World Contraception Day 2018

    1. What is the CART program?

The Contraception and Abortion Research Team (CART) is a national, interdisciplinary, cross-sectoral collaboration performing research to support health services and policies to ensure equitable access to high-quality family planning knowledge, methods and services for people throughout Canada. The overarching goal of the team is to support Canadians to plan and space their pregnancies. The team was founded and led by Dr. Wendy Norman, an Associate Professor at UBC Department of Family Practice and the CIHR-PHAC Chair in Family Planning Public Health Research. 

    1. Why is it important to continue research around contraception?

In Canada, approximately half of all pregnancies are unintended. Access to highly effective contraception is important to Canadians who typically spend 3 or fewer years pregnant or attempting to become pregnant and more than 30 years attempting to avoid pregnancy. Improving access to contraception, especially long-acting reversible contraception, has been acknowledged to be one of the top public health advances that can lead to population-level gains, and yet there are still many obstacles, such as knowledge, access, and affordability of highly effective contraception, that need to be studied, addressed and mitigated. 

    1. What are some of the ways that access to contraception contributes to gender equality?

Disadvantaged and vulnerable populations, particularly youth, those of low socio-economic status or those subjected to Adverse Childhood Experiences (ACES) and/or intimate partner violence, those living with substance use and mental health disorders, residents in rural and remote communities, and immigrants are over-represented among those with unintended pregnancy. Lack of knowledge of highly effective contraception, unaffordability and limited access to services all contribute to the societal inequalities of access to contraception, which in turn impact the health of Canadians. 

    1. How might the CART research impact women and their families?

One major theme of the CART research program is Health Policy Research. We aim to effectively translate research evidence to support health policy that will improve access to family planning knowledge, methods and services. 

One example is the BC wide Safe Methods at the Right Time program (SMART Program) providing free contraception at the time of abortion implemented in 2016. This policy decision was directly based on research provided by Dr. Norman and the CART collaborators to the BC Ministry of Health. The proposal used data from two CART RCTs in rigorous simulation modelling to demonstrate that subsidy for highly effective contraception at the time of abortion can save government costs and improve health outcomes. 

Similar CART studies have been undertaken to support decision making on the cost-effectiveness of government subsidy to provide free contraception for all women.