Magnitude of Repeat Use of Emergency Contraceptives Among Women of Reproductive Age in Tanzania

Abstract

Background: Emergency contraceptives are intended to mitigate the risk of conceiving unwanted pregnancies following unprotected sexual intercourse. However, there is concern about the increasing repeated use of emergency contraceptive pills among women of reproductive age.

Objectives: This study aimed to determine the use and magnitude of repeated use of emergency contraceptive pills and associated factors among women of reproductive age.

Methods: A cross-sectional study was conducted in six out of twenty-six administrative regions of mainland Tanzania. A total of 1,284 women of reproductive age were interviewed using a structured questionnaire.

Results: The rate of ever use of emergency contraceptives was 17.4%. One out of 10 women of reproductive age have used emergency contraceptive pills in the previous 12 months. Nearly half of clients of emergency contraceptive pills were prevented by their spouses or partners from using regular family planning methods. Of the 224 users of emergency contraceptives, 198 (88.4%) affirmed that they had used the pills more than once. Of those, 159 (80.3%) reported to have used emergency contraceptive pills several times (more than three times). Knowledge of the use of emergency contraceptive pills varied with education, marital status, geographical location, age, and wealth index. Most women of reproductive age (82.9%) do not know the appropriate use of emergency contraceptive pills, particularly in Mbeya and Mwanza, where all interviewed women of reproductive age were not aware that emergency contraceptive pills are used to avoid unwanted pregnancy in emergencies only. A significantly low proportion of women of reproductive age in Mbeya (6.7%), adolescent girls (34.6%), slightly over one-third of married and unmarried women, and those in middle and lower wealth index knew the right time to take emergency contraceptive pills. A significantly low proportion of women of reproductive age in Mbeya (36.7%) agreed that emergency contraceptive pills are safe for use and that they can be recommended to a friend. Nearly one-third of women of reproductive age in Mwanza (27.3%), one-fifth of women of reproductive age with tertiary education (21.6%), and almost a quarter of employed women of reproductive age (24%) had a negative perception of the use of emergency contraceptive pills. Repeated use of emergency contraceptive pills was associated with the region of residence, the status of the use of regular FP methods, education, knowledge of indication and appropriate time to take emergency contraceptive pills, and perceived safety of emergency contraceptive pills.

Conclusion: Although the use of emergency contraceptives is still modest, the proportion of women of reproductive age who reported several repeated uses of emergency contraceptive pills is high, particularly so among women of reproductive age in Mwanza and Mtwara, those with tertiary education and those who do not know that prescription is not required to get emergency contraceptive pills. Interventions to educate women of reproductive age on indication and appropriate use of emergency contraceptives are required.