180745 Contraceptive Injections in Rural Drug Shops in Uganda

Wednesday, October 29, 2008: 12:45 PM

John Stanback, PhD , Applied Research Department, Family Health International, Research Triangle Park, NC
Martha Bekiita , Save the Children - Uganda, Kampala, Uganda
Olivia Nakayiza , Save the Children - Uganda, Kampala, Uganda
Conrad Otterness, MPH , Family Health International, Research Triangle Park, NC
Background: Small private drug shops are ubiquitous in many African countries, and, at the community level, are often the first stop for rural dwellers seeking health care. They are also controversial: drug shop operators are notorious in some countries for selling controlled, counterfeit or tainted drugs, and for providing health services for which they are not qualified. In Uganda, most rural drug shops illegally sell and inject Depo Provera.

Methodology: In August 2007, we visited 139 drug shops in three rural districts of Uganda and interviewed the operators, collecting data on provider qualifications, injection practices, and contraceptive knowledge and attitudes. Subsequently, we trained many of the drug shop operators as community-based distributors of Depo Provera, and then re-interviewed the operators in subsequent months to evaluate the impact of training on safe provision of injectable contraception.

Results: Baseline data showed that nearly 90% of drug shops both sold and injected Depo Provera. We also present data on drug shop operator qualifications, and pre-post changes in injection practices and contraceptive knowledge and attitudes.

Conclusions: Provision of Depo Provera by rural drug shop operators in Uganda remains illegal and ubiquitous. The relative innocuousness of DMPA and the pre-packed autodisable syringes in the socially-marketed product likely make these injections the safest offered in drug shops, yet there is a need to better regulate this sector and to insure safe injections.

Learning Objectives:
1. Describe the reasons why drug shops are controversial in Africa 2. Discuss the potential advantages of drug shop provision of DMPA in rural areas, and how safety issues might be overcome.

Keywords: Family Planning, Access to Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Principal investigator of study
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.