Donors and a small group of implementing partners are working to understand how to best support and involve drug shops as safe and reliable family planning providers. Expanding the broader community of family planning professionals’ understanding of the drug shop operators’ impact is going to be important for ensuring a supportive policy and programmatic environment for these providers.
Small commercial drug shops have long been recognized as the first line of health care in low- and middle-income countries, especially in rural areas with few private or public clinics. Drug shops often provide a variety of health services, products, and information, which sometimes go beyond the strictures of local laws and regulations. These services range from the diagnosis and treatment of diseases such as malaria and sexually transmitted infections and ailments such as pneumonia, diarrhea, or respiratory infections to preventive care including family planning.
Drug shops provide an important opportunity to expand access to family planning, for women and harder-to-reach groups through convenience, anonymity, and cost savings. Drug shops as providers of methods, both sanctioned and unsanctioned, are largely missing from countries’ family planning strategies, policies, regulation, and monitoring. Most decision-makers have been slow to adapt policies and programs despite numerous studies demonstrating the feasibility of training drug shop operators to deliver various long-term methods. Instead, they are often viewed as mere merchants of limited short-term methods, which ignores their capacity for increasing uptake of family planning services and methods in a systematic and collaborative way with the public sector, social marketing groups, and product distributors.
Many studies have examined contraceptive use patterns, market trends, and the role of the private sector in improving access. The positive implications for women, providers, and communities are clear. For instance in Uganda, the scale-up of providing depot medroxyprogesterone acetate subcutaneous (DMPA-SC) through drug shops led to increased access and uptake. FHI 360, in collaboration with the Uganda Ministry of Public Health and Population and PATH Uganda, carried out a Catalytic Opportunity Fund project August 2019 to January 2020.1
More and more drug shops will be enlisted to help meet the growing demand for family planning, specifically injectable contraceptives, in rural and hard-to-reach areas by improving the availability of high quality and reliable services. A better understanding of the current practices, opportunities, challenges, and gaps in drug shops provision of family planning will be required of more professionals in this field as we collectively discuss mechanisms to effectively and strategically integrate these providers in our global, national and local conversations on increasing family planning access and health services more broadly.
1. FHI 360. “Use of the catalytic opportunity fund for DMPA-SC scale-up in Uganda: August 2019 to January 2020” (unpublished report, March 26, 2020). Durham (NC).↩