The handbook draws heavily on lessons and experiences from work done by FHI 360, Uganda’s Ministry of Health, and the national task force on contraceptive injectable provision in drug shops. In Uganda, private drug shops are considered community-based health service providers, yet are not included in national family planning strategies or policies. In developing the handbook, therefore, we sought to bridge this gap.
Q: What steps were taken, and why, in developing the handbook?
A: Since the handbook is designed for national-level stakeholders, we held consultations with stakeholders at the national level, particularly members of the family planning injectables task force. They were supportive and helped align the handbook with realities and expectations on the ground. Content was packaged and reviewed by the members of the Drug Shops Task Force before it was finalized and published.
Q: Why did Uganda present a unique case study?
A: Uganda was the first country in sub-Saharan Africa to amend its policy to support national scale-up of an expanded family planning method mix in drug shops, including provision and administration of injectable contraceptives and self-injection in 2019. There had been similar interventions before for community health workers who were trained to administer injections.
Q: What is the primary user base seeking injectable contraceptives from drug shops, and what is their typical experience?
A: Injectables are the most popular family planning method in Uganda but, until recently, were offered only by health workers at health facilities and hospitals. The country’s 10,000 drug shops, which provide greater access to family planning services in hard-to-reach rural areas, were authorized to supply only short-acting, non-prescription methods such as condoms and emergency contraceptive pills. We found out that younger women under 25 years of age preferred getting family planning services from drug shops to other service providers. This was mainly because drug shops are often closer to home and therefore easy to access, have contraceptives in stock, and have extended hours of operation compared with public health centers. We also established that men and women in communities generally approve of drug shops providing depot medroxyprogesterone acetate (DMPA), an injectable contraceptive that is highly effective and safe for most women and can also be self-administered. Clients desire convenience and reliability in accessing family planning services.