Evaluation of Emergency Contraceptive Pill Use with Health Management Information Systems Data in Pakistan.

According to the WHO, all clients should have access to a range of contraceptive methods, including at least one short-term, one long-term, one permanent, and one emergency method of contraception. While there are data on the contraceptive method mix available for many low- and middle-income countries, there are limited data on emergency contraception (EC). This is likely due to some surveys not routinely collecting this information, how survey questions are asked, dual method use, and/or low levels of reported use of EC pill (ECP). Even with low reported use in surveys, contraceptive social marketing statistics from DKT International. show a trend in recent years of increasing product sales of ECPs. To understand a more complete scope of ECP use, we use Pakistan as a case study and analyze Pakistan's Demographic Health Survey (DHS) surveys and Pakistan's Contraceptives Logistics Management Systems. Based on commodities dispensed data for ECPs in 2021, about 0.4 percent of all married women in Pakistan use ECPs. While there is currently a small proportion of women, it is growing and the use of ECPs is not zero as indicated by the DHS. Therefore, where available, countries should review their health management information systems data alongside survey data for ECP use.

Dynamics of Emergency Contraceptive Use in Accra, Ghana.

Recent data suggest increasing rates of emergency contraception (EC) use in Ghana, particularly in urban areas. In 2018, we collected survey data from 3,703 sexually experienced women aged 16-44 years living in low-income settlements of Accra. We estimated the prevalence of lifetime and current EC use. Multivariate logistic regression was used to assess factors associated with current use of EC. Retrospective monthly calendar data on contraceptive use were analyzed to identify patterns of EC use, including repeat and continuous use, and uptake of other contraceptive methods in the months following EC use. Nearly 15 percent of women had ever used EC. About half of recent EC users (52 percent) used EC for at least four months cumulatively within a 12-month window. There was no evidence of adoption of other modern methods in the months after using EC. Our results suggest that EC is a common method for pregnancy prevention in Accra, particularly among young, unmarried, highly educated women. Counseling on effective EC use and strategies that promote equitable access should be prioritized.

Factors associated with knowledge and use of the emergency contraceptive pill among ever-married women of reproductive age in Bangladesh: findings from a nationwide cross-sectional survey.

OBJECTIVES: The study aimed to assess the prevalence and factors associated with knowledge and use of the emergency contraceptive pill (ECP) among ever-married women in Bangladesh. METHODS: The study was based on a secondary dataset of the 2014 Bangladesh Demographic and Health Survey. Complete (weighted) data of 17,592 women aged 15-49 years were analysed. RESULTS: The prevalence of having knowledge and use of the ECP among ever-married women in Bangladesh was 13.6% and 1.8%, respectively. Administrative region and type of residence (urban or rural), household wealth index, educational level (of both the woman and her spouse), spouse's occupation, number of living children, weight, current use of contraception and a history of pregnancy termination were positively associated with knowledge and use of the ECP. CONCLUSION: A large proportion of Bangladeshi women of reproductive age had a lack of knowledge and use of the ECP. Nationwide reproductive health education programmes may improve the situation.

Family planning among undergraduate university students: a CASE study of a public university in Ghana.

BACKGROUND: Globally, the rate of unplanned pregnancies among students at institutions of higher education, continue to increase annually despite the universal awareness and availability of contraceptives to the general population. This study examined family planning among undergraduate university students focusing on their knowledge, use and attitudes towards contraception in the University of Education Winneba. METHODS: The study was a descriptive cross-sectional survey using a structured self-administered questionnaire. One hundred undergraduate students from the University of Education Winneba were selected using a multistage simple random sampling technique. A Likert scale was used to assess the attitude of the respondents towards family planning methods. RESULTS: Findings show that the respondents had a positive attitude towards family planning with an average mean score of about 4.0 using a contraceptive attitude Likert scale. Knowledge of contraception, awareness and benefits however do not commensurate contraceptive use among undergraduate students since availability, accessibility and preference influence usage. Emergency Contraception (Lydia) was reported as easy to get contraceptive, hence the most frequently used contraceptive (31%) among young female students aged 21-24 years who appeared as the most vulnerable in accessing and using contraceptives due to perceived social stigma. CONCLUSION: The observation that levels of Family Planning awareness levels do not commensurate knowledge and usage levels calls for more innovative strategies for contraceptive promotion, and Education on the various university campus. The study recommends that public Universities in Ghana should consider a possible curriculum restructuring to incorporate family planning updates. In this regard, a nationwide mixed method study targeting other tertiary institutions including colleges of education in Ghana is required to explore the topic further to inform policy and programme decisions.

