Emergency contraception in Albania: A multi-methods qualitative study of awareness, knowledge, attitudes, and practices

Abstract

Objectives: Contraceptive prevalence is relatively low in Albania and abortion is the mainstay of family planning. Although levonorgestrel-only emergency contraceptive pills are available, uptake of this method is minimal. Emergency contraception (EC) could play a significant role in addressing women's need for an effective and discreet pregnancy prevention method. However, information about the dynamics surrounding EC is limited.

Study design: In 2016-2017, we conducted a multi-methods qualitative study that aimed to explore awareness, knowledge, attitudes, and practices toward EC in Albania. This project comprised four components: a community-based survey with 115 respondents, six focus group discussions with women of reproductive age, 19 semi-structured key informant interviews, and 16 structured interviews with retail pharmacists. We analyzed our data using descriptive statistics and for content and themes.

Results: Our findings suggest that EC is widely available in pharmacies in Albania. However, a quarter of our survey participants did not know whether EC was available and more than a third did not think EC was safe to use. Women face numerous barriers to accessing this form of contraception. Misconceptions about hormonal contraceptives, in general, and about progestin-only EC in particular, lack of training among providers, and stigma and fear of judgment, were common obstacles identified by participants.

Conclusions: Misinformation and lack of knowledge about EC among women and providers in Albania appears common. Training health service providers, raising awareness among women, and developing linguistically and culturally resonant materials for distribution could be keys to improving access to and use of EC.

Implications: Although the availability of progestin-only EC is widespread in Albania, our findings suggest that more work needs to be done to align national regulatory policies with international standards, facilitate evidence-based service delivery, and increase access to medically accurate information in Albanian.

Comment: The best way to prevent an abortion, is to prevent a pregnancy. And one way to do that, is to use emergency contraception (EC) when needed. This study from Albania shows that the knowledge about EC is still lacking in many young women, so education should include information on EC and the material should be available in a way that is easy to understand and in the local language. (HMV)