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Refining paracervical block techniques for pain control in first trimester surgical abortion

Angel Foster, IBIS Reproductive Health, 2011

Project abstract

In 2001, Tunisia became the first country in the Arab world to register a dedicated emergency contraceptive pill (ECP). Over the last decade, emergency contraception (EC) has been integrated into both the public and private health sectors, incorporated into national service delivery guidelines, and made available, without a prescription, directly from pharmacists. Although ECPs have been registered in six other Arab countries, Tunisia remains the only country in the region to have undertaken significant efforts to expand access to EC.

However, though Tunisia’s policies and programs evince a longstanding national commitment to comprehensive reproductive health service delivery that is exceptional within the region, national statistics mask persistent geographic, urban/rural, and marital status disparities. Little research has been undertaken to systematically evaluate the service delivery and use patterns of ECPs in Tunisia.

Our proposed study aims to fill this gap. Through this multi-methods study we will assess the availability, accessibility, and acceptability of EC in Tunisia and focus on the perspectives and experiences of pharmacists and both married and unmarried women. The study design is informed by preliminary research conducted in Tunisia by the Principal Investigator in 2009-2010 and includes three components: a retail pharmacy survey, a mystery client survey in pharmacies, and in-depth interviews with family planning clients.

As EC has the potential to play an important role in meeting women’s, and particularly unmarried women’s, pregnancy prevention needs, improving service delivery is critical. The research findings will not be limited to academic publications but will also be offered to government agencies and non-governmental organizations in the hope of identifying avenues for improving women’s access to ECPs throughout the country. Further, in showcasing the Tunisian experience, this project has the potential to inform broader regional efforts to introduce ECPs and incorporate EC into reproductive health and family planning services.

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