A Study on the Feasibility and Acceptability of Pericoital Levonorgestrel 1.5mg
Condition: Pregnancy Related
Study type: Observational

Summary: 
      This study intends to build on the previous research and gather data in an actual use study /
      patient registry of pericoital LNG 1.5mg to understand women's acceptability of the product
      along with associated side effects, and monitoring for their correct and incorrect use. These
      findings will contribute to the discussion around the feasibility of pericoital LNG as an
      additional contraceptive by adding to the body of evidence.
    

Detailed description: 
      The study would consist of distributing pericoital LNG 1.5mg across 75 pharmacy sites in
      Ghana over the course of 12 months. Recruitment will be staggered, and women will be
      recruited up to 9 months into the study. As such, the data collection period per participant
      will be at least 3 months.

      Consistent with the recent WHO study (Festin et al. " A prospective, open-label, single arm,
      multicentre study to evaluate efficacy, safety and acceptability of pericoital oral
      contraception using LNG 1.5mg" (2016)), participants will be given instructions on how to
      correctly use LNG 1.5mg, namely to take one pill 24 hours before or after sexual relations,
      and no more than 6 times per month. Contraceptive protection requires use only once per 24
      hours, regardless of how many times sexual relations are had during those 24 hours.

      Participants will include a broad population of women age 18-49, not currently on any
      long-term modern method, who do not wish to get pregnant in the following 6 months but would
      not consider it a serious issue if they did become pregnant. They will be asked to use LNG
      1.5mg as their exclusive method of contraception for the period of the study, with the
      exception of condoms.

      The drug used for the study is LNG 1.5mg, specifically Marie Stopes International's BK-1
      pill, repackaged for the study purposes. The BK-1 pill is currently registered as an
      emergency contraceptive and sold in Ghana with good quality assurance procedures in place.
      The BK-1 emergency contraception pill is manufactured for Marie Stopes International by Acme
      Formulation Pvt., Limited, one of the leading drug manufacturers of India. It is registered
      as an emergency contraception by the Food and Drugs Authority in Ghana and assigned
      registration number FDA/SD.183-11710. The package will read "LNG 1.5mg for Pericoital Use -
      for study purposes only" and be devoid of any other branding (please see Appendix for
      artwork).

      Data collection components with research participants include:

        1. Baseline background information about the research participants will be collected during
           the screening (e.g., qualifications for inclusion/ exclusion) and enrollment process

        2. Biweekly (i.e., every two weeks) phone call surveys with research participants. They
           will be asked 10 questions about user satisfaction, circumstances of use, and outcomes
           (e.g., self-reported side effects)

        3. Two extended surveys per participant to better understand participant perception of LNG
           1.5mg, customer satisfaction with product and service, and future contraceptive
           intentions

      Data collection components with pharmacies will include:

        1. Baseline data of average packs of FP products sold at the pharmacy, in order to
           understand the overall increase in FP methods sold over the course of the study

        2. A mystery shopping survey to check the quality of service provision and monitoring of
           recruitment/quality of information at each of the 75 study sites 2x during the study

        3. Register collected at pharmacy point of sale, with units sold over the course of the
           12-month pilot. Note: participants will be able to go to any of the participating
           pharmacies during the course of the project.

        4. Pharmacists feedback surveys to understand the provision of LNG 1.5mg
    

Intervention name(s): Levonorgestrel 1.5mg
Intervention type(s): Drug
Intervention description(s): Levonorgestrel 1.5mg for pericoital use
Intervention MeSH terms: Levonorgestrel
Observational model: Case-Only
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        women from areas surrounding distribution sites (pharmacies)