New Delhi, Jan 25 (IANS) Emergency contraceptive pills (ECPs) or the ‘curb abortion’ pills are considered India’s latest weapon in the armoury against unwanted pregnancies. But concerns are being voiced over their impact if taken too frequently or by those too young.
“In India, there is a lack of awareness – among both providers and clients – about use and indications, dosage schedule and possible side effects, and social availability of the pill,” noted an online discussion on the issue conducted on the UN-run Solutions Exchange Maternal and Child Health Community.
ECPs (levonorgesterol pills)) were included in India’s national health programme about four years ago. The government has allowed distribution of these pills through its social marketing programmes.
The government is also considering their inclusion in ASHA (Accredited Social Health Activist) kits that are given to women community health activists under the National Rural Health Mission.
Besides, the drug controller general of India has permitted over-the-counter sales and pharmaceutical companies have launched advertisement campaigns to raise awareness.
Available evidence suggests that these pills are safe and have limited side effects. Medical experts say that no medical condition rules out the use of ECPs and they can be used any time during the menstrual cycle.
But there is a counter view too.
Nandini Gopalamenon of the Health and Family Welfare Training Centre, Kozhikode, warns of the dangers of the social marketing of the pills.
“The best way to promote e-pills is training for doctors and field workers on the availability, use, side effects and the result of misuse of the drug. Social marketing is highly dangerous in the way that the drug may be misused and without any desired result,” argued Gopalamenon.
Shibu Vijayan of Kerala State Health Services, Kollam, said the pills may replace barrier methods of contraception like condoms.
“I fear that the way EC pill is coming up will reduce the use of condoms that in a way increase the spread of STDs. EC pills can be promoted in a knowledge society, which have the capacity to choose,” said Vijayan.
Those who participated in the online discussion suggested a staggered and monitored approach to distribution of these pills in India.
In the first phase, an attempt should be made to integrate family welfare services with primary health centres (PHCs) and provide prescriptions for the use of the pills through PHC and community health centre (CHC) doctors.
The second phase should aim to make ECPs available through auxiliary nurse midwives.
In phase three, ECP could be offered through anganwadi workers, village health nurses, accredited social health activists and members of self-help groups.
Also stressed was the need to make ECPs available in emergency rooms and at the doctor’s clinic for emergency situations such as contraceptive failure (like burst condoms or a dose of oral pills being missed) and rape.
Some raised the issue of corporate social responsibility while designing marketing campaigns on ECPs.
Kaushik Desai of the Gujarat Voluntary Health Association, Ahmedabad, voiced his concern over the lack of awareness.
“Some girls even in the age group of 20-25 do not have enough knowledge of the anatomy and physiology of the reproduction system, which results in ignorance about menstrual hygiene, as well as risk factors of early sex relations,” said Desai.
Yamini Sarwal of the Central Health Services warned against the possibility of these pills encouraging promiscuity.
“Emergency contraception is a double-edged sword. It promises better reproductive health by reducing the need for abortions. Yet, it may convey a false sense of security leading to its over-use or misuse and indirectly promote casual sex, already on the rise among youngsters, who are found commenting that ‘after the i-pod it is the i-pill for the youth’,” said Sarwal.