Advanced Prescription of Emergency Contraceptive Pills Among Adolescents and Young Adults.

OBJECTIVE: To examine healthcare providers' adherence to professional recommendations for advanced prescription of emergency contraceptive pills (ECPs). METHODS: We conducted a retrospective chart review of 432 visits by 282 unique nonpregnant women 14 to 25 years of age seen at an obstetrics and gynecology teaching clinic to determine the percentage of visits during which advanced prescriptions of ECPs were provided when indicated. A logistic regression model, which accounted for nonindependent observations through generalized estimating equations, was used to identify factors associated with the provision of ECP advanced prescriptions. RESULTS: Approximately one-fifth of eligible visits (19.9%) and eligible patients (19.1%) had documentation of an ECP advanced prescription when indicated. Healthcare providers in this clinical setting were more likely to prescribe ECPs to adolescents and women whose primary contraceptive methods were associated with higher failure rates in typical use, such as condoms. Compared with women aged 20 to 25 years, the adjusted odds ratio of receiving an advanced prescription for ECPs was 5.94 (95% confidence interval [CI] 2.85-12.41) for adolescents. Compared with users of depot medroxyprogesterone acetate, the adjusted odds ratio was 4.25 (95% CI 1.62-11.15) for condom users, and 3.90 (95% CI 1.54-9.86) for users of other short-term hormonal contraceptives. CONCLUSIONS: Despite clear professional recommendations for ECP advanced prescriptions for all women at risk for unintended pregnancy, a substantial gap exists between this standard of care and routine clinical service provision in an obstetrics and gynecology teaching clinic.

Enhancing use of emergency contraceptive pills: A systematic review of women's attitudes, beliefs, knowledge, and experiences in Australia.

Over a decade after emergency contraceptive pills (ECPs) became available without a prescription, the rate of unintended pregnancies remains high in many settings. Understanding women's experiences and perceptions of ECPs may provide insights into this underutilization. We systematically searched databases to identify qualitative and quantitative primary studies about women's beliefs, knowledge, and experiences of ECPs in Australia. Findings demonstrate persistent misunderstandings around access, how ECPs work, and a moral discourse around acceptable versus unacceptable use. Addressing knowledge and the stigma around ECPs use is fundamental to increasing the use of this medically safe and effective strategy.

Bills as Band-Aids: Hopes and Challenges of Expanding Pharmacists' Prescriptive Authority to Include Contraceptives.

