Evaluation of sexual health interventions

BMJ 1995; 310 doi: http://dx.doi.org/10.1136/bmj.310.6987.1140a (Published 29 April 1995) Cite this as: BMJ 1995;310:1140
  1. Pilar Garcia,
  2. Sue Ziebland
  1. Research officer Department of Epidemiology and Public Health, University College London, London WC1E 6BT
  2. Senior research fellow General Practice Research Group, University of Oxford, Oxford OX2 6HE

    EDITOR,—Ann Oakley and colleagues rightly emphasise the need for rigorous evaluation of sexual health interventions.1 Much early sex is unplanned, and, even though it is encouraging that many more young people now report using condoms,2 there is a need to publicise the timing and availability of emergency contraception for those occasions when some form of failure occurs, be it failure to buy a condom, failure to use it, or its failure to remain intact.

    Improving knowledge of the availability and appropriate use of emergency contraception has been identified as one of the relatively few opportunities for reducing the high incidence of unplanned pregnancy in Britain, a target in the Health of the Nation. Many women, however, while vaguely aware that a postcoital method exists, are unsure of when it can be used and where it is available.3

    Last summer we undertook two surveys of publicity for emergency contraception. In one we visited a random sample of 30 general practices in Camden and Islington to see if there was anything in the waiting room to suggest that the service was obtainable there. Only a third of the practices had either specific leaflets or posters about emergency contraception. Their impact, however, varied considerably, from prominently displayed posters to out of date leaflets positioned at the back of a rack. A questionnaire survey of 113 young people's clinics and advice centres was conducted and achieved a response rate of 70% (n=79). Although leaflets were available in 70, 24 reported that they were displaying a leaflet published by the Family Planning Association in 1984, which refers to the “morning after pill” and should have long since been replaced.4 There were isolated examples of well designed posters and reminders the size of a credit card.

    Several commentators have drawn attention to the need for better publicity, and, as the Health Education Authority prepares to launch an initiative on emergency contraception, the opportunity to evaluate the impact should not be lost. The key indicators will be public knowledge of where and when emergency contraception is available, the proportion of women seeking terminations who remain unaware of or unable to access emergency contraception, and the impact on trends at district level in rates of emergency contraception and termination of pregnancy.5


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