tuberculosis and Malaria, Vernier-Geneva, Switzerland.
5
Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.

Abstract

OBJECTIVES:

Emergency contraception pills (ECP) are among the 13 essential commodities in the framework for action established by the UN Commission on Life-Saving Commodities for Women and Children. Despite having been on the market for nearly 20 years, a number of barriers still limit women's access to ECP in low- and middle-income countries (LMIC) including limited consumer knowledge and poor availability. This paper reports the results of a review to synthesise the current evidence on service delivery strategies to improve access to ECP.

METHODS:

A narrative synthesis methodology was used to examine peer reviewed research literature (2003 to 2013) from diverse methodological traditions to provide critical insights into strategies to improve access from a service delivery perspective. The studies were appraised using established scoring systems and the findings of included papers thematically analysed and patterns mapped across all findings using concept mapping.

FINDINGS:

Ten papers were included in the review. Despite limited research of adequate quality, promising strategies to improve access were identified including: advance provision of ECP; task shifting and sharing; intersectoral collaboration for sexual assault; m-health for information provision; and scale up through national family planning programs.

CONCLUSION:

There are a number of gaps in the research concerning service delivery and ECP in LMIC. These include a lack of knowledge concerning private/commercial sector contributions to improving access, the needs of vulnerable groups of women, approaches to enhancing intersectoral collaboration, evidence for social marketing models and investment cases for ECP.

PMID:
25285438
PMCID:
PMC4186851
DOI:
10.1371/journal.pone.0109315
[Indexed for MEDLINE]
Free PMC Article

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