This paper critically examines the implications of state efforts to expand prescriptive authority of pharmacists, which will allow them to prescribe various types of hormonal contraceptives. With this expansion, women no longer need to see a physician before being prescribed such contraceptives, but instead, they must answer self-assessment questionnaires at the pharmacy to ensure that their chosen method is safe and appropriate. This paper argues that while these measures to expand pharmacists' prescriptive authority will surely meet the stated goal to increase access to hormonal contraceptives, the measures may have detrimental consequences that have largely been downplayed. Studies consistently show that the OB-GYN is a significant primary care provider identified by young female patients, and some of the main reasons provided by these young women for going to the OB-GYN is to discuss, or obtain a prescription for, contraceptives. Through the expansion of pharmacists' prescriptive authority, a likely consequence is that some women will relinquish going to the OB-GYN. However, the OB-GYN provides important services beyond contraceptives, such as preventive screenings for hypertension, cardiovascular diseases, alcohol abuse, mental health, etc., and there is evidence supporting both the effectiveness and cost-benefits of these interventions. By increasing access to contraceptives, the likely result is that many women will have less interaction with a physician and will receive fewer preventive screenings. I do not wish to suggest that these bills should not pass, nor that OB-GYNs should hold contraceptives hostage, only that there are consequences to expanded prescriptive authority that must be anticipated. Further, expanding prescriptive authority obscures the real problem: some individuals have trouble accessing the health care system, not merely trouble accessing hormonal contraceptives. The expansion of prescriptive authority to include contraceptives applies a Band-Aid to treat one aspect of this problem. What is needed is not merely expanded access to hormonal contraceptives, but better access to health care in general.

The knowledge and perceptions of the first year medical students of an International University on family planning and emergency contraception in Nicosia (TRNC).

BACKGROUND: Informing the individuals on family planning including emergency contraception is a significant step for preventing unintended pregnancies. Although there is a number of studies on family planning and emergency contraception globally and in Turkey, no such data are available in the Turkish Republic of Northern Cyprus. The objective of this study was to evaluate the knowledge and perceptions on family planning and emergency contraception of the first year students of an international medical school in Nicosia, Northern Cyprus and to increase awareness for developing new policies on the issue. METHODS: The data of this cross-sectional study were collected in February 2016 by a questionnaire of 36 questions. Of the 229 students, 189 (82.5%) completed the questionnaire. The data were evaluated by SPSS 18.0 statistical program. The differences of variables were evaluated by Chi square test, p < 0.05 being accepted as significant. RESULTS: The distribution of participants from 23 countries according to nationality revealed three leading countries: Nigeria, Turkey and Syria. Of the students, 53.6% knew the definition of family planning. The sources of information were mainly school, the internet and media, with a total of 60.9% of the participants who stated having prior information on the subject. Awareness of contraceptive methods was indicated by more than 90% and emergency contraception by 66.1% of the participants. However, the students were unable to differentiate between modern and traditional family planning methods; 85.6% did not have knowledge of the most effective period for emergency contraception and 63.1%, of the definition of emergency contraceptive pills. CONCLUSIONS: In conclusion, the knowledge and awareness level of the first year medical students on family planning and emergency contraception was insufficient. Family planning and emergency contraception education should be provided for the students at the first year of all faculties as well as medical schools and relevant programs should be included in the curricula of medical education.

Prevalence of emergency contraceptive pill use among Spanish adolescent girls and their family and psychological profiles.

BACKGROUND: Adolescent girls' family context and psychological characteristics play important roles in their sexual behavior, including the use of the emergency contraceptive pill (ECP). This study aims to (1) determine the prevalence of ECP use among girls who have had sexual intercourse and (2) comparatively analyze their family and psychological profiles according to whether they have used ECPs. METHODS: The sample of 1735 Spanish girls aged 15 to 18 came from a representative sample of the 2014 edition of the Health Behaviour in School-aged Children (HBSC) study. Of this sample, 398 girls had sexual intercourse and reported their ECP use. Data collection for the HBSC study was performed through an online questionnaire to which adolescents responded anonymously in school. Data analyses were descriptive and bivariate and were performed with the statistical program IBM SPSS Statistics 23. RESULTS: The results demonstrated that 30.65% of girls who had sexual intercourse used ECPs. Noticeable differences in paternal knowledge and communication with the father were observed between girls who used the ECP at least once and those who did not use it. In contrast, differences between girls who used the ECP once and those who used it twice or more were pronounced with regard to parental knowledge, communication with parents, maternal affection, life satisfaction, sense of coherence and depression. CONCLUSIONS: This work demonstrates a high prevalence of ECP use and a more positive family and psychological profile for girls who used ECP once compared with those who used it twice or more.

