Wales: greater access to EC and routine contraception through community pharmacies

January 2022. Last December, Welsh Health authorities announced changes on the Community Pharmacy Contractual Framework. These will enable all pharmacies to provide emergency contraception (EC) and some forms of routine contraception. Other priority services that will be included are the common ailment, emergency medicine supply and seasonal influenza vaccination services.

The 713 community pharmacies registered in Wales already play an important role in making EC more accessible, having provided over 24.000 EC consultations in 2019-20.

For more details on the new contractual framework click here.

Lower EC knowledge in Roma settlements

December 2021. Data on emergency contraception’ knowledge and use are included in Unicef’s Multiple Indicator Cluster Surveys (MICS) for some countries. National survey reports are available on-line.

Serbia and North Macedonia identified important EC knowledge gaps between overall population and population in Roma settlements.

Serbia:1 

% of all women aged 15-49 who have heard of EC: 91,4%
% of all women aged 15-49 who have heard of EC in Roma Settlements: 30,1%
North Macedonia:2
% of all women aged 15-49 who have heard of EC: 67,7%
% of all women aged 15-49 who have heard of EC in Roma Settlements: 27,7%

Efforts are needed to ensure that education and information reach all populations, in order to ensure equal access to EC and all contraceptive methods.

 


Source: Statistical Office of the Republic of Serbia and UNICEF. 2020. Serbia Multiple Indicator Cluster Survey and Serbia Roma Settlements Multiple Indicator Cluster Survey, 2019, Survey Findings Report. Belgrade, Serbia: Statistical Office of the Republic of Serbia and UNICEF.

Source: State Statistical Office and UNICEF. 2020. 2018-2019 North Macedonia Multiple Indicator Cluster Survey and 2018-2019 North Macedonia Roma Settlements Multiple Indicator Cluster Survey, Survey Findings Report. Skopje, North Macedonia: State Statistical Office and UNICEF. 

Black Friday discount for essential reproductive health supplies?

December 2021. Last week, a big retail pharmacy chain in the United Kingdom announced a 50% discount on emergency contraception pills during Black Friday.

The promotion has raised strong criticism from a number of organisations and Members of Parliament, who point out that essential women’s health products should not be used to make a profit. MPs and campaigners are now urging the company to keep the EC pill at the discounted price. Read more on BBC News or The Guardian.

Scotland: Novel measures to bridge EC to ongoing contraception

November 2021. Individuals ages 13 to 55 will be able to access a temporary 3-month supply of oral contraception (a progestogen-only contraceptive pill) from community pharmacies, at the time of obtaining emergency contraception (EC). The Scottish government just announced this innovative measure, aimed at bridging the gap between EC and use of longer-term contraception.

Until now, pharmacies could only supply EC and recommend clients to see their doctor or contraceptive specialist, for counselling and/or a prescription of a long-term method. Now they will be able to provide a temporary supply of oral contraceptive pills

The measure is based on a successful pilot tested in pharmacies across Lothian and Tayside, which resulted in a clinically meaningful increase in the subsequent use of effective contraception.

Read more about the new measure in the Scottish Government website or here.

Malta at 2021: “How are we still discussing accessibility to the morning-after pill?”

November 2021. In a valuable monitoring effort, a journalist from MaltaToday conducted again and for the 2nd year in a row, a survey to assess EC accessibility. Through a phone interview, pharmacies that will be on-call in the coming 6 weekends and holidays were asked if they sell emergency contraception (EC) pills, or not.

According to the findings, accessibility to EC pills in Malta has not improved much since last year: out of 119 pharmacies consulted across Malta and Gozo, an average 61% sell EC (similar to the 64% in 2020); this ranges from 45% to 75%, depending on the day and location (this range was 50% to 75% in 2020).

In Malta pharmacists have the right not to dispense EC on the grounds of conscientious objection. In response to these findings, a member of parliament said: “It’s 2021, and we still have people who impose their morality on others.”

Read the full report by MaltaToday here or here. And related news here or here.

