Women’s preferences for the provision of emergency hormonal contraception services
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To elicit women’s preferences for routes of supply for emergency hormonal contraception (EHC). The objectives were to identify which attributes of services women regard as important and to identify how women trade off reductions in one attribute for an improvement in another.
A stated preference discrete choice experiment. Women attending sexual health services in a Primary Care Trust in the North West of England were invited to complete a self-completion questionnaire. Each respondent completed a questionnaire containing nine pair-wise choices. Demographic data were also collected. Conditional logit models were used to analyse the data.
Main outcome measure
Women’s preferences for, and trade-offs between, the attributes of opening hours, medical staff seen, cost of EHC, length of wait for an appointment, privacy of consultation and attitude of staff.
Two hundred and sixty-nine women attending clinics (mean age 23.8 years, SD±8.69) completed the questionnaire. Almost two thirds of the sample had previously used EHC. All six attributes of EHC services were statistically significant factors influencing women’s preferences for the supply of EHC. A significant proportion of women indicated on at least one occasion that they would risk pregnancy rather than choose one of the services offered to them.
These results suggest that the way in which a service is configured and presented to women is likely to influence which service is chosen. In this study, women prioritised visiting a service where they would be treated in a sympathetic and non-judgemental manner. They also prioritised privacy. The results also suggest that if women are dissatisfied with aspects of an EHC service, they may choose not to visit it, thereby risking an unwanted pregnancy.
KeywordsContraception EHC services Emergency hormonal contraception Family planning United Kingdom Women’s preferences
The authors would like to thank all the women who took part in the study. They would also like to thank the staff at the clinics within the Primary Care Trust who assisted in the distribution of the questionnaire. This paper reports work funded as part of the first author’s Ph.D. study. This was funded by the NHS Northwest Regional Training Programme.
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