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ORIGINAL ARTICLE

Getting closer to people: family planning provision by drug shops in Uganda

Angela Akol, Dawn Chin-Quee, Patricia Wamala-Mucheri, Jane Harriet Namwebya, Sarah Jilani Mercer and John Stanback
Global Health: Science and Practice December 2014, 2(4):472-481; https://doi.org/10.9745/GHSP-D-14-00085
Angela Akol
aFHI 360 Uganda, Kampala, Uganda
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  • For correspondence: aakol@fhi360.org
Dawn Chin-Quee
bFHI 360, Durham, NC, USA
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Patricia Wamala-Mucheri
cFHI 360 Uganda, Kampala, Uganda, Now with the Clinton Health Access Initiative, Kampala, Uganda
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Jane Harriet Namwebya
aFHI 360 Uganda, Kampala, Uganda
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Sarah Jilani Mercer
bFHI 360, Durham, NC, USA
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John Stanback
bFHI 360, Durham, NC, USA
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Figures & Tables

Figures

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    Figure 1.

    Client Method Choice at Drug Shops for New and Continuing Users, Selected Districts of Uganda, N = 585

  • Figure 2.
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    Figure 2.

    Market Share of Family Planning Servicesa Provided by Clinics, Community Health Workers (CHWs), and Drug Shops in 3 Districts of Uganda, April–June 2011

    a Measured by couple-years of protection delivered by each source.

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    Table 1. Distribution of Study Participants and Other Characteristics by District, Uganda
    BugiriMayugeLuweroNakasongolaTotal
    Total population in 2002a237,441324,674341,317127,064
    No. of drug shop owners interviewed1614121254
    No. (%) of drug shop family planning clients interviewed181 (30.9)168 (28.7)112 (19.2)124 (21.2)585 (100.0)
    No. of government clinics in the evaluation subcountiesb11813N/A32
    No. of community health workers in the evaluation subcountiesb303030N/A90
    • ↵a Data from the 2002 Uganda Population and Housing Census.14

    • ↵b Family planning service statistics from government clinics and CHWs were used for the market share analysis.

    • View popup
    Table 2. Background Characteristics of Drug Shop Family Planning Clients, N = 585
    Characteristics
    Sex, %
     Female90.1
     Male9.9
    Age,a mean (range), y28.8 (13.0–52.0)
    Marital status, %
     Single10.3
     Married66.5
     Unmarried, living together15.7
     Separated/divorced/widowed7.5
    No. of children,a mean (range)3.4 (0.0–13.0)
    Highest level of education completed, %
     Did not attend school6.5
     Kindergarten/nursery school24.8
     Primary43.1
     Secondary or higher25.4
     Missing0.2
    Works for money, %
     Yes77.9
     No15.1
     Missing7.0
    Type of work, %
     Running a shop/stall/business44.3
     Farming24.1
     Housewife12.0
     Other12.6
     Missing7.0
    Socioeconomic status, %
     Very low30.3
     Low29.9
     Medium31.4
     High8.4
    Desires a baby in the future, %70.6
    • ↵a Data are among 584 clients (missing data for 1 client).

    • View popup
    Table 3. Contraceptive Methods Used by Drug Shop Family Planning Clients, N = 585
    CharacteristicPercent
    Method received at drug shop
     DMPA injectable78.6
     Condoms10.9
     Oral contraceptive pills10.2
     Implantsa< 1%
    Ever use of family planning (FP)
     Used FP in the past, same method as current60.3
     Used FP in the past, different method from current29.1
     First-time user10.6
    • ↵a One client reported that she received an implant from a drug shop operator.

    • View popup
    Table 4. Reasons for Switching Methods Among Family Planning Clients Reporting Use of a Different Method in the Past, n = 170
    ReasonsaPercent
    Side effects41
    Excessive/prolonged bleeding24
    Logistics/adherence18
    Couples’ discussion/preference14
    Other12
    • ↵a Total does not sum to 100% because clients could choose more than 1 reason.

    • View popup
    Table 5. Reasons for Switching to the Drug Shop Among Clients Who Switched From Pharmacies or Government Facilities, n = 184
    ReasonsaPercent
    Convenient location43
    Shorter wait time12
    Flexible hours of operation/better service or cost11
    Fewer stock-outs10
    Other10
    Missing22
    • ↵a Total does not sum to 100% because clients could choose more than 1 reason.

    • View popup
    Table 6. Client Perceptions of Quality of Care and Client Satisfaction, N = 585
    CharacteristicPercent
    Friendliness of DSO
     Talked to client in a friendly way89.1
     Did not talk to client much8.7
     Talked to client in a unfriendly way2.2
    DSO treated client with respect100.0
    Trust the DSO will protect privacy
     Yes93.3
     No1.2
     Do not know5.3
     Missing0.2
    Feel family planning DSO services are affordable
     Yes75.6
     Noa21.7
     Missinga2.7
    Will continue to go to DSO for family planning services
     Yes94.0
     No5.5
     Missing0.5
    Satisfied with the way the DSO provided the method
     Yes99.0
     No1.0
    Satisfied with DMPAb
     Very much satisfied73.9
     Somewhat satisfied22.2
     Not at all satisfied3.3
     Missing0.6
    Always go to same DSO for DMPAb
     Yes90.0
     No9.8
     Missing0.2
    • Abbreviations: DSO, drug shop operator; DMPA, depot medroxyprogesterone acetate.

    • ↵a Many of the clients with “no” or “missing” responses had received services for free.

    • ↵b Data among DMPA users only (n = 460).

    • View popup
    Table 7. Client Satisfaction and Reports of Counseling Received (%), by Sex of Drug Shop Operator (DSO),a N = 585
    Services Received by:
    CharacteristicFemale DSOsMale DSOsP Value
    Satisfaction with family planning services received at DSO.54
     Satisfied/somewhat satisfied74.124.4
     Not at all satisfied1.00.5
    DSO discussed:
     Side Effects48.213.5.04
     Advantages42.913.2.48
     Disadvantages28.48.7.75
     Warning signs42.112.7.47
    Would continue to go to DSO for family planning services70.823.7.74
    • P < .05 was considered statistically significant (shown in italics).

    • ↵a The majority of the DSOs were women (42 female DSOs vs. 12 male DSOs).

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Global Health: Science and Practice: 2 (4)
Global Health: Science and Practice
Vol. 2, No. 4
December 01, 2014
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Getting closer to people: family planning provision by drug shops in Uganda
Angela Akol, Dawn Chin-Quee, Patricia Wamala-Mucheri, Jane Harriet Namwebya, Sarah Jilani Mercer, John Stanback
Global Health: Science and Practice Dec 2014, 2 (4) 472-481; DOI: 10.9745/GHSP-D-14-00085

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Getting closer to people: family planning provision by drug shops in Uganda
Angela Akol, Dawn Chin-Quee, Patricia Wamala-Mucheri, Jane Harriet Namwebya, Sarah Jilani Mercer, John Stanback
Global Health: Science and Practice Dec 2014, 2 (4) 472-481; DOI: 10.9745/GHSP-D-14-00085
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