Center for Research on Environment, Health and Population Activities (CREHPA), Kathmandu, Nepal.
Best Pract Res Clin Obstet Gynaecol. 2020 Feb;63:67-73. doi: 10.1016/j.bpobgyn.2019.06.003. Epub 2019 Jul 5.
Despite the legalization of abortion in 2002 has made extensive efforts to expand services throughout the country, access to safe abortion care remains a constraint in Nepal, particularly in remote areas where trained providers and equipment are scarce. Expanding access to medical abortion (MA) through pharmacy workers could be a promising avenue to reach such women with safe and convenient care, but neither Nepali law nor the World Health Organization (WHO) recommends pharmacy provision of MA citing the reason of insufficient evidence. This paper examines the pharmacy provision of MA in expanding women's access to safe MA service in Nepal. Available literature between 2005 and 2018 was searched, and relevant information was extracted using a template, and findings were summarized and interpreted according to the objective of this study. We identified 83 studies that were related to MA in Nepal, but only five of them reported about pharmacy workers' involvement in the provision of MA in Nepal. Findings suggest that trained pharmacy workers can safely and effectively provide MA. MA services provided by pharmacy workers are acceptable to women who were satisfied with the service they had received. Therefore, it is essential that the Government of Nepal acknowledges the role pharmacy workers currently play in the provision of MA and formulate polices to permit pharmacy workers to give information about and dispense MA tablets to women in the first trimester of pregnancy.
尽管 2002 年堕胎合法化后，尼泊尔已在全国范围内做出广泛努力以扩大服务范围，但在尼泊尔，特别是在培训提供者和设备稀缺的偏远地区，获得安全堕胎护理仍然受到限制。通过药剂师来扩大药物流产（MA）的可及性，可能是为这些妇女提供安全便捷护理的一个有希望的途径，但无论是尼泊尔法律还是世界卫生组织（WHO）都不建议药剂师提供 MA，理由是证据不足。本文探讨了在尼泊尔，药剂师提供 MA 以扩大妇女获得安全 MA 服务的可及性。对 2005 年至 2018 年期间的现有文献进行了搜索，并使用模板提取了相关信息，根据本研究的目的对研究结果进行了总结和解释。我们确定了 83 项与尼泊尔 MA 相关的研究，但其中只有 5 项报告了尼泊尔药剂师参与 MA 提供的情况。研究结果表明，经过培训的药剂师可以安全有效地提供 MA。接受调查的妇女对药剂师提供的 MA 服务表示满意，因此，尼泊尔政府必须承认药剂师在提供 MA 方面所发挥的作用，并制定政策，允许药剂师向怀孕头三个月的妇女提供有关 MA 药片的信息和配药。
