Melissa Garcia, Sarah Rich and Elizabeth Westley
Just days after officially joining the MSH family and receiving an initial quick orientation in Medford, the International Consortium for Emergency Contraception (ICEC) team headed out to Indonesia to participate in the International Conference on Family Planning. ICEC has been hosted by Family Care International (FCI) and joined MSH along with colleagues from the FCI program based in New York. All three of our staff members attended: Melissa Garcia, Sarah Rich and Elizabeth Westley. We all really enjoyed the opportunity to meet MSH staff from so many offices and felt very much a part of the MSH family.
Outreach was one of our primary goals, and to this end we had our own booth and signed up around 100 new contacts to our listservs. We also participated in training of two groups of journalists (anglophone and francophone) hosted by Population Reference Bureau, and were pleased to see that several of the journalists we spoke with published and aired accurate and favorable stories about emergency contraception (see an example from Pakistan).
On the technical front, we hosted a full-day side event with the World Health Organization, attracting around 50 experts from around the world to discuss emerging issues related to emergency contraception. We also hosted two panels on emergency contraception focused on access gaps and new research, and Elizabeth spoke on another panel related to classification of contraceptives.
Some of the key themes that emerged from our events include:
- Community-based distribution of EC: We learned about how community-based distribution (CBD) of EC is increasing access to this contraceptive method in South Asia and what the challenges are to implementing these programs. We also discussed the feasibility of implementing CBD of EC in other settings, particularly Uganda. We see this as a key area for EC moving forward. Conferences like this one give us time to provide hands-on technical assistance and support to partners, resulting in this note from a participant: “It was a great opportunity interacting with Sarah Rich and your team during the recent ICFP in Indonesia Bali. You helped me plan how to kick start an EC program … The materials you shared with me are helping me to …design strategies on how to reach the different audiences.”
- Demand generation of EC: Population Media Center, with whom we are partnering in DRC, presented on its positive messaging about EC in entertainment media (link). Our partners at JHU-CCP shared a new tool for generating demand for EC (link). Given that knowledge of EC remains extremely low overall, globally, we are optimistic that these efforts can increase EC awareness, although donor commitment is still inadequate.
- Affordability of EC: Elizabeth presented findings from an ICEC study looking at the price and affordability of EC around the world. Across Africa, Asia, and Latin America, EC is least affordable in Africa, particularly Francophone West Africa, and most affordable in Asia.
- Regional and country trends on EC access: Sarah presented a big-picture view of EC access issues in Asia, showing that access is particularly lacking in the Middle East. Two other presentations also covered EC access in specific countries: (1) Trends in EC provision and use in urban Nigeria, presented by the Urban Reproductive Health Initiative; and (2) Access to EC in Malawi at public sector facilities, pharmacies and via police units (for rape survivors), presented by the University of Malawi. Additionally, Melissa and the team convened a number of meetings with partners from the DRC, including the director of the adolescent health division within the Ministry of Health, who has now included EC in their national strategic plan. Melissa provided EC training materials for FP provider training sessions to be held imminently by the Ministry of Health’s reproductive health division and CARE.
- EC access for survivors of sexual assault: The ICEC team met with staff from the Population Council to discuss our partnership to ensure that national sexual assault treatment guidelines and protocols include EC throughout Anglophone Africa. We began preparations for a consultation we are co-hosting with Pop Council and WHO in Zimbabwe in April that will bring together key focal points from 7 countries to strategize about improving their national guidelines for post-rape care.
- Clinical updates: WHO made two important presentations in our panels: (1) Results of WHO multi-center clinical trial showing that a dose of levonorgestrel (the same drug used in many EC pills) can safely be used repeatedly as an on-going method of contraception. (2) Results of a WHO reanalysis of clinical trials to look at whether weight and BMI affect efficacy, indicating that we do not have a strong enough evidence base to associate weight/BMI with EC effectiveness.
- Classifying contraceptive methods: Elizabeth presented in a panel on classification of contraceptive methods, looking at questions such as how EC should be included in surveys, can it be a “current” or modern contraceptive method, and how it contributes to contraceptive prevalence rate and other indicators.
In between hosting these formal events, we organized a number of side meetings, developing next steps for moving our work forward with both new and existing partners.
ICEC achieved our goals and more at the conference! We look forward to discussing EC and the potential to work together with our new MSH colleagues.