Emergency contraception

Objective: To assess the acceptability and effectiveness of Levonorgestrel 0.75 mg in preventing pregnancy in women of squatter settlements and to identify the best service provision for emergency contraception (EC). Place: Five squatter settlements of Karachi, Pakistan. Subjects and Methods: Interviews were conducted on 174 married women who were dispensed Levonorgestrel 0.75 mg in tablet form. A baseline survey was conducted to assess the knowledge and practices of health care providers and married men and women regarding EC. Based on the results of the survey, training for health care providers and IEC campaign for general community was conducted. Consenting health care providers were provided with Levonorgestrel 0.75 mg. A record of the number of packets distributed to health care providers (HCPs), and the quantity dispensed by them to clients were kept. Follow-up interview of clients were also conducted. Acceptability was assessed with reference to availability, cost and reported side effects of the drug. Effectiveness was assessed by number of women reporting withdrawal bleeding after taking Levonorgestrel. Results: The mean age of the ECP user was 28.5 (-6.2) years. Overall, 72.4 percent (126/174) of respondents were using some form of contraception prior to EC use. Of 174 women who used emergency contraception, 75.3% (131/174) continued to use regular methods of family planning after EC use. One hundred and fifty-seven (90.2%) women had withdrawal bleeding after the use of EC pills. Fifty-six women (32.2%) reported adverse effects of ECP. Most frequently reported complaints were vertigo/dizziness (28.6%), nausea/vomiting (26.8%), menstrual disturbances (21.4%), headache (7.1%), and other complaints (10.7%). Conclusion: There is a need for provision of emergency contraception to married couples. Levonorgestrel, as emergency contraception is acceptable to the community, front-line health care providers can motivate community for emergency contraception.