Evaluation and experience in using Contraceptive Implants & Emergency contraceptive pills in Palestine

Background: Norplant has recently been introduced in Palestinian Family Planning and Protection Association (PFPPA) services in the last 3 years. This study covered the experience of Norplant and ECPs in WB and GS, using survey questionnaires and interview method. The total number of responders in Norplant survey were 178 (34%) of total population that received Norplant services. The total number of ECPs responders were 75 (33.3%) of total population that received service. Four focus groups were conducted, two FGs with beneficiaries and others with health care providers, who are working in PFPPA clinics in WB. Telephone interview was done in women's Health Center, Al-Bureij in GS and other calls to policy makers, healthcare providers at UNRWA and MOH in WB to understand their experience.

Study findings emerged that satisfaction and advantages was greatest for both method of Norplant and ECPs. The percentage of occurrence of side effects and number of removed Norplant (29% in WB, 8.8% in Gaza) was acceptable rate compared with international studies. The most side effects were change in menstrual cycle after using implants, mood change, bleeding/spotting other than period and weight gain and this is in line with previous studies.  The most common barriers of using Norplant and ECPs were lack of awareness and information of this new method among women, unavailability of Norplant in FPS except in PFPPA, considered it as a luxury element and cultural reasons such as misperception about Norplant. It is crucial to understand community and women’s perceptions and incorporate these understandings into contraceptive consultations.

Study findings revealed that ECPs and Norplant are not available at UNRWA or MOH agenda. The main reasons for not using Norplant in MOH and withdraw it from Al-Bureij center in GS was the absent of capabilities for training and cultural issues.  In recent study about “quality of FP services in Palestine”; highlighted the problem of having countless multi-modalities in FP services that effect quality of service. Another point is SRHS in Palestine are designed to serve married women only. ECPs pills should be offered in essential drug list to ensure the availability for women in need. The PFPPA are Member Associate of IPPF. Running training sessions for insertion and removing Norplant, as well providing FP including Norplant and ECPs to beneficiaries is high quality service. The PFPPA has followed a practical guide and committed to increasing effectiveness, evidence-based decision, and accountability.

 Finally, Governments and policy makers should commit to ensure the implementation of a national FP strategy. The FP services should include modern contraceptive as Norplant and ECPs to meet women’s need.

Keywords: Norplant, Emergency pills, Contraceptive

Author(s): Eman Alshawish

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