The context of emergency contraception use among young unmarried women in Accra, Ghana: a qualitative study.

BACKGROUND: Over the past decade, awareness and use of emergency contraceptive pills (ECPs) among young women has rapidly increased in Ghana; however, the rate of unintended pregnancy among this group remains high. We conducted a qualitative study to better understand the context and patterns of ECP use among young unmarried women in Ghana. METHODS: We conducted in-depth interviews with unmarried sexually active women aged 18-24 in Accra, Ghana to explore their perceptions, experiences, and opinions regarding sexual relationships and contraceptive methods, and to examine the factors that influence choice of ECPs. A total of 32 young women participated in the study. RESULTS: Most participants had used ECPs at least once. Participants described being unable to plan for sexual encounters, and as a result preferred ECPs as a convenient post-coital method. Despite being widely and repeatedly used, women feared the disruptive effects of ECPs on the menstrual cycle and were concerned about long-term side-effects. ECPs were sometimes used as a back-up in cases of perceived failure of traditional methods like withdrawal. Misinformation about which drugs were ECPs, correct dosage, and safe usage were prevalent, and sometimes spread by pharmacists. Myths about pregnancy prevention techniques such as urinating or washing after sex were commonly believed, even among women who regularly used ECPs, and coincided with a misunderstanding about how hormonal contraception works. CONCLUSIONS: ECPs appear to be a popular contraceptive choice among young urban women in Ghana, yet misinformation about their correct usage and safety is widespread. While more research on ECP use among young people is needed, these initial results point to the need to incorporate information about ECPs into adolescent comprehensive sexuality education and youth-friendly services and programmes.

Annual report of the Women's Health Care Committee, Japan Society of Obstetrics and Gynecology, 2017.

To improve women's quality of life, the activity of the Women's Health Care Committee over a year up to July 2017 focused upon: (i) breast management; (ii) the influence of gynecological disease therapy on physical condition; (iii) non-surgical management of pelvic organ prolapse; (iv) survey of infectious diseases in obstetrics and gynecology in Japan; (v) health care for female athletes; (vi) a training program for women's health care advisors; (vii) revising the Japanese guidelines on hormone replacement therapy; and (viii) revising the 2016 Japanese guidelines for the proper use of emergency contraceptives. The detailed activity of the eight subcommittees is described herein. This report is based on the Japanese version of our annual report (Acta Obst Gynaec Jpn 2017;69(6):1480-1491), to publicize the activities of our committee.

Contraceptive use in the Nordic countries.

INTRODUCTION: The aim was to compare contraceptive use in the Nordic countries and to assess compliance with recommendations from the European Medicines Agency regarding the use of combined oral contraception containing low-dose estrogen and levonorgestrel, norethisterone or norgestimate. MATERIAL AND METHODS: Data on hormonal contraceptive prescriptions and sales figures for copper intrauterine devices were obtained from national databases and manufacturers in Denmark, Finland, Iceland, Norway and Sweden in 2010-2013. RESULTS: Contraceptive use was highest in Denmark (42%) and Sweden (41%), followed by Finland (40%). Combined oral contraception was the most used method in all countries, with the highest use in Denmark (26%). The second most used method was the levonorgestrel-releasing intrauterine system, with the highest use in Finland (15%) and ≈10% in the other countries. Copper intrauterine devices (7%) and the progestin-only pill (7%) were most often used in Sweden. Combined oral contraception use decreased with increasing age and levonorgestrel-releasing intrauterine system and progestin-only pills use increased. The use of long-acting reversible methods of contraception (=levonorgestrel-releasing intrauterine system, copper intrauterine devices, and implants) increased with time and was highest in Sweden (20%) and Finland (18%). The highest use of European Medicines Agency recommended combined oral contraception was in Denmark, increasing from 13 to 50% between 2010 and 2013. In Finland, recommended combined oral contraception remained below 1%. CONCLUSIONS: Contraceptive use was highest in Denmark and Sweden, levonorgestrel-releasing intrauterine system use was highest in Finland and all long-acting methods were most common in Sweden. The use of combined oral contraception recommended by the European Medicines Agency was highest in Denmark.

