Getting closer to people: family planning provision by drug shops in Uganda

Abstract

Private drug shops can effectively provide contraceptive methods, especially injectables, complementing government services. Most drug shop clients in 4 peri-urban areas of Uganda were continuing users of DMPA; had switched from other providers, mainly government clinics, because the drug shops had fewer stock-outs and were more convenient (closer location, shorter waiting time, more flexible hours); and were satisfied with the quality of services. The drug shops provided a substantial part of the total market share for family planning services in their areas.

Key Role of Drug Shops and Pharmacies for Family Planning in Urban Nigeria and Kenya

“…Literature shows that regardless of the regulatory environment and the training level of staff, drug shops in Africa are providing injectable contraception 13 . Major policy shifts in recent years toward expanded access to certain forms of family planning (such as implants and injectables) down to a community level, as well as successful trials of Sayana Press in multiple countries, indicate that drug shops and pharmacies may play an increasingly important role in the provision of new methods for certain populations 9 , 14 , 17 . For instance, in 2012, Nigeria approved a policy to allow trained community health extension workers (CHEWs) to administer injectables and implants.…”

“…Pharmacies and drug shops offer easy access to a number of common contraceptive methods including condoms, oral contraceptive pills, and emergency contraception. Women are able to purchase injectable contraceptives in some contexts in the private non-medical sector, but they are often not able to obtain the injection at the same site; however, regulations are beginning to change to expand access 9 , 14 …”

“…While the legal criteria of drug shops vary by country, usually they are permitted to sell prepackaged patent drugs that are considered to be safe for public use 12 , 14 , 15 , 16 . Notably, they are generally not allowed to dispense drugs outside of their manufacturer package unlike pharmacies 9 , 12 , 16 .…”

“…Moreover, in societies where premarital sex is strongly discouraged, adolescents and unmarried individuals are less likely to get services at conventional health facilities. In addition to provision of contraceptive commodities, evidence shows that drug shops provide family planning information and counseling to their clients 11 , 12 , 14 , 15 , 16 . An observational study on interactions between drug shops and customers in urban and rural Nigeria showed that 25% of the clients interviewed saw drug shops as a source of advice 16 …”

Sale and provision of injectable contraceptives in drug shops in developing countries: conclusions from a technical consultation

“…However, it is often difficult to obtain from the public health sector in rural areas because of limited access to clinics, acute staff shortages and stockouts. Several recent studies document current practices and the potential of DMPA provision in drug shops [1,[4][5][6]. The sale and provision of injectable contraceptives in drug shops is not a new phenomenon; it is quite commonalthough currently unlawful -in countries such as Uganda and Nigeria.…”