Introduction of a 24-hour toll-free hotline for Youth Emergency Contraceptive services in a developing country

Introduction of a 24-hour toll-free hotline for Youth Emergency

Contraceptive services in a developing country

P.S. Steyn (1), A.A. Britz (1), P.M. Foster (2)

Family Planning and Reproductive Health Unit, Department of Obstetrics and

Gynaecology, Tygerberg Hospital and Stellenbosch University, South Africa (1);

World Population Foundation, Hilversum, The Netherlands (2)

Introduction: Early evidence suggests that abortion rates among

adolescents drop following access to information and use of emergency

contraception (EC). In a survey among women requesting termination of pregnancy

(TOP) at Tygerberg Hospital (TBH), 40% had no knowledge of EC and 36% heard

about EC, but had never used it. Of these women almost 50% had had sexual

intercourse by the age of 19, highlighting the need for increased awareness of

EC in this group.

Objective: To increase the availability of and accessibility to EC

information, counselling and services for adolescents, youth and their


Methods: A 24-hour toll free hotline was implemented to provide

information on the appropriateness and usage of EC and details on the location

nearest to the caller where EC is available. Training on EC was done to

providers working in public and private health care centres throughout the

Western Cape Province. Research is designed to examine: The knowledge, attitudes

and use of contraception (including EC) in young people; knowledge and attitudes

toward safer sex and sexually transmitted infection; factors that contribute to

a decision to seek a TOP; factors that contribute to a young person to continue

with a pregnancy; and satisfaction of the adolescents with reproductive health

care information and services.

Results: Six hotline staff (five lay councillors and one registered

nurse) was specially trained for the information and referral service. Two

gynaecologists with a special interest in family planning, back up the staff for

any inquiries. Up to date 261 health care professionals (42 medical doctors, 12

specialists, 31 pharmacists and 176 nursing staff) have been trained in 11

workshops and one satellite training transmission. A linear increase in calls to

the hotline was logged from its commencement on 24 October 2003. Of the 521

calls during the first 20 weeks, 210 were during the evening and 311 during

daytime. The complimentary website had 622 visits during the same time. The

project also received 10532 units of progesterone-only-emergency contraception

free of charge from the public sector.

Conclusions: This free information and referral service on EC may

result in a more supportive community environment for addressing adolescent

reproductive health service issues and increase the usage of EC with a resulting

decrease in TOP-rate.

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