FIGO: committed to protect and promote girls and young women SRHR

October 2021. The International Federation of Gynecology and Obstetrics (FIGO) calls on its members to commit to discussing sexual and reproductive health, including contraception, infection prevention and safe sex, in their conversations with young people, girls, and boys.

Around the world, complications during pregnancy and childbirth are the leading cause of death for 15–19-year-old girls. According to FIGO’s recent new statement, all health cadres can play a role in addressing early and unintended pregnancies. Promoting young people’s sexual and reproductive health and rights (SRHR) will save their lives, improve their physical and mental health, and enable them to pursue the educational and economic futures of their choice.

 “Obstetricians, gynaecologists, and those in related health care professions, including nurses, midwives, and even pharmacists, can prevent this needless risk of morbidities and loss of life (…) for many young women and girls. By having open and honest discussions about safe sex, contraception, and infection prevention, health care practitioners can protect the health and lives of young people (…)”.

Read FIGO’s statement and commitments here and on FIGO’s website.

Report reveals negative impact of COVID-19 on access to contraception across Europe

October 2021. Last week, the European Parliamentary Forum for Sexual and Reproductive Rights (EPF) launched a report on access to contraception during the COVID-19 pandemic in 46 European countries.

The report concludes that countries that usually prioritize and protect sexual and reproductive health and rights (SRHR), took measures to ensure continued access to contraception during the pandemic, whereas in countries where SRHR is systematically neglected, existing barriers were exacerbated.

EPF recommends that, among other measures, access to contraception (including long-acting reversible methods and emergency contraception), is defined as essential health care service to be delivered, and reimbursed, even in times of crisis.

The full report is available on EPF’s website.

Italy: the objection map

October 2021. Pharmacies or pharmacists that object to supplying emergency contraception, remain a problem for access in many European countries. In Italy, a collective and participatory effort is in place to identify services where providers do not get in the way of women’s reproductive choice.

On the website of Objection Rejected (https://obiezionerespinta.info), a map points at services where emergency contraception is supplied without objections. The map is built from input provided by EC users and their experiences. Using the “Search” function, different types of services (pharmacies, counselling centers, hospitals, etc.) are pointed and categorized: those in green were considered adequate by users; those in red were not. Anyone can report anonymously on their experience procuring EC from a given venue and contribute to extend the map.

This is a very creative way to guide individuals to find responsive postcoital contraception services.

 

Italy and UK: different ways to address pharmacies objecting EC dispensing

September 2021. BBC3 recently reported the case of  two women in the United Kingdom being denied emergency contraception from their local pharmacy, which triggered serious criticism from the Royal Pharmaceutical Society (RPS) president: “Pharmacy refusal to provide emergency contraception is ‘completely unacceptable’”, said professor Claire Anderson. In 2017, the RPS updated its own  guidance on EC prescribing.

In Italy, last July, the magazine Donna Moderna conducted a small mystery shopper survey, finding that only six out of  the 10 pharmacies visited sold EC to women under 18. Age restrictions to buy UPA or LNG EC pills without prescription were lifted in October 2020 in Italy. The National Federation of Pharmacy License Holders (FEDERFARMA) sustains that objecting is not possible in Italy. A group of civil rights defenders have taken action and set up a website to report, identify and signal objecting pharmacists: https://obiezionerespinta.info/segnala/.

France: Emergency contraception not included in new gratuity measures

September 2021. The French Health Minister recently announced that in 2022, access to contraception will be free for women up to 25 years old.

This policy that makes access to some contraceptive methods free of cost (no charges for medical appointments to get a prescription, checkups, tests, and the method itself) extends now to all women up to age 25, in order to address financial barriers associated with a lower use of modern contraception among the young population, according to the Ministry of Health. A number of contraceptive methods were already available at no cost in the French Republic for women age 15 to 18 since 2013, and to women under-15 since 2020.

With regards to emergency contraception (EC), this new policy will not entail any change: EC pills are available in pharmacies without a medical prescription and can be dispensed anonymously and free of charge to girls under 18. For adult women, EC pills are reimbursed at 65% by the Health Insurance only when procured by medical prescription.

For more details visit the website of l’Assurance Maladie, the national health insurance program.