Emergency contraception in Jordan: Assessing retail pharmacists' awareness, opinions, and perceptions of need

Jordan has a robust contraceptive method mix in both the public and private sectors and oral contraceptive pills and the copper-T intrauterine device are widely available. However, Jordan remains one of only a few countries in the world without a registered dedicated product for emergency contraception (EC). We aimed to explore retail pharmacists' knowledge of and attitudes toward EC in six Jordanian governorates.

In 2016, we conducted 100 structured interviews with pharmacists in both urban and rural areas regarding their EC knowledge and provision practices. We interviewed representatives from both chain and independently-owned pharmacies in purposively selected areas of the country. We analyzed interviews for content and themes using deductive and inductive techniques.

Our findings reveal a lack of knowledge of all EC modalities as well as misinformation about effectiveness and protocols for use. However, after describing dedicated progestin-only EC pills, study participants expressed tremendous enthusiasm for a dedicated product and the overwhelming majority indicated that they would stock EC pills if and when they were registered.

The private sector plays a major role in contraceptive service delivery in Jordan. Although pharmacists are not well-versed in post-coital contraception they appear interested in incorporating EC pills into the contraceptive method mix. Redoubling efforts to register a dedicated progestin-only EC pill and supporting initiatives to educate pharmacists about how to use available technologies as EC appear warranted.

Lack of access to emergency contraception has significant implications for women, in general, and refugee and displaced populations in particular. Supporting efforts to incorporate EC pills into the contraceptive mix in Jordan is a first step in supporting adherence to global standards of care and could help address unmet contraceptive needs.