Grant: Planning and Dissemination Grant - Institute Community Support

Objective(s): At 11%, the contraceptive prevalence rate with modern methods is relatively low in Albania, even though an array of methods are freely available. Abortion remains the mainstay of family planning in the country. Emergency contraception (EC) could play a significant role in addressing women's need for an effective and discreet method of pregnancy prevention. Although two different levonorgestrel-only EC pills (NorLevo® and Postinor®) are available directly from pharmacies, use remains limited. This study aimed to explore awareness, knowledge, attitudes, and practices toward EC in Albania. Design and methods: In 2016, we conducted a multi-methods qualitative study with women and service providers in Albania. We invited women to report on their knowledge of, attitudes toward, and practices surrounding EC in an online survey and through six focus group discussions. Additionally, we conducted 19 in-depth semi-structured interviews with key informants and 16 structured interviews with retail pharmacists in Tirana. We analysed our data using descriptive statistics and for content and themes. Results: Our findings suggest that EC is widely available in pharmacies in Albania. However, women face numerous barriers to accessing this form of contraception. Lack of knowledge among providers and women, misconceptions about hormonal contraceptives, misinformation about the side effects of and risks associated with EC, lack of public sector provision, and stigma and fear of judgment among women pose obstacles to timely access. Conclusions: Misinformation about EC among women and providers in Albania appears common. Training of health service providers, raising awareness among women, and developing Albanian-language and culturally resonant materials for distribution could play a key role in improving knowledge and uptake of EC.