Provision of Injectable Contraceptives within Drug Shops: A Promising Approach for Increasing Access and Method Choice

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In sub-Saharan Africa, drug shops, known in some countries as chemist shops or patent medicine vendor shops, are often the most widely used source for health services, information, and products, especially in rural areas with few facilities, pharmacies, and community health workers (Stanback et al. 2011; Wafula and Goodman 2010). In these areas where there is high unmet need for health services and family planning in particular, all feasible means of increasing access and method choice must be explored to meet ambitious development and family planning goals.

Injectable contraceptives are the most popular contraceptive method in sub-Saharan Africa but can be difficult for people in rural areas to obtain from the public sector because of limited access to clinics, acute staff shortages, and stockouts. Injectables are widely available in pharmacies, often at very low prices, as part of organized social marketing programs. Pharmacies are scarce or nonexistent in rural areas where the majority of people in many low-income countries still live.

Drug shops could offer opportunities to expand access to a broader family planning method mix because they are commonplace in rural areas and privately owned and support a sustainable commercial market for health products. However, in most African countries, combined oral contraceptive pills and injectable contraceptives are classified as prescription drugs, and thus, their distribution in drug shops is prohibited by law. In addition, some countries have weak regulatory bodies, which struggle to provide the quality training and supervision needed to ensure family planning is not sold or provided by unlicensed vendors.