Providers\u27 attitudes and practices regarding emergency contraception in India: Key findings

This policy brief reports key findings of a study in India that explored providers’ knowledge of how emergency contraception (ECP) works and its safety and effectiveness, their perceptions of the frequency of repeat use, their provision of ECP, and their attitudes toward women who seek it. Many of the findings of this study are encouraging. Most providers believed that ECP is an effective and safe method to prevent pregnancy and that it cannot induce abortion, and half supported the over-the-counter provision of ECP. Nevertheless, the study revealed many biases and gaps in knowledge. Recommendations include a number of ways to increase education and information about ECPs

Providers\u27 and key opinion leaders\u27 attitudes, beliefs, and practices regarding emergency contraception in India: Final survey report

The Population Council undertook this study to assess the knowledge, attitudes, and practices regarding emergency contraception (ECPs) among providers in public and private facilities and pharmacies in India. This study’s objectives were: 1) to assess providers’ knowledge of ECP’s biological mechanism; 2) to understand providers’ knowledge and attitudes about ECP’s safety, effectiveness, and availability as an over-the-counter drug; and 3) to identify providers’ definitions of “repeated use” and profiling of women who are “repeated users” of ECP. The study recommends intervention programs and advocacy strategies to increase knowledge and access to ECP

Key opinion leaders\u27 views regarding emergency contraception in India

This policy brief explores the views of key opinion leaders (KOLs) in the field of reproductive health and family welfare on provision of emergency contraception (ECPs). The study’s objective was to gain a better understanding of how the attitudes and beliefs of KOLs might influence policy and program implementation, either encouraging or opposing ECP promotion and service delivery. Results suggest strong support by the majority of KOLs to continue the sale of ECP as an over-the-counter drug. KOLs also emphasized the importance of comprehending and addressing the main barriers to ECP provision and use: poor knowledge, lack of training, moral reservations, biases, and misus

Whole Health coaching to rural Veterans through telehealth: Advantages, gaps, and opportunities

BackgroundThe Veterans Health Administration (VHA) is one of the largest providers of telehealth in the United States and continues to lead the way in transforming healthcare services. VHA has been implementing its Whole Health (WH) initiative since 2018, a proactive practice empowering patients to take charge of their health and well-being. A key facilitator of the WH initiative is the WH coach who partners with Veterans to achieve their health-related goals. A gap exists in the literature regarding the understanding of WH coaches’ use of telehealth to engage rural-residing Veterans. COVID-19 unexpectedly interrupted in-person VHA delivery of care, including WH coaching which primarily relied on in-person delivery and focused less on telehealth. During the pandemic, WH coaches had to adapt and integrate different modalities to engage their Veteran patients. We examined WH coaches’ approaches to extending coaching to rural Veterans via technology, emphasizing the advantages of telehealth, existing gaps in telehealth delivery, and opportunities for telehealth as a coaching modality.MethodsThis project was implemented as part of a larger mixed methods evaluation regarding WH coaching for rural Veterans; this manuscript presents the findings from the qualitative data from the larger study. The qualitative dataset is comprised of data collected using three different qualitative methods: four focus groups (n = 11; 3–4 participants per group), in-depth individual interviews (n = 9), and open-ended responses from a national web-based survey (n = 140). Focus group, in-depth interview, and open-ended survey data were collected sequentially and separately analyzed following each wave of data collection. Findings from the three analyses were then collaboratively merged, compared, reorganized, and refined by the evaluation team to create final themes.ResultsThree final themes that emerged from the merged data were: (1) Advantages of Telehealth; (2) Telehealth Gaps for Rural Veterans, and (3) Strategies for Bridging Telehealth Gaps. Themes explicate telehealth advantages, gaps, and opportunities for rural Veteran WH coaching.ConclusionFindings highlight that video telehealth alone is not sufficient for meeting the needs of rural Veterans. Digital technologies hold promise for equalizing health access gaps; however, both human factors and broadband infrastructure constraints continue to require WH coaches to use a mix of modalities in working with rural Veterans. To overcome challenges and bridge gaps, WH coaches should be ready to adopt a blended approach that integrates virtual, in-person, and lower-tech options

