title: Provider resistance to advance provision of oral contraceptives in Africa.
abstract: BACKGROUND
  In Africa, many new family planning clients are not menstruating at the time they present for services. Where pregnancy tests are unavailable, clients are often denied their method of choice and sent home to await menses. For pill clients, one obvious solution is 'advance provision' of oral contraceptives for later use. However, this practice is rare in Africa.
  
  
  OBJECTIVE
  To assess the level of provider resistance to advance provision of oral contraceptives.
  
  
  METHODS
  We added questions about advance provision of pills to five provider surveys in three African countries. We also used simulated clients in Ghana to assess provider resistance to the practice.
  
  
  RESULTS
  In Kenya, only 16% of providers thought it safe to give women oral contraceptives to be started at a later date. In Ghana and Senegal, fewer than 5% of providers mentioned advance provision as a way to manage non-menstruating pill clients.
  
  
  CONCLUSIONS
  Training programmes and service delivery guidelines in developing countries should provide for advance provision of pills to appropriate clients
authors.affiliation: Health Services Research, Family Health International, Research Triangle Park, NC 27709, USA. jstanback@fhi.org
authors.forename: John
authors.initials: J
authors.lastname: Stanback
authors.forename: Barbara
authors.initials: B
authors.lastname: Janowitz
mesh_terms: D000349:Africa; D001291:Attitude of Health Personnel; D003278:Contraceptives, Oral, Hormonal / Q000600:supply & distribution*; D005193:Family Planning Services / Q000592:standards*; D005260:Female; D006297:Health Services Accessibility; D006302:Health Services Research; D006801:Humans
chemical_list: D003278:Contraceptives, Oral, Hormonal