Mixed-methods study on pharmacies as contraception providers to Kenyan young people: who uses them and why?
Mixed-methods study on pharmacies as contraception providers to Kenyan young people: who uses them and why?
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DOI：
10.1136/bmjopen-2019-034769
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发表时间：
2020-01-01
期刊：
影响因子：
2.9
通讯作者：
Hilber, Adriane Martin
中科院分区：
文献类型：
--
作者：
Gonsalves, Lianne;Wyss, Kaspar;Hilber, Adriane Martin
目标 本研究试图回答两个问题：(1) 使用从药房购买避孕药具的 18-24 岁肯尼亚年轻人有哪些特征，以及 (2) 为什么药房对避孕药具的来源有吸引力？设计和设置 这是一项在肯尼亚夸勒县城郊地区进行的一项混合方法研究。方法包括横断面调查（n=740）、六次焦点小组讨论、18 次深度访谈和 25 次关键知情人访谈。定量数据分析确定了促使年轻人去药店购买现代避孕药与其他来源的因素。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 参与者是（1）来自研究地区的18-24岁的年轻人，包括最近从药房购买过避孕药具的子集； (2) 药房人员和药房利益相关者。结果 在曾经发生过性行为并在上次性行为中使用过现代避孕措施的受访者中，59% 的人从药房购买。在多变量分析中，使用安全套或紧急避孕药的参与者以及独居者更有可能从药房获取避孕药具。药店因其便利、隐私、不评判且风度翩翩的员工、服务速度以及可预测且实惠的价格而受到重视。结论 我们的研究结果表明，肯尼亚沿海地区的年轻人使用药店避孕的比例很高。我们将紧急避孕药使用者纳入其中部分解释了这一点。药房被认为具有医疗设施所不具备的一切：快速、私密和无限制。政策制定者应认识到药房作为避孕药具提供者的作用，并寻找机会将药房与公共卫生系统联系起来。这将为年轻人创建一个方便且有吸引力的避孕服务网络。
Objectives 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? Design and setting 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 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. Results 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. Conclusions 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.