Attitudes, beliefs, and practices of providers and key opinion leaders on emergency contraception in India

The Population Council undertook this study to assess the knowledge, attitudes, and practices regarding emergency contraception (ECP) among providers in public and private facilities and pharmacies in India. The objectives of the study were to: assess providers\u27 knowledge of ECP\u27s biological mechanism; understand providers\u27 knowledge and attitudes about ECP\u27s safety, effectiveness, and availability as an OTC drug; and identify providers\u27 definitions of “repeated use” and profiling women who are “repeated users” of ECP. This study\u27s findings show that most providers, including doctors and some KOLs, were incorrectly informed about ECP\u27s mechanism of action. Service guidelines are necessary for accurate and adequate information on ECPs and could be included in the training curricula of all doctors, nurses, and pharmacists. As part of corporate social responsibility, medical representatives of different ECP manufacturing firms could also play a significant role in educating pharmacists about ECP

Gender-based violence in rural Uttar Pradesh, India: Prevalence and association with reproductive health behaviors

This study explores the prevalence of different forms of domestic violence and their impact on women’s reproductive health behavior in rural Uttar Pradesh (UP), India. Data were collected as a part of a large household survey carried out in 2009–2010. A multistage stratified systematic sampling design was used. A total of 4,223 married women aged 15 to 49 years and 2,274 husbands of these women were interviewed. Data were analyzed using bivariate and multivariate analyses. More than one third of married women in rural UP had experienced one or more forms of violence, such as verbal abuse, physical manhandling, and sexual abuse by their spouse. Nearly 47% of the women had experienced some form of violence during their last pregnancy. Significant associations were found between violence and incorrect reproductive health behaviors, pregnancy complications, poor birth preparedness, poor likelihood of institutional delivery, limited postnatal care, and limited spousal communication for family planning. After controlling for socio-economic variables in multivariate analysis, only pregnancy complications (odds ratio [OR] = 1.62, 95% confidence interval [CI] = [1.40, 1.85]) and lack of delivery preparedness (OR = 0.79, 95% CI = [0.68, 0.93]) were found to be significantly associated with violence. Husband’s attitude and reporting of violence by their wives in different situations were not significantly associated. This study provides evidence of the association of violence on the reproductive health behavior of married women in rural India. The results argue for frontline health workers to identify and counsel pregnant women experiencing violence during antenatal check-up to reduce maternal morbidity and mortality

Intimate partner violence and sexual coercion among pregnant women in India: Relationship with depression and posttraumatic stress disorder

Abstract Background: Intimate partner violence (IPV) is prevalent in most parts of the world. It is also prevalent during pregnancy. Methods: This study assessed the prevalence of IPV during pregnancy and evaluated its relationship with mental health outcomes, including depression and post-traumatic stress disorder (PTSD). Pregnant women (n = 203) attending an antenatal clinic in a public hospital in Bangalore were assessed for presence of IPV as well as depressive, somatic, PTSD symptoms and life satisfaction. Results: Self-reported physical violence in the last year was reported by 14% of women, psychological abuse by 15%, and sexual coercion by 9%. One-half of these women reported ongoing abuse during pregnancy. Depression, somatic, and PTSD symptoms were higher in those with a history of abuse or sexual coercion, and life satisfaction was poorer in those with any form of violence. Among those reporting a history of sexual coercion, severity of violence was related to increased psychiatric morbidity. Alcohol abuse in the spouse was a predictor of the presence and severity of abuse. Limitations: The study was conducted in a single clinic in southern India which is a large country with very diversified populations. Conclusion: The experience of intimate partner violence and its mental health consequences are quite prevalent in India which is a culture where gender disparities are normative and pregnancy is a particularly vulnerable period