Women shy away from morning-after pill for fear of being judged by health workers

How often do you buy an emergency contraceptive pill from either a chemist or a hospital? Do you need to consult the pharmacist to be given the pill or is it on a pay and take basis?

Maureen Kerubo says she had to change her picking point for the pills because of the many questions she was asked whenever she went to collect the pills. “Initially, I would walk to a government facility next to my house to pick the pill because of privacy issues, and it was also free.”

She adds: “However, after being shamed by a nurse who shouted at me by telling everyone that I had unprotected sex, I stopped,” says Kerubo.

In some chemists, one has to consult pharmacists before buying the pill while in others, it is an over-the-counter drug. The government rolled out a national programme offering free emergency contraceptive pills at its health facilities, but most women prefer to buy them from private chemists to avoid health workers.

Ironically, the emergency pill is one of the fastest moving medical products at private pharmacies in Nairobi and other urban centres.

Estimates from four pharmacies in Nairobi indicated they each sell the emergency pill to between 100 and 150 young women every week for Sh100 for the two tiny tablets.

A study published last week recommended the morning-after pill “should be available in front of the counter” and off the shelf, alongside pregnancy tests and condoms.

At the moment, women and girls have to have a consultation with a pharmacist before they can be given an emergency contraceptive or morning-after pill — taken within five days of unprotected sex.

This can leave them feeling “uncomfortable, embarrassed or judged”, the report says. A report by the Royal College of Obstetricians and Gynaecologists recommends that women and girls should be able to get hold of emergency contraception more efficiently without the need for a consultation with a pharmacist.

“There are too many barriers to health services for women which leads to rising conception rates and abortions among older women, because of unplanned pregnancies,” the report says.

HIGH NUMBER OF ABORTIONS

One of the significant reasons for unsafe abortions is unintended teen pregnancies, which stem mainly from the unmet need for family planning.

A report, The Costs of Treating Unsafe Abortion Complications in Public Health Facilities in Kenya, estimates that 464,690 abortions take place annually, killing seven Kenyans daily.

These comprise only the cases reported in the public healthcare system, meaning the number could be much higher.

Many of the victims are aged between 10 and 24 years. The report also calls for the progestogen-only contraceptive pill to be available over the counter in pharmacies instead of with a prescription from a general practitioner.

It says girls and women should be able to order the pills online like any other pharmacy product. Prof Lesley Regan, president of the Royal College of Obstetricians and Gynaecologists, said the progestogen-only contraceptive pill was very safe, and a consultation with a GP before starting to take it was “unnecessary”.

Dr Asha Kasliwal, president of the Faculty of Sexual and Reproductive Healthcare, said women and girls must have free and timely access to all methods of emergency contraception. “While emergency contraception is free in some places, many will choose to access it in pharmacies where cost and opening times vary considerably.”

She added: “Consultations with pharmacists are highly recommended and best practice, as this is a valuable opportunity for individuals to discuss their contraceptive needs with a healthcare professional. However, a consultation should not be a barrier to receiving emergency contraception.”