A new wave in the quiet revolution in contraceptive use in Nepal: the rise of emergency contraception.

BACKGROUND: In Nepal, while the use of the emergency contraceptive pill (ECP) has been increasing rapidly in recent years, very little is known about the profile of ECP users. This study assesses the increasing role of ECP and the profile of ECP users in Nepal. Some policy and programmatic concerns are also addressed. METHODS: Survey interviews were undertaken involving 185 women who visited five metropolitan medical shops located in Pokhara seeking to purchase ECP for their own use. Descriptive statistics were calculated for data analysis. RESULTS: ECP is popular among young (<25 years old) and educated women. Also, nearly 70 % of the ECP users described their most recent sexual relationship as infrequent/casual. The overwhelming majority of users are aware that ECP is for emergency use only. Most ECP users are also aware of other options like condoms, the oral pill, and injectable contraceptives; and a considerable proportion of women using ECP had also used these methods before. CONCLUSION: ECP is filling an important and unique role in reducing unplanned or unwanted pregnancy, especially among young, educated women, and those with infrequent sexual relationships.

Physicians' information to patients and prescription of the emergency contraceptive pill according to their personal experience of using the method and perception of its mechanism of action.

OBJECTIVES: The aim of the study was to evaluate the association between physicians' understanding of the mechanism of action of the emergency contraceptive pill (ECP), their personal use of it, and their practice in informing their patients about the method and in prescribing it. METHODS: The study was carried out in a sample of 3337 obstetrician-gynaecologists who responded to a mailed questionnaire. Bivariate analysis was used to test the association between physicians' personal use of the ECP, their understanding of its mechanism of action, and their practice in informing their patients about the method and in prescribing it. Multiple Poisson regression analysis was carried out to identify variables independently associated with the two dependent variables. RESULTS: Multiple regression analysis showed that the percentage of physicians who had informed their patients about the ECP was significantly lower among those who had needed it themselves but had not used it and among those living in the northeast of Brazil. A significantly higher percentage of female than male physicians had provided information on the ECP. The percentage of physicians who had prescribed the ECP was significantly lower among those who had needed it themselves but had not used it and among those who believed that it caused a mini-abortion. The proportion of physicians who had ever-prescribed the ECP was greater among those who worked exclusively in private practice and among those who worked in a state capital. CONCLUSIONS: The misconception that emergency contraception could cause a mini-abortion was associated with its denial to potential users, while physicians' personal experience of needing to use it favoured the likelihood of their informing potential users about it and prescribing it.

Emergency contraception. Widely available and effective but disappointing as a public health intervention: a review.

Emergency contraception (EC) prevents pregnancy after unprotected sex or contraceptive failure. Use of EC has increased markedly in countries where a product is available over the counter, yet barriers to availability and use remain. Although effective in clinical trials, it has not yet been possible to show a public health benefit of EC in terms of reduction of unintended pregnancy rates. Selective progesterone receptor modulators developed as emergency contraceptives offer better effectiveness than levonorgestrel, but still EC is less effective than use of ongoing regular contraception. Methods which inhibit ovulation whenever they are taken or which act after ovulation to prevent implantation and strategies to increase the uptake of effective ongoing contraception after EC use would prevent more pregnancies.

Effects of ulipristal acetate on human embryo attachment and endometrial cell gene expression in an in vitro co-culture system.

