Abstract
Private-sector drug shops are often the first point of health care in sub-Saharan Africa. Training and supporting drug shop and pharmacy staff to provide a wide range of contraceptive methods and information is a promising high-impact practice for which more information is needed to fully document implementation experience and impact. Between September 2010 and March 2011, we trained 139 drug shop operators (DSOs) in 4 districts of Uganda to safely administer intramuscular DMPA (depot medroxyprogesterone acetate) contraceptive injections. In 2012, we approached 54 of these DSOs and interviewed a convenience sample of 585 of their family planning clients to assess clients' contraceptive use and perspectives on the quality of care and satisfaction with services. Finally, we compared service statistics from April to June 2011 from drug shops, community health workers (CHWs), and government clinics in 3 districts to determine the drug shop market share of family planning services. Most drug shop family planning clients interviewed were women with low socioeconomic status. The large majority (89%) were continuing family planning users. DMPA was the preferred contraceptive. Almost half of the drug shop clients had switched from other providers, primarily from government health clinics, mostly as a result of more convenient locations, shorter waiting times, and fewer stock-outs in drug shops. All clients reported that the DSOs treated them respectfully, and 93% trusted the drug shop operator to maintain privacy. Three-quarters felt that drug shops offered affordable family planning services. Most of the DMPA clients (74%) were very satisfied with receiving their method from the drug shop and 98% intended to get the next injection from the drug shop. Between April and June 2011, clinics, CHWs, and drug shops in 3 districts delivered equivalent proportions of couple-years of protection, with drug shops leading marginally at 36%, followed by clinics (33%) and CHWs (31%). Drug shops can be a viable and convenient source of short-acting contraceptive methods, including DMPA, serving as a complement to government services. Family planning programs in Uganda and elsewhere should consider including drug shops in the network of community-based family planning providers.
Highlights
Global Health: Science and Practice 2014 | Volume 2 | Number 4 are not required to employ trained pharmacists
All clients reported that the DSOs treated them respectfully, and 93% trusted the drug shop operator to maintain privacy
Drug shops are often the first line of health care in subSaharan Africa,[1] and, in countries such as Uganda that have high rates of maternal mortality and morbidity, they can play an important role in providing basic health care.[2]
Summary
Global Health: Science and Practice 2014 | Volume 2 | Number 4 are not required to employ trained pharmacists. Training and supporting drug shop and pharmacy staff to provide a wide range of contraceptive commodities and information is one of several promising highimpact practices in family planning,[3] especially in light. Planning provision by drug shops in Uganda www.ghspjournal.org of evidence that paraprofessional health workers can safely administer injectable contraceptives in addition to providing oral contraceptive pills and condoms.[4] more information is needed to fully document implementation experience and impact. Training and supporting drug shop and pharmacy staff to provide a wide range of contraceptive methods and information is a promising high-impact practice for which more information is needed to fully document implementation experience and impact
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