Workforce interventions to improve access to emergency contraception pills: a systematic review of current evidence in low- and middle-income countries and recommendations for improving performance
BACKGROUND In a majority of sub-Saharan African countries, counseling and provision of emergency contraception (EC) lag behind that of developed countries. As policymakers expand EC programs in the region, an understanding of provider knowledge and bias regarding EC is critical. STUDY DESIGN Using data from recent surveys of Kenyan and Ethiopian health care providers in bivariate analyses and multivariate logit regression models, this study assesses whether variation in provider knowledge and bias regarding EC is associated with variation in EC counseling and provision. RESULTS Survey results indicate that 54% and 31% of Kenyan and Ethiopian providers, respectively, display strong EC counseling behavior, while 61% and 55%, respectively, report having ever provided EC. Bivariate and multivariate results show that, in Kenya, increased EC counseling and provision behaviors are associated with higher levels of provider knowledge. CONCLUSION Training on EC can increase provider knowledge and lower bias, leading to improved access for clients.