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.
In 2016–2017, we conducted a multimethods 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 semistructured key informant interviews, and 16 structured interviews with retail pharmacists. We analyzed our data using descriptive statistics and for content and themes.
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.
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.
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.
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- Kodi Penal [Penal Code]. Chapter 4: Krime kunder personit [Crimes against a person], Section III: Krime te rrezikeshme per jeten dhe shendetin [Dangerous crimes against life and health], Articles 158–160. 1952 ([Accessed through the archives of the National Library of Albania, Nr. 89.r.230])
- Nesmark. Nesmark — The Albanian Contraceptive Social Marketing Foundation.http://nesmark.org.al/about.htmlDate: 2009
- Albania Demographic and Health Survey 2008–09.Institute of Statistics, Institute of Public Health and ICF Macro, Tirana2010 (Available online at)
- Factors influencing women's reproductive health choices in Tirana, Albania.EngenderHealth, New York2013 ([RESPOND Project Study Series: Contributions to Global Knowledge. Report No.: 12])
- Emergency postcoital contraception.N Engl J of Med. 1997; 337: 1058-1064
- Fact sheet no. 244: emergency contraception.
- Emergency contraception: a last chance to prevent unintended pregnancy.Contemp Read Law Soc Justice. 2014; 6: 7-38
- Foster A.M. Wynn L.L. Emergency contraception: The journey of a global reproductive health technology. Palgrave Macmillan, New York (NY)2012
- Contraceptive social marketing in Albania — The NESMARK story.Eur J Contracept Reprod Health Care. 2013; 18: 221-229
- Status and availability database: Albania.http://www.cecinfo.org/country-by-country-information/status-availability-database/countries/albania/Date: 2015
- The qualitative content analysis process.J Adv Nurs. 2008; 62: 107-115
- The constant comparative method of qualitative analysis.Soc Probl. 1965; 12: 436-445
- The birth of a global reproductive health technology: An introduction to the journey of emergency contraception.in: Foster A.M. Wynn L.L. Emergency contraception: the story of a global reproductive health technology. Palgrave Macmillan, New York (NY)2012: 3-17
- “In rape cases we can use this pill”: a multimethods assessment of emergency contraception knowledge, access, and needs on the Thailand-Burma border.Int J Gynaecol Obstet. 2015; 130: E37-E41
- Emergency contraception in a public health emergency: exploring pharmacy availability in Brazil.Contraception. 2016; 94: 109-114
- Country profile: Albania.http://databank.worldbank.org/data/views/reports/reportwidget.aspx?Report_Name=CountryProfile&Id=b450fd57&tbar=y&dd=y&inf=n&zm=n&country=ALB(Previous page: https://data.worldbank.org/country/albania)Date: 2016
Published online: April 11, 2018
Accepted: March 28, 2018
Received in revised form: March 27, 2018
Received: February 15, 2018
☆Conflicts of interest: The authors declare that they have no conflicts of interest, financial or otherwise.
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