Population Council Research that makes a difference

"Emergency contraception" (EC) refers to several contraceptive methods that can be used to prevent pregnancy after sex, including emergency contraceptive pills and intrauterine devices. They offer women an important second chance to prevent pregnancy when a regular method fails, no method was used, or sex was forced. Research over the past 30 years has shown that these methods are safe and effective, reducing a woman's risk of becoming pregnant from a single act of intercourse by between 75 and 99 percent.

As one of the first countries in Africa to introduce EC into its private and public sectors, Kenya has been a pioneer in the EC field. In 1996, the dedicated EC pill, Postinor-2, was registered and introduced in the country. Although the method proved highly popular in both the private and public sectors, the depletion of public-sector EC stocks in 1999 signaled the end of services and relegated Postinor-2 exclusively to private pharmacies.

In late 2006, Kenya's Ministry of Health (MOH), the Population Council, and Population Services International (PSI) launched an initiative to mainstream emergency contraception (EC) in both the private and public sectors of Kenya. The specific objectives of the initiative were to: increase knowledge, awareness, and use of EC among Kenyan women aged 18–30 years; increase knowledge and awareness of EC among providers and pharmacists; and strengthen EC provision in both the private and public sectors. It was intended to serve as a model for other countries interested in improving access to EC, and to generate in-depth knowledge on EC program strategies and utilization characteristics in sub-Saharan Africa.

When the initiative concluded in 2009, sales of EC in the private sector had more than tripled, and public-sector utilization had also increased tremendously. Overall knowledge among providers increased significantly over the life of the initiative, and those trained on EC under the MOH’s Contraceptive Technology Updates series demonstrated more favorable attitudes and practices toward EC. Provider capacity also increased in the private sector through an innovative, noninvasive strategy to improve information provision in pharmacies. On a national level, the preservice training curriculum for nurses was updated to include EC, and the MOH has revised the national guidelines based on the experiences of this initiative. The results of the project were disseminated to the national press guild, policymakers, and donors at a national dissemination meeting in June 2010.

The Council was awarded a follow-on project for January–December 2010 to institutionalize and sustain the achievements realized under this initiative, which are vulnerable to competing demands and limited resources. Continued support involves securing funding to guarantee supplies; conducting additional awareness activities and training efforts; providing continued technical assistance to partners; and promoting lessons learned. Activities under this follow-on project included: assisting the MOH in institutionalizing and sustaining the achievements of the initiative; providing continued support to the private sector to address concerns over EC "misuse;" locating additional support for EC activities in Kenya; and promoting the Kenyan experience as a model for other countries.