STUDY QUESTION: Does ulipristal acetate (UPA) used for emergency contraception (EC) interfere with the human embryo implantation process? SUMMARY ANSWER: UPA, at the dosage used for EC, does not affect human embryo implantation process, in vitro. WHAT IS KNOWN ALREADY: A single pre-ovulatory dose of UPA (30 mg) acts by delaying or inhibiting ovulation and is recommended as first choice among emergency contraceptive pills due to its efficacy. The compound has also been demonstrated to have a dose-dependent effect on the endometrium, which theoretically could impair endometrial receptivity but its direct action on human embryo implantation has not yet been studied. STUDY DESIGN, SIZE, DURATION: Effect of UPA on embryo implantation process was studied in an in vitro endometrial construct. Human embryos were randomly added to the cultures and cultured for 5 more days with UPA (n = 10) or with vehicle alone (n = 10) to record the attachment of embryos. PARTICIPANTS/MATERIALS, SETTING, METHODS: Endometrial biopsies were obtained from healthy, fertile women on cycle day LH+4 and stromal and epithelial cells were isolated. A three-dimensional in vitro endometrial co-culture system was constructed by mixing stromal cells with collagen covered with a layer of epithelial cells and cultured in progesterone containing medium until confluence. The treatment group received 200 ng/ml of UPA. Healthy, viable human embryos were placed on both control and treatment cultures. Five days later the cultures were tested for the attachment of embryos and the 3D endometrial constructs were analysed for endometrial receptivity markers by real-time PCR. MAIN RESULTS AND THE ROLE OF CHANCE: There was no significant difference in the embryo attachment rate between the UPA treated group and the control group as 5 out of 10 human embryos exposed to UPA and 7 out of 10 embryos in the control group attached to the endometrial cell surface (P = 0.650). Out of 17 known receptivity genes studied here, only 2 genes, HBEGF (P = 0.009) and IL6 (P = 0.025) had a significant up-regulation and 4 genes, namely HAND2 (P = 0.003), OPN (P = 0.003), CALCR (P = 0.016) and FGF2 (P = 0.023) were down-regulated with the exposure of UPA, compared with control group. LIMITATIONS, REASONS FOR CAUTION: This proof of concept study was conducted with a few human embryos, as their availability was limited. Although the 3D model used for this study is well established and the artificial endometrial luminal epithelium shown to express progesterone regulated markers of endometrial receptivity it is still an in vitro model, lacking all cell types that constitute the receptive endometrium in vivo. WIDER IMPLICATIONS OF THE FINDINGS: This study provides new insights on the mechanism of action of UPA on human embryo implantation, demonstrating that UPA in a dosage used for EC does not affect embryo viability and the implantation process of embryo. Progesterone receptor modulators (PRMs) hold the potential to be attractive estrogen- and gestagen-free contraceptives and thus may be made available to a larger proportion of women globally due to these findings. STUDY FUNDING/COMPETING INTERESTS: Swedish Research Council (K2010-54X-14212-09-3) and support provided through the regional agreement on medical training and clinical research (ALF) between Stockholm County Council and Karolinska University Hospital.

Who is using the morning-after pill? Inequalities in emergency contraception use among ever partnered Nicaraguan women; findings from a national survey.

