User:R.Ea, Pharm.D Candidate/sandbox

Europe
Although Europe is relatively widely acceptant of contraception, some countries within Europe have differing views on contraceptive accessibility, education, and usage. A study conducted by the International Health Foundation polled 6630 women from European countries including Germany, Poland, Denmark, and Italy which had shown that there was a relatively variable use of contraception from country to country. When reviewing what types of contraception were most common in each country, it was shown that IUDs (intrauterine devices) and oral contraceptives were most commonly used in Denmark, Germany, and Northern Italy. Poland more commonly adopts more traditional contraceptive techniques such as periodic abstinence and withdrawl. Individuals also reported that voluntary sterilization (for both males and females) was most common among Germany, Spain, and Denmark.

According to study done about natural family planning, only about 47% of married couples have used some form of contraception in Western Europe.

Each country in Europe addresses accessibility to contraceptives differently. In Germany, various laws including the 1968 United Nations International Conference of Human Rights has made many things such as family planning services and access to contraception a human right. Germany requires a prescription for many of their contraceptives including IUD's and birth control. Germany has mandatory health insurance for woman under the age of 18, and these contraceptives are typically covered by that insurance, and they only need to pay a 10% copay. In Romania, citizens are able to obtain contraceptives for free and citizens are required to contribute to a healthcare fund. This healthcare fund allows individuals access to things like family planning consultations, subsidized contraceptives, as well as social benefits. Although this healthcare fund is in place, a study has shown that accessbility to these services is increasingly difficult as they are not widely advertised and will not often be offered unless first requested. In Spain, condoms are widely available free of charge, and emergency contrace3ption is required to be dispensed by law without a prescription or age limitations. In the UK, individuals are able to receive hormonal contraception for free if they have a prescription. Their goal is to reduce unplanned pregnancies, decrease abortion rates, and lower STD transmission. For most European countries, contraception seems to be mostly widely available and quite accessible to the typical individual.

Barriers to access - high cost as not all countries' health insurance covers contraceptives, inadequate sexuality education,

Africa
While many other continents have relatively open access to contraceptives, individuals in Africa have a difficult time getting contraception, and this is a result of poor funding, lack of social support, and unaffordable contraceptives. In Africa, around 80% of women do not use any form of contraception at all. One of the biggest reasons for this is because of how unaffordable contraceptives are for the average person in Africa. The majority of countries within Africa are considered LMIC (low-middle income countries). This makes it difficult for most working-class individuals to purchase contraception as condoms can cost as much as 3000 Ugandan shillings (about 0.75 United States dollars). A singular condom would cost half of the monthly income of the average person living in sub-Saharan Africa. This cost also does not factor in transportation costs that individuals would incur getting to the urban areas which sell these contraceptives.

Religion and culture also play a very large role into the decision that many women make on whether or not to use contraception in Africa. In Luweero, it is typically desirable to have very large families and thus affects decisions on family planning and contraceptive use. On top of this, many Catholic and Muslim communities believe that God have a set plan for each individual and that contraceptive use directly goes against those beliefs.

Many villages in Africa do not have accurate sexual education available for their people. There are many misconceptions about contraception that include things such as; IUD's can enter your heart and cause death or that contraception will cause permanent infertility. Sometimes, these rumors stem from individuals' general distrust of the government. There are often negative social stigmas that are attached to the use or implantation of contraceptive devices which further discourages individuals from using them. Men are also discouraged from supporting contraceptive use as many believe that it will encourage their wives to be unfaithful.

According to a study done in Sub-Saharan Africa, "about 13% of pregnancies end up in abortions and 97% of these are unsafe" (Bain, 2021). Many of these pregnancies occur in adolescent women, a time in their lives when childbearing has more complications, higher maternal mortality rates, and miscarriage.