Development action with informed and engaged societies
After nearly 28 years, The Communication Initiative (The CI) Global is entering a new chapter. Following a period of transition, the global website has been transferred to the University of the Witwatersrand (Wits) in South Africa, where it will be administered by the Social and Behaviour Change Communication Division. Wits' commitment to social change and justice makes it a trusted steward for The CI's legacy and future.
 
Co-founder Victoria Martin is pleased to see this work continue under Wits' leadership. Victoria knows that co-founder Warren Feek (1953–2024) would have felt deep pride in The CI Global's Africa-led direction.
 
We honour the team and partners who sustained The CI for decades. Meanwhile, La Iniciativa de Comunicación (CILA) continues independently at cila.comminitcila.com and is linked with The CI Global site.
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Emergency Contraception Promotion Project (ECPP)

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The USA-based Population Services International (PSI) conducted the Emergency Contraception Promotion Project (ECPP) in Sacramento, California and in Portland, Oregon's Tri-County area (Multnomah, Washington, and Clackamas counties) between 2000 and 2002. PSI and its partners (The Pacific Institute for Women's Health, or PIWH, and the Program for Appropriate Technology in Health, or PATH) combined strategic community mobilisation, health worker training, and a media campaign to increase awareness of emergency contraception pills (ECPs) as a means of reducing unintended pregnancies and abortions among young women. The project addressed sexually active women between the ages of 15-24; special emphasis was placed on Spanish-speaking Latina women.
Communication Strategies

ECCP focussed on community mobilisation and networking to make people aware of, and to promote, EC. Partners convened an advisory team to ensure community input and approval of the campaign; interpersonal contacts were designed to build a foundation of support. Networking with community-based and social service organisations that served the audience of young women was a strategy for increasing the venues through which women hear about EC and facilitating distribution of campaign materials. For example, in order to integrate information about EC into the efforts of other groups working in teen pregnancy prevention and reproductive health issues, project staff attended regular meetings of groups such as the Hispanic Services Round Table, the Oregon Teen Pregnancy Prevention Task Force, and the Pro Choice Coalition of Oregon. PSI worked closely with sales representatives of Plan B® (click here for more information) to identify pharmacies in the Portland area to be recruited to carry this ECP. Organisers also presented project details at statewide conferences, Town Hall meetings, and a special legislative meeting. The purpose of these presentations was to educate legislatures on EC with the hope that they would make more informed votes on 2 pieces of legislation that would have increased access to EC for Oregon women by making it possible for trained pharmacists to prescribe ECPs directly to women.


The provider training component addressed lack of knowledge about ECPs and unfavorable attitudes among providers that prevented women from accessing ECPs. PSI and PATH developed training curricula and trained 10 clinical and 8 non-clinical providers to conduct a 1-hour in-service presentation for their peers. This training covered EC's role in reducing unintended pregnancy, as well as background on EC, safety, cost, mechanism of action, effectiveness, key messages for women, follow-up communication with patients, prescribing ECPs (including advance prescription), and opportunities for EC discussion. PSI also organised a session on how to best communicate with adults. Each trainer was given an EC Tool Kit that included the presentation and training notes; a sample EC protocol and standing order form; handouts for providers that identify the key messages for women about EC; information on brands and doses; and materials on EC that providers can give to their patients/clients. Through this process, a total of 794 clinical providers and 410 non-clinical providers were trained.


The purpose of the EC media campaign, entitled "Accidents Happen, Pregnancy Doesn't Have To", was to increase young women's awareness and accurate knowledge of EC and to encourage them to talk to their health care providers or call the EC Hotline (1-888-NOT-2-LATE) for more information and referrals. Formative research with the population being addressed guided the development of initial media concepts, which PSI then pretested for effectiveness and appeal. The English and Spanish media consisted of radio ads, posters, and informative wallet cards. The radio ads aired on 6 stations that reached the audience being addressed, while the posters and wallet cards were distributed through health care providers, community-based organisations, and at community outreach events. The latter component incorporated several "edu-tainment" activities, including a reproductive health quiz game and "EC Lady", a costumed person styled after Rio de Janeiro carnival figures who wandered through crowds of young people and engaged them in discussions about pregnancy prevention and EC.

Development Issues

Family Planning, Women.

Key Points

According to PSI, rates of unintended pregnancy in the United States are highest among women between the ages of 18-24 and those who are unmarried, low-income, African-American, or Latina. Increased access to ECs for young women can reduce unintended pregnancies, while connecting women with comprehensive reproductive health services and counseling. However, ECs have not been widely promoted as a backup contraceptive option to women in the USA, and knowledge of EC remains low among both health care providers and the general public.

Partners

PSI, PIWH, PATH. The Meyer Memorial Trust, The John Merck Fund, The Charla Richards-Kreitzberg Foundation, Rose E. Tucker Charitable Trust, and the Lawrence Family Fund supported the project.

Sources

Emails from Alexandra Lowell to The Communication Initiative on January 27 2004 and April 16 2007; The Emergency Contraceptive Newsletter, Spring 2001, Vol. 6, No. 1 (no longer available online); and United States page on the PSI website (page no longer available, but click here to learn more about PSI's EC initiatives.)

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