Abstract
Background: This research assessed the potential for expanding access to family planning through private sector pharmacies in Senegal, by examining the quality of the services provided through private sector pharmacies, and pharmacy staff and client interest in private sector pharmacy-based family planning services. Methods: This was a cross-sectional, descriptive study conducted in eight urban districts in and around Dakar and two urban districts outside of Dakar employing an audit of 225 pharmacies, a survey with 486 private sector pharmacy staff and a survey with 3,567 women exiting private sector pharmacies. Results: Most (54%) pharmacies reported offering method-specific counseling to clients. Family planning commodities were available in all pharmacies, and 72% had a private space available to offer counseling. Three quarters (76%) did not have any counseling materials available. 49% of pharmacists and 47% of assistant pharmacists reported receiving training on family planning during their professional studies. Half had received counseling training. Few pharmacists met pre-determined criteria to be considered highly knowledgeable of the oral contraceptive pill (OCP) and injectable contraceptive provision (0.6% and 1.1%). Overall, 60% of women surveyed were current family planning users and 11% procured their method through a private sector pharmacy. Among non-users of family planning, and current users who did not obtain their method through a pharmacy, 47% said they would be interested in procuring a method through a private sector pharmacy. Conclusions: There is both actual and latent demand for accessing family planning through Senegal's urban, private sector pharmacies. With proper training, pharmacy staff could better provide effective counseling and provision of OCPs and injectables, and lifting the requirement for a prescription could help support gains in contraceptive prevalence.
Highlights
Limited access to family planning services has been linked to the high rates of unmet need for contraception found in many African countries1
Research has shown drug shops, which typically do not employ a licensed pharmacist and are normally restricted to selling only over-the-counter medications, and private sector pharmacies to be a major source for contraceptives, oral contraceptive pills (OCPs), emergency contraception, and condoms, especially for hard to reach women such as those who are younger or unmarried3–5
Community health workers in the public sector, and pharmacy and drug shop staff in the private sector, have all been trained in various countries to provide OCPs and injectable contraception—the two most popular forms of contraception in sub-Saharan Africa— without the need for a prescription written by a higher-level clinician, even when it is the first time the woman is using the method7
Summary
Limited access to family planning services has been linked to the high rates of unmet need for contraception found in many African countries. Community health workers in the public sector, and pharmacy and drug shop staff in the private sector, have all been trained in various countries to provide OCPs and injectable contraception—the two most popular forms of contraception in sub-Saharan Africa— without the need for a prescription written by a higher-level clinician, even when it is the first time the woman is using the method. 4. Per my comment above, please provide at a short paragraph that describes some of the possible downsides or existing concerns regarding drug shop/pharmacy OTC provision of FP. 60% of women surveyed were current family planning users and 11% procured their method through a private sector pharmacy. Pharmacy staff could better provide effective counseling and provision of OCPs and injectables, and lifting the requirement for a
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