A qualitative study to explore the barriers and enablers for young people with disabilities to access sexual and reproductive health services in Senegal, Reproductive Health Matters, 25:50,[43][44][45][46][47][48][49][50][51][52][53][54]
While social franchising has been highly successful with private-sector providers, in Mali the approach was expanded to public-sector community health clinics. From 2012 to 2015, these clinics served >120,000 family planning clients, 78% of whom chose long-acting reversible methods. Many clients were young, poor, and had not been using a method during the 3 months prior to their visit.
BackgroundMaking misoprostol widely available for management of postpartum haemorrhage (PPH) and post abortion care (PAC) is essential for reducing maternal mortality. Private pharmacies (thereafter called “pharmacies”) are integral in supplying medications to the general public in Senegal. In the case of misoprostol, pharmacies are also the main supplier to public providers and therefore have a key role in increasing its availability. This study seeks to understand knowledge and provision of misoprostol among pharmacy workers in Dakar, Senegal.MethodsA cross-sectional survey was conducted in Dakar, Senegal. 110 pharmacy workers were interviewed face-to-face to collect information on their knowledge and practice relating to the provision of misoprostol.ResultsThere are low levels of knowledge about misoprostol uses, registration status, treatment regimens and side effects among pharmacy workers, and corresponding low levels of training on its uses for reproductive health. Provision of misoprostol was low; of the 72% (n = 79) of pharmacy workers who had heard of the product, 35% (n = 27) reported selling it, though rarely for reproductive health indications. Almost half (49%, n = 25) of the respondents who did not sell misoprostol expressed willingness to do so. The main reasons pharmacy workers gave for not selling the product included stock outs (due to product unavailability from the supplier), perceived lack of demand and unwillingness to stock an abortifacient.ConclusionsKnowledge and availability of misoprostol in pharmacies in Senegal is low, posing potential challenges for delivery of post-abortion care and obstetric care. Training is required to address low levels of knowledge of misoprostol registration and uses among pharmacy workers. Barriers that prevent pharmacy workers from stocking misoprostol, including weaknesses in the supply chain and stigmatisation of the product must be addressed. Low reported sales for reproductive health indications also suggest limited prescribing of the product by health providers. Further research is needed to explore the reasons for this barrier to misoprostol availability.
Program accomplishments during the first 18 months:
More than 58,000 free vouchers distributed to young people, of which 74% were redeemed.79% chose long-acting reversible contraceptives (LARCs) and 51% received STI counseling.Client profile data snapshot:
69% had never previously used contraception and 96% were 20 or younger.
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