Identity and the Availability of Emergency Contraception from Pharmacies in Istanbul

Abstract

Emergency contraception (EC) has been and remains available in Turkey without prescription since 2002. This study attempted to determine the availability of emergency contraception from pharmacies in Istanbul, Turkey and whether the identity of the purchaser had any impact on availability. More specifically, we sought to understand if young women feel shamed or denied access to EC. This study employed a mystery patient/shopper approach where mystery patients attempted to purchase emergency contraception from a random sample of 352 pharmacies in Istanbul. Mystery shoppers, ages 18-22, were trained and provided a standard scenario and identity. The identities included: conservative/ religious female; secular/modern female; and male. After each pharmacy visit, the mystery patients recorded the details of their attempts to purchase EC. In 95.4% of visits mystery shoppers were able to purchase EC. Despite the availability of several types of EC, little choice was given to shoppers. Male mystery shoppers were given more choice of EC than their female counterparts and were more often able to purchase the less expensive form of EC. In the majority of transactions, pharmacists offered no medical instructions or recommendations. EC is widely available from pharmacies in Istanbul but lack of choice and information from pharmacists result in a less than ideal health care experience.