Student Dissertation

Agency : ASHA; ANMs; Emergency Contraceptive Pills; KAP

Objective : • To review the guidelines of administration of oral contraceptive pills given by National Health Mission under family planning program. • To assess the knowledge and attitudes of ASHAs & ANMs towards the administration of oral contraceptive pills. • To study the practices of the administration of oral contraceptive pills by ASHAs & ANMs

Background : Emergency contraceptive pill (ECP), also known as “morning after pill” was scheduled under National Family Welfare Program in 2013. In India about 22 per cent of conceptions each year are unplanned, of which approximately 50 per cent are unwanted, which lead to abortion, mostly unsafe. The high incidences of unwanted pregnancy and unsafe abortion are mainly to unmet need of family planning resulting from non-availability of effective family planning program. At the grassroots level, ANM and ASHA distribute contraceptives and therefore, their understanding makes difference in the successful implementation of ECP.

Methodology : To assess knowledge, attitude, and practice of ASHAs and ANMs towards the administration of Emergency Contraceptive pills, a cross sectional study was conducted in two blocks of Dang district of Gujarat selected on the basis of high and poor. performance in consultation with the RCHO. A total of 64 ASHAs and 32 ANMs were selected randomly. The interview schedule was developed on the basis of ECP guidelines. The study was conducted during March-April 2015.

Findings : Results show that 86 percent of the ASHAs and 94 percent of the ANMs know ECP that prevents conception. Of those who had knowledge of ECP around 97 percent of the ASHAs and all the ANMs correctly responded that the time period within which ECP can be given. But, when it came to dosage of ECP, 11 per cent of ASHAs and 23 per cent of the ANMs knows the correct dosage of ECP for prescription. None of the ASHAs and ANMs could respond correctly how to calculate 72 hours of interval for dispensing ECP. However, 27 percent of the ASHAs and 20 percent of ANMs knew that up to 72 hours ECP can be prescribed after unprotected intercourse. On being asked about the safety of the pills, 68 percent of the ASHAs and 80 percent of the ANMs feel that the pills are safe. Practice of ASHAs was being checked by asking question on screening of the couples for eligibility to use ECP, 71 percent that they get their clients screened by Medical Officer and ANM. On being reported side effects by their beneficiaries such as headache, breast pain, weight gain, nausea, vomiting, and irregular menses the ANMs and ASHAs could not counsel properly to their clients. Thirty-five percent of ASHAs and 43 percent of ANMs have negative attitude towards promotion of ECP as it can be counterproductive because of its misuse. The ANMs and ASHAs lack complete knowledge of ECP, resulted in not so positive attitudes, and practice.