Jamaican and Barbadian Health Care Providers' Knowledge, Attitudes and Practices regarding Emergency Contraceptive Pills

Context: Little is known about health care providers' knowledge of, attitudes toward and provision of emergency contraceptive pills in the English-speaking Caribbean, where sexual violence and unplanned pregnancies are persistent public health problems. Methods: We conducted interviewer-administered surveys of 200 Barbadian and 228 Jamaican pharmacists, general practitioners, obstetrician-gynecologists and nurses in 2005-2006. For each country, Pearson's chi-square tests were used to assess differences in responses among the four provider groups. Results: Nearly all respondents had heard of emergency contraceptive pills, and large majorities of Barbadian and Jamaican providers had dispensed the method. However, about half had ever refused to dispense it; frequently cited reasons were medical contraindications to use, recent use, method unavailability, safety concerns and being uncomfortable prescribing it. Only one in five providers knew that the method could be safely used as often as needed, and few knew that it was effective if taken within 120 hours of unprotected sexual intercourse. About a quarter of Barbadian and half of Jamaican providers thought the method should be available without a prescription, and half of all providers believed that its use encourages sexual risk-taking and leads to increased STI transmission. Nonetheless, most respondents believed the method was necessary to reduce rates of unintended pregnancy and were willing to dispense it to rape victims, women who had experienced condom failure and women who had not used a contraceptive. Conclusions: Future educational efforts among Jamaican and Barbadian health care providers should emphasize the safety and proper use of emergency contraceptive pills, as well as the need to increase the availability of the method. /// Contexto: Se sabe poco sobre el conocimiento, actitudes y provisión de pildoras de anticoncepción de emergencia por parte de los proveedores de atención a la salud en el Caribe de habla inglesa, en donde la violencia sexual y los embarazos no planeados persisten como problemas de salud pública. Métodos: Entre 2005 y 2006, condujimos encuestas administradas por entrevistador entre un total de 200 proveedores de salud barbadenses y otros 228 jamaiquinos; los proveedores eran farmacéuticos, médicos generales, obstetras-ginecólogosy enfermeras. Con el fin de valorar las diferencias en las respuestas de los cuatro grupos de proveedores de servicios, se utilizo la prueba Ji cu