Contraception, 2018 - http://www.safeabortionwomensright.org/medical-abortion-a-special-edition-of-contraception/
Provision of menstrual regulation with medication among pharmacies in three municipal districts of Bangladesh: a situation analysis
Huda FA, Mahmood HR, Alam A, Ahmmed F, Karim F, Sarker BK, Al Haque N and Ahmed A
Abstract
Objective: The objective was to assess the provision of the combination of mifepristone–misoprostol for menstrual regulation (MR) in randomly selected urban pharmacies in Bangladesh.
Study design: We conducted a cross-sectional survey among 553 pharmacy workers followed by 548 mystery client visits to the same pharmacies in 3 municipal districts during July 2014–December 2015.
Results: The survey found that 99% of pharmacy workers visited had knowledge of MR procedures but only two-thirds (67%) could state the legal time limit correctly; they mentioned misoprostol (86%) over mifepristone–misoprostol combination (78%) as a procedure of MR with medication (MRM); 36% reported knowing the recommended dosage of mifepristone–misoprostol combination; 70% reported providing information on effectiveness of the medicines; 50% reported recommending at least one follow-up visit to them; 63% reported explaining possible complications of using the medications; and 47% reported offering any post-MR contraception to their clients. In contrast, mystery client visits found that the mifepristone–misoprostol combination (69%) was suggested over misoprostol (51%) by the pharmacy workers; 54% provided the recommended dosage of mifepristone–misoprostol combination; 42% provided information on its effectiveness; 12% recommended at least one follow-up visit; 11% counseled on possible complications; and only 5% offered post-MR contraceptives to the mystery clients.
Conclusions: We found knowledge gaps regarding recommended dosage for MRM and inconsistent practice in informing women on effectiveness, follow-up visits, possible complications and provision of post-MR contraceptives among the pharmacy workers, particularly during the mystery client visits.
Implications: Pharmacy workers in Bangladesh need to be trained on legal time limits for MR services provision, on providing accurate information on disbursed medicine, and on proper referral mechanisms. A strong monitoring and regulatory system for pharmacy provision of MRM in pharmacies should be established.
Comment: Like in one of the earlier abstracts we see again that pharmacy workers, here in Bangladesh, but certainly in other countries as well, are willing to help women who ask for medical termination of pregnancy. However, they need to be well trained to give the right doses, instructions, etc. Training for pharmacists needs to be the same as for other healthcare workers. (HMV)
