Is repeat use of emergency contraception common among pharmacy clients? Evidence from Kenya

Background: As emergency contraception (EC) becomes more widely available in African pharmacies, public concern in many countries has emerged over perceived "repeat use" of the method. This study examines issues of repeat use in Kenya, a country where women almost exclusively obtain EC from pharmacies. Study Design: Interviews were conducted with all clients who purchased EC from private pharmacies located in five urban areas across Kenya. Over a period of 5 days, a total of 182 male and female EC purchasers were interviewed. chi(2) tests were used to determine the statistical significance of differences between repeat and nonrepeat users. Results: The majority (58%) of respondents had purchased EC at least twice in the past 1 month. All women interviewed reported purchasing EC a mean of 3.8 times in the 6 months prior to the survey. Those who purchased EC at least twice in the past 1 month were significantly more likely to hold misperceptions about EC's efficacy or side effects. Two thirds of all users reported having a chance to ask questions at the pharmacy, although one quarter felt that they did not receive adequate information. Conclusions: This study indicates that many of the women surveyed, particularly those who had sex on an infrequent basis, chose to use EC as a regular family planning method. Among these women, it also indicates the need for better information on EC's efficacy and side effects. Such information-sharing could take place within pharmacies, although interventions must not undermine the core benefits of pharmacy access: convenience and confidentiality. (C) 2011 Elsevier Inc. All rights reserved.