Progesterone-only emergency contraception (EC) is currently being introduced in West Africa, and could represent an efficient means towards the reduction of unwanted pregnancies and unsafe abortions. The general objective of this research is to fill a gap in existing knowledge by understanding the potential role of EC in improving couples' sexual and reproductive health in that region. The diffusion of EC is particularly important in the context of HIV-AIDS, widespread in West Africa, since EC can back up condom failures. Progesterone-only EC is not subjected to medical counter-indications and can be sold over the counter, thus widening access to contraception in contexts where contraceptive supply infrastructures mainly target women in union.
As a post-coital method entailing a one-time intake, EC could also help women gain autonomy in contraceptive decision-making. But EC does not help in alleviating other obstacles to modern contraceptive use: the high value attributed to fertility and abstinence, and the fear of side effects; the price of EC may also be a barrier to its use.
Postulating that EC use is embedded in the articulation of conflicting social logics which depend simultaneously on reproductive and sexual norms, gender relations, and client-provider relations, our specific objectives are to study, in the context of West Africa:
1) the accessibility of EC,
2) its acceptability by women, men, and providers,
3) the situations in which its use is particularly adapted,
4) the specific obstacles to its utilisation, and
5) its place in regard to the other fertility regulation practices.
The study will be conducted in Senegal, Burkina Faso, and Ghana. Morocco is included in the study design to test whether the success of EC depends on pre-existing widespread contraceptive use. In the capital of each country, we will identify EC's diffusion channels, and EC sales figures.
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Funding SchemeSTIP - Specific Targeted Innovation Project