Promoting the Most Effective Form of Emergency Contraception: The Copper IUD

Long-Acting Reversible Contraceptives

Alexandrina Nakanwagi

PACE Uganda | Communications Assistant

Goretti Masadde

PACE Uganda | Head of Social Marketing

Andrea Mooney, MPH

Populations Services International | Communications and Knowledge Management Advisor
Copper IUDs are the most effective form of EC, and in Uganda, the cost is less than half that of EC pills. Photo: PACE Uganda

Copper IUDs are the most effective form of EC. In Uganda, the cost is less than half that of EC pills. Photo: PACE Uganda

Every day in Uganda, women die from unsafe abortion-related causes, mostly due to unplanned pregnancies. Though general knowledge of modern contraception is high, married women still face a 34% unmet need for contraception—and while around 30% of all Ugandan women know about emergency contraception (EC), fewer than 1% actually use it.

EC is a woman’s only chance to prevent pregnancy after unprotected sex. EC pills are safe and effective and can be used up to five days after intercourse, but they become less effective over time and are relatively expensive for women in Uganda.

Copper intrauterine devices (IUDs) are the most effective form of EC, and in Uganda, the cost is less than half that of EC pills. What’s more, IUDs maintain their effectiveness for up to five days after unprotected sex, and if desired, can become a woman’s regular method of contraception, providing protection from unintended pregnancy for up to 12 years.

But many Ugandan women are still skeptical about the IUD due to myths and misconceptions that persist in communities.

To better equip women with the education they need to make an informed choice, PACE, PSI’s member network in Uganda, has begun promoting IUDs as a safe, effective, and affordable method of EC in its family planning interventions. In 2015, PACE trained 177 community health workers, known as interpersonal communication agents (IPCs), and 176 health providers in private health clinics to educate women on their EC options.

However, challenges persist, even among IPC agents. These workers are often met with resistance from clients who believe that EC is a form of abortion. What’s even more difficult is that sometimes the IPC workers themselves hold those same beliefs, making it even harder for them to effectively communicate about the issue.

To help IPC agents address misconceptions and better understand the concept and benefits of IUDs and EC, including how it differs from abortion and how to address client concerns, PACE is conducting new trainings. The goal is to change its own staff’s perceptions and those of the women with whom they speak. PACE will also track messages and referrals for the IUD as EC to measure the effectiveness of its new messaging.

To educate youth, PACE plans to create a friendly environment where young people can discuss their sexual reproductive health needs, including IUD as EC. PACE will include the IUD as EC on Human Network International’s on-demand SMS-based health information system, which is ideal, since most adolescents have mobile phones. The SMS-based application is toll-free and offers both audio and text information, allowing for various messaging preferences.

The IUD as a form of EC is still a relatively unknown method—not just in Uganda, but in many countries, including the United States. PACE has a lot of work to do to increase awareness of this option, but it is dedicated to expanding access to the most effective form of EC.