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Research Articles (Development Studies)

Permanent URI for this collectionhttps://hdl.handle.net/10413/6665

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Browsing Research Articles (Development Studies) by Author "Maharaj, Pranitha."

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    Missing opportunities for preventing unwanted pregnancy: a qualitative study of emergency contraception.
    (BMJ Publishing Group, 2010) Maharaj, Pranitha.; Rogan, Michael J.
    BACKGROUND AND METHODOLOGY:High levels of unplanned pregnancy among young people are a huge public health problem in South Africa. However, use of emergency contraception (EC) remains low. Studies suggest that providers constitute an important link to increasing access to EC use. The aim of the study was to provide greater insights into the attitudes of providers towards EC in order to better understand factors influencing uptake. The study drew upon 30 in-depth interviews with providers at private and public health facilities in Durban, South Africa. RESULTS: The results of the study highlight several barriers to the provision of EC in both public and private health facilities. The cost of EC products in commercial pharmacies is likely to be a major barrier to use for many women. In addition, providers in both public and private facilities are often reluctant to provide EC over the counter because they feel that the use of EC is likely to discourage regular use of contraception and increase the risk of unprotected sexual intercourse and, as a result, contribute to the spread of HIV/AIDS in South Africa. In addition, they reported that they do not have an opportunity to counsel women about EC because of time constraints. Providers in both the public and private sectors also demonstrated a level of uncertainty about the clinical effects of EC pills and on the regulations surrounding their provision. DISCUSSION AND CONCLUSIONS: Despite relatively progressive legislation on EC provision and the widespread availability of EC products in South Africa, providers in pharmacies, family planning clinics and public health clinics need more training on EC provision. Interventions should aim to educate health providers on both the clinical and social aspects of EC provision.
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    Promoting and prioritising reproductive health commodities : understanding the emergency contraception value chain in South Africa.
    (Women's Health and Action Research Centre (WHARC), 2010) Rogan, Michael J.; Nanda, Priya.; Maharaj, Pranitha.
    Use of emergency contraception is low in South Africa despite high rates of unplanned and unwanted pregnancies. Existing studies have demonstrated that women access emergency contraception from commercial pharmacies rather than from public health facilities at no charge. Research has also demonstrated that awareness of emergency contraception is a key barrier to improving uptake, especially in the public health sector. This study investigates the low use of emergency contraception in South Africa and employs a qualitative value chain analysis to explore the role of market and regulatory structures in creating an enabling environment for the supply and promotion of emergency contraception. The results suggest that there are several ‘market imperfections’ and information barriers impacting on the effective supply of emergency contraception to women who are dependent on the public health sector for their health care. Balancing commercial interests with reproductive health needs, it is argued, may form a crucial part of the solution to the low uptake of emergency contraception in South Africa.