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Indian Journal of Medical Sciences, Vol. 63, No. 3, March, 2009, pp. 115-117 Letter To Editor Emergency contraception - knowledge in medical students Sharma JaiBhagwan, Bahadur Anupama, Chadha Sameer, Mehta Shikha, Mittal Suneeta Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences and Maulana Azad Medical College, New Delhi Code Number: ms09022 Sir, Emergency contraception (EC) is a method of contraception that can be used to prevent pregnancy after an unprotected act of sexual intercourse. [1],[2] Recent multicentric and WHO-sponsored studies have found a dose of 0.75 mg of levonorgestrel (LNG) repeated 12 hours after the first dose and within 72 hours of exposure as the preferred method of contraception, being more effective and much better tolerated than Yuzpe regimen, which contained high doses of estrogen and progesterone. [3] At present LNG-only regimen has become the first progesterone-only tablet especially developed for post-coital contraception and is approved by the United States Food and Drug Administration (USFDA) and the Drug Controller of India. [4] LNG-ECP is available as a 2-pill pack, each tablet containing 0.75 mg of LNG, and can be used as a 2-dose regimen preferably within 72 hours but not later than 120 hours of exposure. It can also be used as a single dose (1.5 mg LNG) within 72 hours but not later than 120 hours of exposure. It has been made available as an over-the-counter drug for popularizing it and is also available free of cost in most government hospitals. We conducted this open-ended questionnaire survey which was pre-validated over 100 medical students [31 interns, 61 fourth professional and 8 third professional] of Maulana Azad Medical College, New Delhi, to assess their knowledge on various aspects of emergency contraception as per a fixed questionnaire. In this medical college, obstetricians and gynecologists were taught about contraception, including emergency contraception, in the third and fourth professionals. A total of 130 interns and fourth and third professional students were requested to participate, of which 100 (76.92%) agreed to participate and 30 did not participate due to lack of time or were not interested. Age of participants was between 21 and 24 years. Out of the 100 participants, 64 were boys; and 36, girls. They were asked about the knowledge of EC, source of knowledge of EC, including their knowledge about the best method of EC, method licensed by the Government of India for EC, dosage and free availability of EC, its cost and also their opinion about popularizing EC among the general population. The various facets of knowledge about various aspects of EC in general and LNG in particular among the medical students are shown in [Table - 1]. A total of 91 students were taught about EC in the medical school, and all of them (100%) had read about EC in medical books. About the best method of EC, only 48% of the students wrote about LNG while 95% knew that EC should be given within 72 hours; and all of them stressed the need of counseling while prescribing EC. They advocated the necessity of the role of doctors, governmental and nongovernmental agencies and media in popularizing EC. Only 55% of the students knew that only LNG has been licensed by the Government of India for EC. Forty-five percent of the students knew the cost and dosage, and 33% knew the correct regimen of LNG for EC. A total of 77% of the students were aware of the free-of-cost availability of LNG for EC, 91% knew of its availability over the counter and 41% knew about its exact price. The current study clearly shows that though the medical students were aware of EC, there is still lack of awareness of LNG being the right drug for EC, its dosage and regimen and various other aspects of EC amongst medical students in a well-known teaching hospital of Delhi. The awareness is bound to be even poorer in medical students of remote regions. Questionnaires and surveys have been used to know the views of doctors and patients, and important data have been collected by their use about their knowledge of various aspects of obstetrics and gynecology, including emergency contraceptives and urogynecology. [4],[5] EC is important to prevent many unintended pregnancies; it is very crucial that both health care providers and women (consumers) among the general population should be aware of the availability of EC and that doctors should be fully aware of all aspects of EC for better delivery of EC-related services. There is need to popularize emergency contraception in India for its better usage amongst women to avoid unwanted pregnancies and abortions - with the help of media, government and health-management agencies and health care providers. There is a mistaken belief amongst some people that over-the-counter availability of EC may make women, especially adolescent girls, promiscuous and that they may not use regular contraception. This, however, is not true. It is important to counsel women regarding the use regular contraception and keep EC in reserve for emergency purpose. Community-based intervention regarding emergency contraceptive pills, including a mass media campaign and dissemination of information to women visiting family planning clinics, has been found to be effective in promoting better usage of emergency contraceptive pills. [4] References
Copyright 2009 - Indian Journal of Medical Sciences The following images related to this document are available:Photo images[ms09022t1.jpg] |
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