Emergency Contraceptive

 By Sarah Eunice |

Every Saturday, Hannah Kathomi , a 22-year-old university student in Nairobi, walks into a local pharmacy and asks for “the pill.” The pharmacist knows what she means — the morning-after pill, a common brand of emergency contraception (EC). It’s become part of her weekend ritual after unprotected sex, something she says is “easier than using regular contraception.”But experts warn that this casual reliance on EC — meant for emergencies, not regular use — is becoming an overlooked health issue in Kenya and across sub-Saharan Africa.

“Emergency contraception was designed for occasional use — after a condom breaks or unprotected sex occurs — not as a regular birth control method,” says Dr. Esther Muia, a reproductive health specialist in Nairobi. “Frequent use can cause hormonal imbalance and menstrual irregularities, and it’s a sign of deeper gaps in sexual health education.”

A Growing Trend in Sub-Saharan Africa

According to the World Health Organization (WHO), emergency contraception can prevent up to 95% of pregnancies if taken within five days after sex. Yet across sub-Saharan Africa, misuse and over-reliance on EC pills are growing trends.

A 2023 Kenya Demographic and Health Survey (KDHS) found that nearly 1 in 4 sexually active women aged 18–24 had used EC at least once, often without medical advice. Pharmacies in urban centers like Nairobi, Kisumu, and Mombasa report a sharp rise in EC sales, driven by young women who view it as a quick, discreet solution.

Across Africa, over 7 million women rely on EC annually, according to UNFPA, often due to barriers in accessing long-term contraception — such as stigma, partner disapproval, or clinic shortages.

The Misuse Problem

In Kenya and neighboring countries, many women purchase EC pills over the counter, with little to no counseling on dosage, side effects, or alternative options.

Some even take EC multiple times in one menstrual cycle, believing it to be “harmless.” But WHO cautions that frequent use can lead to irregular bleeding, nausea, and hormonal disruptions — and more importantly, it’s less effective with repeated misuse.

“Emergency contraception is safe, but not foolproof,” says Dr. Rukia Hassan from Kenyatta National Hospital. “When used too often, it signals a lack of access to consistent, affordable, and stigma-free contraception.”

Barriers Beyond the Counter

While EC is widely available, misinformation remains a barrier. Some pharmacists still wrongly describe it as an “abortion pill,” deterring young women from asking for it openly.

Cultural taboos around sex and contraception further silence open conversations. “We can’t talk about emergency contraception without talking about shame,” says Lucy Wanjiku, a youth advocate with Amref Health Africa. “Girls are judged for buying EC, yet boys face no stigma for unsafe sex.”

In rural Kenya, the situation is worse. Many chemists sell counterfeit or expired EC pills, often at inflated prices. WHO warns that unregulated sales and fake products undermine reproductive health gains made over the last decade.

The Global Overview

Globally, WHO estimates that 121 million unintended pregnancies occur every year, nearly half of which end in abortion — many unsafe. Proper use of EC could prevent a significant share of these cases.

In Europe and parts of Asia, EC is integrated into sexual health education and provided free or subsidized in public clinics. In contrast, in most African nations, including Kenya, policy gaps, stigma, and limited youth-friendly services keep young women in the dark.

A Call for Better Education and Policy

Experts are urging Kenya’s Ministry of Health to strengthen sexual and reproductive health programs by integrating comprehensive sex education, training pharmacists to give proper EC guidance, and improving access to long-term contraceptive options like implants and IUDs.

“Emergency contraception saves lives — but it should never replace proper family planning,” Dr. Muia emphasizes. “Empowering women means giving them choices, not just quick fixes.”

WHO Recommendation

• EC pills (levonorgestrel or ulipristal acetate) should be taken within 120 hours after unprotected sex — the sooner, the better.
• Frequent EC use is not dangerous but less effective and may cause irregular periods.
• For higher effectiveness, copper IUDs can prevent over 99% of pregnancies when inserted within five days.
• WHO insists that all women and girls have the right to access EC as part of routine reproductive healthcare.

Sources:

• World Health Organization (2021, 2023)
• Kenya Demographic and Health Survey (2023)
• UNFPA Reproductive Health Data Portal

 

Leading Voices from ICFP 2025

Diene Keita, Executive Director, UNFPA
“Contraception saves lives. It’s the front line of defense against maternal mortality. We cannot afford complacency — women and girls are counting on us.”
(Source: theicfp.org)

Dr Tedros Adhanom Ghebreyesus, Director-General, World Health Organization
“Quality family planning and reproductive health and rights are essential components of universal health coverage and primary health care.”
(Source: who.int)

Dr Philip Anglewicz, Director, William H. Gates Sr. Institute
“Evidence is only as powerful as the action it inspires.”
(Source: theicfp.org)

Dr Samukeliso Dube, Executive Director, FP2030
“The family planning community is united in its determination to safeguard the rights of women and girls everywhere. We cannot backslide — we must keep progress moving forward.”
(Source: fp2030.org)

Alvaro Bermejo, Director-General, IPPF
“Our new identity is not cosmetic — it’s a declaration that we stand with the communities that built this movement, and we will continue to fight for them unapologetically.”
(Source: ippf.org)

Gerda Leroux, Senior Researcher, Rutgers International (Netherlands)
“Behind every statistic is a woman navigating stigma, fear, and systemic barriers. Our work is about restoring humanity and empathy to reproductive health.”
(Source: rutgers.international)

Dr Herminia Palacios, Conference Co-Chair, ICFP 2025
“This conference has shown that innovation and resilience go hand in hand. The next decade of family planning will be shaped by evidence, by community, and by courage.”
(Source: theicfp.org)