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Exploring the Journey of Emergency Contraception in Jordan
Abstract
Emergency contraceptives are medications or devices that can be used after sex to reduce the risk of pregnancy. Over the last decade, dedicated emergency contraceptive pills (ECPs) have been registered in Algeria, Egypt, Lebanon, Libya, Morocco, Tunisia and Yemen. Yet, despite Jordan’s longstanding commitment to family planning service delivery for married women at the national level, dedicated ECPs have not been registered. This lack of product registration is somewhat surprising given the robust contraceptive method mix available through the public sector and the relatively strong local pharmaceutical industry. Based on fieldwork conducted over the last eight years, this paper chronicles the journey of emergency contraception (EC) in Jordan and argues that there have been three distinct phases in EC’s history. The first act of the EC drama was influenced by research conducted in the early 2000s suggesting that although knowledge of EC was virtually non-existent among both health service providers and women of reproductive age, there was considerable need for post-coital methods of pregnancy prevention, particularly among unmarried women in the capital. Modest attempts to introduce a dedicated product during this period were thwarted by professional medical organizations precisely because the technology had the potential to be used by unmarried women. In the second phase of EC’s history in Jordan, the influx of Iraqi refugees in the mid-2000s prompted the international humanitarian relief community to call for registration of a dedicated product. However, as EC became conflated with larger debates about the status of Iraqi refugees, mobilized opposition to EC’s introduction from a range of stakeholders mounted. Yet by the end of the 2000s, married and unmarried Jordanian women alike began to approach health service providers with requests for “urgent pills” or “honeymoon pills.” The third phase of the EC saga is centered in the retail pharmacy sector and is characterized by demand from women. Clinicians are increasingly providing women with oral contraceptive pills (to varying degrees of efficacy) for post-coital use. Retail pharmacists have now become key players in the provision of EC and research conducted in 2010 suggests that pharmacists in Jordan are strong, but not yet mobilized, proponents of dedicated product registration. Although the current chapter in EC’s history is still unfolding, the story of EC in Jordan offers instructive lessons of competing political, professional, and medical interests and highlights the importance of women’s agency in expanding access to new and contentious reproductive health technologies.
Discipline
Medicine/Health
Geographic Area
Jordan
Sub Area
Health