INTRODUCTION: Few studies have described the inequalities in hormonal emergency contraception (HEC) use in developing countries. Thus, the main aim of this manuscript is to study socio-demographic inequalities in HEC use among Nicaraguan women, and to study if inequalities in HEC use arise from exposure to different forms of intimate partner violence (IPV). METHODS: Data from a national cross-sectional study conducted from 2006 to 2007 was used. This study included data from 8284 ever partnered, non-sterilized women. Separate multivariate logistic regressions with each form of IPV were conducted to study how different forms of IPV were associated with HEC. Women's age, residency, education, socioeconomic status, parity, and current use of reversible contraception were included in the multivariate logistic regressions to obtain adjusted odds ratios showing inequalities in HEC use. RESULTS: Six percent of the women had ever used HEC (95% CI 5.1-6.9). Multivariate analyses showed that urban residency, higher education, and higher socioeconomic status were significantly associated with higher odds of ever using HEC, and age was associated with decreased odds of HEC use. A key finding of this study is that after controlling for socio-demographic factors, the odds of using HEC were higher for those women ever exposed to emotional IPV (AOR 1.58, 95% CI 1.16-2.00), physical IPV (AOR 1.82, 95% CI 1.30-2.55), sexual IPV (AOR 1.63, 95% CI 1.06-2.52), and controlling behavior by partner (AOR 1.51 95% CI 1.13-2.00) than those not exposed. CONCLUSIONS: This study provides sound evidence supporting the hypothesis that there are inequalities in HEC use even in countries where inequalities in use to other forms of contraceptive technology has been reduced. HEC use among Nicaraguan women is strongly influenced by individual factors such as age, residency, educational level, socioeconomic status, and exposure to different forms of IPV. It is paramount that actions are taken to diminish these gaps.

Selective progesterone receptor modulators.

PURPOSE OF REVIEW: Review of recent data from clinical trials and descriptions of endometrial morphology with administration of selective progesterone receptor modulators (SPRMs). RECENT FINDINGS: Recent reports concerning administration of SPRMs, specifically the efficacy of ulipristal acetate in reducing fibroid size and rapid control of menstrual blood loss, have renewed clinical interest in this class of compound. Histological data from studies with SPRMs report that this class of drugs is associated with progesterone receptor modulator-associated endometrial changes. Data on mechanisms of action are lacking. The antagonistic progesterone effect of SPRMs has shown promising results in animal studies with endometriosis. Sex steroid receptor effects of PRMs outside the reproductive tract raise the potential for use in neurology and oncology, and although there are several randomized trials in these areas, there are limited small studies published to date. SUMMARY: The SPRM ulipristal acetate is an effective treatment for preoperative treatment of fibroids and a reliable emergency contraceptive. This class of compounds holds the potential for long-term effective medical management of fibroids and may have utility in the management of other sex steroid-dependent conditions.

Awareness, use and associated factors of emergency contraceptive pills among women of reproductive age (15-49 years) in Tamale, Ghana.

BACKGROUND: Emergency contraceptive pills (ECPs) are one of the means by which women can use after intercourse to prevent pregnancy. ECPs can be used to reduce the prevalence of unwanted pregnancies and unsafe abortions. This study investigated awareness and use of ECPs among reproductive age (15-49 years) women in Tamale, Ghana. Factors associated with the use of ECPs were also investigated. METHODS: This cross sectional study was conducted among 200 women of reproductive age (15-49 years) in Tamale, Ghana. Data on socio-demographic variables, awareness and usage of ECPs were assessed by means of a previously validated questionnaire. Univariate and multivariate logistic regression analyses were performed to identify factors associated with the use of ECPs. RESULTS: Awareness level of ECPs were found to be 69.0% (n = 138); 42.8% (n = 59) got the awareness from a health worker, 31.8% (n = 44) from the radio/TV and 25.4% (n = 35) from family members/friends. Eighty-five percent (n = 117) knew the correct time-frame for an effective use of ECP to prevent pregnancy. Forty percent (39.9%, n = 55) of the participants who had awareness have ever used ECPs. Factors that were found to be associated with the use of ECPs were; participants who said ECPs were affordable (AOR = 6.1, 95% CI = 2.51-10.40, p = 0.001), available (AOR 2.1, 95% CI = 0.61-6.01, p = 0.001), cultural (AOR = 3.5, 95% CI = 1.01-10.15, p = 0.011) and religious unacceptable (AOR = 4.0, 95% CI = 1.02-10.0, p = 0.005). CONCLUSION: A relatively high level of awareness and usage of ECPs was found. Factors that were associated with the use of ECPs were availability and affordability. Cultural and religious unacceptability did not hinder the use of ECPs. Health authorities should continue to make ECPs available to women of reproductive age.