Knowledge, attitude and practices of emergency contraception among health care providers and medical students in dar es salaam

Abstract

Background: Emergency Contraception (EC) refers to a group of birth control modalities that, when used after an unprotected intercourse within defined time limits, can prevent an unwanted pregnancy. In many low income countries, the lack of knowledge about and access to EC may result in women resorting to unsafe abortions. Health care providers play an important role in making emergency contraceptives (ECs) available to clients. Emergency contraception is particularly appropriate for adolescents because of their patterns of sexual behaviour and contraceptive use. Objectives: The broad objective of the study was to assess knowledge, attitude and practices on emergency contraception among health care providers and medical students in Dar es Salaam. Methodology: A cross sectional study was conducted in the public and private health facilities as well as three medical schools in Dar es Salaam, from 220d October to zo" November 2009. Twelve health facilities of which 3 public municipal hospitals, 3 public health centers, 3 private hospitals and 3 private health centers from each municipality were included in addition to Muhimbili National Hospital. Once the facility was selected, all the health care providers dealing with reproductive health services that were available on the day of data collection were requested to participate. Those who consented to participate were given self administered questionnaires to fill within a 24 to 48 hours period. Medical students from Muhimbili University of Health and Allied Sciences (MUHAS), Hubert Kairuki Memorial University (HKMU) and International Medical and Technological University (IMTU) were included whereby a list of students from each university was used to select the participants randomly. Coding of the open ended questions was done and data cleaning and analysis was done using Epi info 6.

Vll Results: There were 268 health care providers and 300 medical students who responded to the questionnaires. More than half (59%) of the health care providers and 53.7% of the medical students were aware of EC. A lack of knowledge about EC was found as only 30.4% of the health care providers and 32.9% of the medical students were found to have adequate knowledge of EC. EC provision was reported by 31 % of the providers and EC utilization was found to be 14.9% among medical students. Majority of health care providers (94.9%) and 90.7% of medical students had positive attitudes towards EC provision and utilization respectively. Conclusion The awareness of emergency contraception among health care providers and medical students was found to be moderate (59% vs 53.7%). Despite this, adequate knowledge on emergency contraception on both groups was low (30.4% vs 32.9%). Provision of EC by the health care providers as well as utilization of EC among medical students was found to be low. . Majority of the providers and students had positive attitudes towards EC practices i.e. provision among the health care providers as well as EC utilization among the medical students. 9.0: Recommendations Continuing education programmes about Emergency contraception are required for health care providers to update them with the information regarding EC. There is a need to provide information about EC together with the reproductive health education in schools to include the young population who are at a high risk of unintended pregnancy.