Liambila Wilson, Obare Francis, RamaRao Saumya, Oguttu Monica, Nyandat Carol, Denga Benedict, Wekesa Zeka
Population Council Kenya, Nairobi, Kenya.
Population Council, New York, USA.
BMC Health Serv Res. 2024 Dec 30;24(1):1663. doi: 10.1186/s12913-024-12176-5.
Both unintended pregnancy and unsafe abortion are major public health problems in Kenya. The World Health Organization recommends the use of medication abortion to stop unwanted pregnancies. However, the extent of provision and uptake of medication abortion through private pharmacies in Kenya is not well known. This study assessed the feasibility and acceptability of utilizing pharmacy outlets and community health volunteers to increase women's and girls' access to information, medication abortion and other sexual and reproductive health services and rights.
The study utilized a single arm (intervention only) pre-test and post-test design that involved implementing a set of interventions and comparing the baseline and endline indicators using simple frequencies considering the number of respondents involved in the study. The study, referred to as Tembe Mkononi project, was conducted from 1 February 2021 to 31 December 2022, in Homa Bay County. Data collection involved baseline and endline interviews with 10 pharmacy staff (drawn from 9 pharmacy outlets) and 20 community health volunteers while program data was extracted from pharmacy sales records.
A total of 527 clients obtained medication abortion drugs from the 9 participating pharmacy outlets between April and December 2022. There was a steady increase in the number of clients served from 15 clients in April 2022 to 112 clients in December 2022. Out of the 527 clients, 523 of them obtained family planning methods. All the pharmacy staff and community health volunteers expressed satisfaction and positive attitude towards the services provided to clients.
Results of the study show that the provision of medication abortion and other sexual and reproductive health services such as contraceptives to women and girls through private pharmacy outlets was feasible and acceptable. Building the capacity of community health volunteers to create awareness, strengthen referral and follow-up activities increased demand and uptake of sexual and reproductive health services including medication abortion over the project period. Overall, the interventions implemented in a rural county in Western Kenya have potential in addressing the problem of unsafe abortion which is one of the leading causes of maternal morbidity and mortality in Kenya and other developing countries.
意外怀孕和不安全堕胎都是肯尼亚的重大公共卫生问题。世界卫生组织建议使用药物流产来终止意外怀孕。然而，肯尼亚通过私人药店提供和采用药物流产的程度尚不清楚。本研究评估了利用药店和社区卫生志愿者来增加妇女和女孩获取信息、药物流产及其他性与生殖健康服务和权利的可行性和可接受性。
该研究采用单组（仅干预）前后测试设计，包括实施一系列干预措施，并使用考虑参与研究的受访者数量的简单频率来比较基线和终线指标。这项被称为“Tembe Mkononi项目”的研究于2021年2月1日至2022年12月31日在霍马湾县进行。数据收集包括对10名药店工作人员（来自9家药店）和20名社区卫生志愿者进行基线和终线访谈，同时从药店销售记录中提取项目数据。
2022年4月至12月期间，共有527名客户从9家参与的药店获得了药物流产药物。服务的客户数量稳步增加，从2022年4月的15名客户增加到2022年12月的112名客户。在527名客户中，有523人获得了计划生育方法。所有药店工作人员和社区卫生志愿者对向客户提供的服务表示满意和积极态度。
研究结果表明，通过私人药店向妇女和女孩提供药物流产及其他性与生殖健康服务（如避孕药具）是可行且可接受的。在项目期间，增强社区卫生志愿者开展宣传、加强转诊和随访活动的能力，增加了包括药物流产在内的性与生殖健康服务的需求和采用率。总体而言，在肯尼亚西部一个农村县实施的干预措施有潜力解决不安全堕胎问题，不安全堕胎是肯尼亚和其他发展中国家孕产妇发病和死亡的主要原因之一。
