Gonsalves Lianne, Wyss Kaspar, Cresswell Jenny A, Waithaka Michael, Gichangi Peter, Martin Hilber Adriane
Department of Sexual and Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
Swiss Centre for International Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.
BMJ Open. 2020 Jul 8;10(7):e034769. doi: 10.1136/bmjopen-2019-034769.
This study sought to answer two questions: (1) what are the characteristics of young Kenyans aged 18-24 who use contraception obtained at pharmacies, and (2) why are pharmacies appealing sources of contraception?
This was a mixed-methods study in one peri-urban part of Kwale County, Kenya. Methods included cross-sectional survey (n=740), six focus group discussions, 18 in-depth interviews and 25 key-informant interviews. Quantitative data analysis identified factors pushing young people to pharmacies for modern contraception versus other sources. Qualitative data analysis identified reasons pharmacies were perceived to be appealing to young clients.
Participants were (1) young people aged 18-24 from the study area, including a subset who had recently purchased contraception from a pharmacy; or (2) pharmacy personnel and pharmacy stakeholders.
Among surveyed participants who had ever had sexual intercourse and had used modern contraception at last sexual intercourse, 59% obtained it from a pharmacy. In multivariable analysis, participants who used a condom or emergency contraception as well as those living alone were significantly more likely to get contraception from pharmacies. Pharmacies were valued for their convenience, privacy, non-judgmental and personable staff, service speed, as well as predictable and affordable prices.
Our findings indicate a high percentage of young people in Coastal Kenya use pharmacies for contraception. Our inclusion of emergency contraception users partially explains this. Pharmacies were perceived to be everything that health facilities are not: fast, private and non-limiting. Policy-makers should recognise the role of pharmacies as contraception providers and look for opportunities to link pharmacies to the public health system. This would create a network of accessible and appealing contraception services for young people.
本研究旨在回答两个问题：（1）18 - 24岁使用从药店获取的避孕措施的肯尼亚年轻人有哪些特征？（2）为什么药店是有吸引力的避孕措施来源？
这是一项在肯尼亚夸莱县一个城郊地区开展的混合方法研究。方法包括横断面调查（n = 740）、六次焦点小组讨论、18次深入访谈和25次关键 informant 访谈。定量数据分析确定了促使年轻人选择药店获取现代避孕措施而非其他来源的因素。定性数据分析确定了药店被认为对年轻客户有吸引力的原因。
参与者为（1）来自研究区域的18 - 24岁年轻人，包括最近从药店购买过避孕措施的一个子集；或（2）药店工作人员和药店利益相关者。
在接受调查的曾有过性行为且在最后一次性行为中使用过现代避孕措施的参与者中，59%是从药店获取的。在多变量分析中，使用避孕套或紧急避孕措施的参与者以及独居者从药店获取避孕措施的可能性显著更高。药店因其便利性、隐私性、不评判且亲切的工作人员、服务速度以及可预测且价格实惠而受到重视。
我们的研究结果表明，肯尼亚沿海地区有很高比例的年轻人使用药店提供的避孕措施。我们纳入紧急避孕措施使用者这一点部分解释了这一现象。药店被认为具备卫生设施所没有的一切：快速、私密且无限制。政策制定者应认识到药店作为避孕措施提供者的作用，并寻找机会将药店与公共卫生系统相联系。这将为年轻人创建一个可及且有吸引力的避孕服务网络。
