EMERGENCY CONTRACEPTION: KNOWLEDGE, ATTITUDE AND PRACTICES AMONG DOCTORS OF A TERTIARY CARE HOSPITAL
Abstract
Background: In Pakistan maternal mortality rate (MMR) is very high and more than one in five women die from pregnancy related causes; solution to this is to have low fertility rate. The emergency contraceptives (ECs) can be used to prevent unwanted pregnancies. The aim of this study was to assess the knowledge, attitude and practice about ECs among doctors. Methods: Institution-based cross-sectional descriptive study on knowledge, attitude and practice of ECs was conducted at Rawal Hospital from Feb to May, 2012. Data was collected using structured questionnaire and analysed using SPSS-16. Results: Fifty-seven percent of the respondents were >30 years of age, 94% were Muslim, 81% were married and 51% were women. Ninety-seven percent had heard of ECs before, only 17% knew Intra-uterine contraceptive device (IUCD) a method of EC. Sixty-one percent responded that IUCD should be removed if patient gets pregnant (p=0.007) and according to 31% ECs were not abortifacient (p=0.045). Regarding attitude, 55.5% of the participants supported its use (p=0.027) and agreed to its easy accessibility (p=0.004). Thirty-eight percent responded an increased dose of birth control pills as a form of EC (p=0.008), while 40% did not agree that ECs are effective when taken before intercourse (p=0.011). Conclusion: Knowledge and practice of ECs is very low among doctors but a positive attitude is there. Evidence-based knowledge to family physicians regarding emergency contraception is strongly recommended to reduce the chances of MMR.Keywords: Attitude, Emergency Contraception, Knowledge, Practice, Maternal Mortality RateReferences
Ahmed FA, Moussa KM, Petterson KO, Asamoah BO. Assessing knowledge, attitude, and practice of emergency contraception: a cross- sectional study among Ethiopian undergraduate female students. BMC Public Health 2012;12:110–9.
Neinstein LS, Gordon MC, Katzman KD, Rosen SD, Woods RE. Adolescent sexuality. In: Adolescent Health Care: a practical guide. 5th ed. Philadelphia: Lippincott Williams and Wilkins; 2008.p. 533-649.
Kongnyuy EJ, Ngassa P, Fomulu N, Wiysonge CS, Kouam L, Doh AS. A survey of knowledge, attitudes and practice of emergency contraception among university students in Cameroon. BMC Emerg Med. 2007;7:7.
Tasfay T, Tialhun, Girma E. Knowledge, attitude and practice of emergency contraceptive among women who seek abortion care at Jimma University Specialized hospital Southwest Ethopia. BMC Women’s Health 2012;12:2–6.
Hosaain SMI, Khan ME, Rahman M, Sabastian MP. Emergency contraceptive pills Southeast Asia Regional training manual. New Dehli: USAID. Population Council Frontiers; 2005.
Goyal M, Zhao H, Mollen C.. Exploring Emergency Contraception Knowledge,Prescription Practices, and Barriers to Prescriptionfor Adolescents in the Emergency Department. Pediatrics2009;123:765–70.
WHO. Facts on induced abortion worldwide. Gutmacher Institute; 2007. Available at: http://www.who.int/reproductivehealth/publications/unsafe_abortion/induced_abortion_2012.pdf
Abdulghani HM, Karim SI, Irfan F.. Emergency Contraception: Knowledge and Attitudes of Family Physicians of a Teaching Hospital, Karachi, Pakistan. J Health Popul Nutr2009;27:339–44.
Grimes DA1, Benson J, Singh S, Romero M, Ganatra B, Okonofua FE, et al. Unsafe abortion: The preventable Pandemic. Sexual and Reproductive health series. Lancet 2006;368:5-7.
Mangiaterra V, Pendse R, Mclure K, Rosen J. Adolescent pregnancy. MPS Note. 2008.1(1). Available at: http://www.who.int/maternal_child_adolescent/documents/mpsnnotes_2_lr.pdf
Shah N, Hossain N, Noonari M, Khan NH. Maternal mortality and morbidity of unsafe abortion in a university teaching hospital of Karachi, Pakistan. J Pak Med Assoc 2011;61:582–6.
Naz S, Tayyab S, Ali L, Yasir R. Emergency contraception: knowledge and attitude among females. J Surg Pak 2009;14:89–92.
United State Agency for International Development- Supported Pakistan Demographic and Health survey Islamabad, 2008.
United National population Fund (UNFPA). The state of world population, the right to choice reproductive rights health 1997. Available at: http://www.eldis.org/go/home&id=25837&type=Document
Vahratian A, Patel DA, Wolff C, Xu X. College students’ perceptions of emergency contraception provision. J Womens Health 2008;17:103−11.
Graham A, Green L, Glasier A. Teenagers’ knowledge of emergency contraception: questionnaire survey in south east Scotland. BMJ 1996;312:1567−9.
Parey B, Addison L, Mark JK, Maurice B, Tripathi V, Wahid S, et al. Knowledge, Attitude and Practice of Emergency Contraceptive Pills among Tertiary level students in Trinidad: A Cross-sectional Survey. West Indian Med J 2010;59:650–5.
Sorhaindo A, Becker D, Fletcher H, Garcia S, Mitchell S. Exploring knowledge and attitudes about emergency contraceptive pills among university students in Jamaica. A qualitative approach. West Indian Med J 2004;53:33−8.
Sorhaindo A, Becker D, Fletcher H, Garcia S. Emergency contraception among university students in Kingston, Jamaica: a survey of knowledge, attitudes and practices. Contraception 2002;66:261–8.
Adhikari R. Factors affecting awareness of emergency contraception among college students in Kathmandu, Nepal. BMC Women’s Health 2009;9:27.
Muia E, Ellertson C, Lukhando M, Flul B, Clark S, Olenia J. Emergency contraception in Nairobi, Kenya: Knowledge, attitude and practices among policy makers, family planning providers and clients and university students. Contraception 1999;60:223−32.
Uzuner A, Unalan P, Akman M, Cifçili S, Tuncer I, Co-ban E, et al. Providers’ knowledge of, attitude to and practice of emergency contraception. Eur J Contracept Reprod Health Care 2005;10:43–50.
Xu X, Vahratian A, Patel D, McRee A, Ransom S. Emergency contraception provision: a survey of Michigan physicians from five medical specialties. J Women Health (Larchmt) 2007;16:489–98.
Corbett PO, Mitchell CP, Taylor JS, Kemppainen J. Emergency contraception: knowledge and percep¬tions in a university population. J Am Acad Nurse Pract 2006;18:161–8.
Bildircin M, Sahin NH. Knowledge, attitudes and practices regarding emergency contraception among family-planning providers in Turkey. Eurp J Contracept Reprod Health Care 2005;10:151–6.
International Consortium for Emergency Contraception: Emergency Contraceptive Pills. 2nd ed. Washington DC: 2004.
Von Hertzen H, Piaggio G, Ding J, Chen J, Song S, Bártfai G, et al. Low dose mifepristone and two regimens of levonorgestrel for emergency contraception: a WHO multi centre randomised trial. Lancet 2002;360:1803–10.
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