Unveiling reproductive choices: Knowledge and practices of emergency contraceptive pills among the female factory workers in Sri Lanka.

• The awareness of emergency contraception (EC) among Female Factory Workers (FFWs) is significantly lacking, putting them at risk of unintended pregnancies and unsafe abortions. What is particularly troubling is that a considerable number of FFWs who have experienced unintended pregnancies and unsafe abortions have not utilized Emergency Contraceptive Pills (ECPs) in their lives, potentially due to a lack of awareness and knowledge about these available options. • Despite experiencing unintended pregnancies and/or unsafe abortions, individuals have not obtained the crucial, accurate knowledge, rendering them susceptible to recurring incidents. This situation prompts questions about the effectiveness of current Sexual and Reproductive Health (SRH) programs and the quality of post-abortion counseling within this restricted setting. • The study reveals the urgent need for improved family planning programs that target FFWs, with a focus on increasing knowledge and access to ECP as a means of reducing unintended pregnancy and unsafe abortion. Digital health interventions with innovative ICT tools would be a feasible solution in the factory settings. In Sri Lanka, the Emergency Contraceptive Pill (ECP) is categorized as a Schedule 2A medication, allowing it to be purchased over-the-counter without a prescription, but exclusively from licensed pharmacists. It is estimated that around 3 million ECPs are consumed by Sri Lankan women each year. This study aims to assess the knowledge and practices of Female Factory Workers (FFWs) on ECP and to unearth the association with unintended pregnancy and unsafe abortion. After receiving written informed consent, a structured interview schedule was administered among 585 FFWs attached to eight factories in a selected Export Processing Zone (EPZ). Data analysis was performed using SPSS software. Only 26 % of FFWs were aware of the effective time period to take an ECP to prevent a pregnancy. Most (67 %) had the impression that a valid prescription is required to purchase ECP from the pharmacies. Around one-tenth of the FFWs (11.3 %, n = 66) had used ECP during their lifetime. Among the 65 respondents who reported having experienced unintended pregnancies, only 26.2 % (n = 17) had utilized ECPs. In contrast, among the 22 respondents who disclosed a history of abortion, only two women had ever employed ECPs. The study highlights the low knowledge and use of ECP among FFWs in Sri Lanka, contributing to unintended pregnancy and unsafe abortion. Results call for targeted interventions to improve knowledge and access to ECP, helping to reduce unintended pregnancy and improve reproductive health outcomes. [ABSTRACT FROM AUTHOR]