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Improving Access to Emergency Contraception Pills through Strengthening Service Delivery and Demand Generation: A Systematic Review of Current Evidence in Low and Middle-Income Countries

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  • Angela Dawson
  • Nguyen-Toan Tran
  • Elizabeth Westley
  • Viviana Mangiaterra
  • Mario Festin

Abstract

Objectives: Emergency contraception pills (ECP) are among the 13 essential commodities in the framework for action established by the UN Commission on Life-Saving Commodities for Women and Children. Despite having been on the market for nearly 20 years, a number of barriers still limit women's access to ECP in low- and middle-income countries (LMIC) including limited consumer knowledge and poor availability. This paper reports the results of a review to synthesise the current evidence on service delivery strategies to improve access to ECP. Methods: A narrative synthesis methodology was used to examine peer reviewed research literature (2003 to 2013) from diverse methodological traditions to provide critical insights into strategies to improve access from a service delivery perspective. The studies were appraised using established scoring systems and the findings of included papers thematically analysed and patterns mapped across all findings using concept mapping. Findings: Ten papers were included in the review. Despite limited research of adequate quality, promising strategies to improve access were identified including: advance provision of ECP; task shifting and sharing; intersectoral collaboration for sexual assault; m-health for information provision; and scale up through national family planning programs. Conclusion: There are a number of gaps in the research concerning service delivery and ECP in LMIC. These include a lack of knowledge concerning private/commercial sector contributions to improving access, the needs of vulnerable groups of women, approaches to enhancing intersectoral collaboration, evidence for social marketing models and investment cases for ECP.

Suggested Citation

  • Angela Dawson & Nguyen-Toan Tran & Elizabeth Westley & Viviana Mangiaterra & Mario Festin, 2014. "Improving Access to Emergency Contraception Pills through Strengthening Service Delivery and Demand Generation: A Systematic Review of Current Evidence in Low and Middle-Income Countries," PLOS ONE, Public Library of Science, vol. 9(10), pages 1-11, October.
    • Handle: RePEc:plo:pone00:0109315
    DOI: 10.1371/journal.pone.0109315
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    References listed on IDEAS

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    3. David H. Peters & Sameh El-Saharty & Banafsheh Siadat & Katja Janovsky & Marko Vujicic, 2009. "Improving Health Service Delivery in Developing Countries : From Evidence to Action," World Bank Publications - Books, The World Bank Group, number 12334.
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