Promoting and prioritizing reproductive health commodities: understanding the emergency contraception value chain in South Africa.

TLDR

Emergency contraception use is low in South Africa despite high rates of unplanned pregnancies, with women mainly accessing it from commercial pharmacies and limited awareness hindering uptake in the public sector. The study aims to investigate why emergency contraception use remains low in South Africa. A qualitative value‑chain analysis was employed to examine how market and regulatory structures affect the supply and promotion of emergency contraception. The analysis revealed market imperfections and information barriers that impede effective supply to women relying on public health services, suggesting that aligning commercial interests with reproductive health needs could improve uptake.

Abstract

Use of emergency contraception is low in South Africa despite high rates of unplanned and unwanted pregnancies. Existing studies have demonstrated that women access emergency contraception from commercial pharmacies rather than from public health facilities at no charge. Research has also demonstrated that awareness of emergency contraception is a key barrier to improving uptake, especially in the public health sector. This study investigates the low use of emergency contraception in South Africa and employs a qualitative value chain analysis to explore the role of market and regulatory structures in creating an enabling environment for the supply and promotion of emergency contraception. The results suggest that there are several 'market imperfections' and information barriers impacting on the effective supply of emergency contraception to women who are dependent on the public health sector for their health care. Balancing commercial interests with reproductive health needs, it is argued, may form a crucial part of the solution to the low uptake of emergency contraception in South Africa.