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
communities.
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.
