The provision of emergency contraception in Kinshasa's private sector pharmacies: experiences of mystery clients
The provision of emergency contraception in Kinshasa's private sector pharmacies: experiences of mystery clients
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DOI：
10.1016/j.contraception.2017.08.001
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发表时间：
2018-01-01
期刊：
影响因子：
2.9
通讯作者：
Glover, Annie
中科院分区：
文献类型：
--
作者：
Hernandez, Julie H.;Mbadu, Muanda Fidele;Glover, Annie
目标：最近关于解决低收入国家卫生系统差距的方案和研究努力越来越多地将任务转移，即由未受过医学培训的人员提供保健，作为增加特定服务和商品可获得性的可能解决办法。在金沙萨，私营药房是计划生育方法的主要和首选提供者，因此是扩大获得特定避孕药具的潜在资源。这项研究的目的是探索选定的药店为寻求紧急避孕(EC)的妇女提供服务的准备情况。研究设计：本研究使用神秘客户(MC)方法访问了刚果民主共和国金沙萨(DRC)的73家药店。训练有素的面试者伪装成EC的新手，并提出具体的问题，以评估药房工作人员对EC的技术知识以及他们对EC客户的态度。结果：调查结果显示，超过三分之二的EC提供者了解EC的剂量、时间框架和副作用，90%的EC被认为对EC新手有帮助。对EC时间表(20%的提供者)和长期副作用(4%的提供者)的罕见但明显的误解，以及频繁的缺货(22%)和成本问题突出了规划改进的优先事项。结论：随着新的服务提供战略的探索，以补充刚果民主共和国不均衡的卫生结构网络，本研究表明，如果在计划生育规划方面进行适当的培训和整合，私营药房有潜力满足生活在金沙萨的妇女的特定避孕需求。(C)2017年作者。由爱思唯尔公司出版。
Objectives: Recent programmatic and research efforts on addressing gaps in health systems of low-income countries increasingly see task shifting, i.e. the provision of healthcare by non-medically trained personnel, as a possible solution to increase the availability of specific services and commodities. In Kinshasa, private-sector pharmacies are the primary and preferred provider of family planning (FP) methods, and thus constitute a potential resource for expanding access to specific contraceptives. The objective of this study is to explore selected pharmacies' readiness to serve women seeking emergency contraception (EC).Study design: This study used a mystery client (MC) methodology to visit 73 pharmacies in Kinshasa, Democratic Republic of Congo (DRC). Trained interviewers posed as novice EC users and asked specific questions to evaluate the pharmacy staff's technical knowledge of EC and their attitudes towards EC clients. The results of the MC visit were recorded immediately after the MC left the pharmacy.Results: Findings indicate that more than two-thirds of EC providers were knowledgeable about EC dosage, timeframe, and side effects, and 90% were deemed helpful towards novice EC users. Rare but glaring misconceptions about EC timeframe (20% of providers) and long-term side effects (4% of providers), as well as frequent stock-out (22%) and cost issues highlight priorities for programmatic improvements.Conclusions: As new service delivery strategies are explored to complement the uneven network of health structures in DRC, this study suggests that, given proper training and integration in FP programming, private-sector pharmacies have the potential to meet specific contraceptive needs for women living in Kinshasa. (C) 2017 The Authors. Published by Elsevier Inc.