Emergency contraception provision for sexually assaulted women at health facilities in Addis Ababa, Ethiopia

Abstract

Abstract
Background: There is a real challenge of emergency contraception (EC) provision at health facilities in Addis Ababa, Ethiopia.
Objective: The aim of the study was to assess EC provision for sexually assaulted women (SAW) during medical evaluation time.
Methods: The study employed both qualitative and quantitative methods of data collection. It focused on five health facilities
where SAW in Addis Ababa and its environs were managed in 2005. A structured questionnaire was used to review the medical
records of SAW attending these facilities, and who faced the risk of unwanted pregnancy. In-depth interviews with health care
providers and selected SAW were also conducted.
Results: Out of the 384 cases included in the study, 28.4% were provided with EC. Fifty-five percent of the cases were evaluated
within the first five days of the incident. Thirteen percent had already conceived by the time they were evaluated. All the five
health facilities considered sexual assault as an emergency. Among the reasons for failure to report early were: threat from the assailant,
financial constraints, abduction, and the lack of services in the nearby health facility. Some of the conditions that
prompted rape survivors to report early to health facilities were presence of visible trauma, excessive bleeding from genitalia and
fear of acquiring HIV.
Conclusions: In order to improve EC provision, the necessary efforts have to be made by key stakeholders. Moreover, to provide
appropriate medical care including counseling for SAW, regular training has to be organized for service providers.
Keywords: sexual assault, risk of pregnancy, emergency contraception.