Key Role of Drug Shops and Pharmacies for Family Planning in Urban Nigeria and Kenya

Meghan Corroon; Essete Kebede; Gean Spektor; Ilene Speizer

doi:10.9745/GHSP-D-16-00197

Figures & Tables

Tables

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TABLE 1.

Descriptive Characteristics of Surveyed Women Who Had Sex in the Last Year in Selected Urban Areas, by Country, 2010/2011

Characteristic	Nigeria (N = 11,930)	Kenya (N = 7,085)
Characteristic	No. (%)	No. (%)
Age category, years
15–24	2429 (20.4)	2476 (35.0)
25–34	5296 (44.4)	3100 (43.8)
≥35	4205 (35.2)	1509 (21.3)
Highest education level
None/Quranic	1653 (13.9)	429 (6.1)
Primary	2030 (17.0)	2673 (37.7)
Secondary	5140 (43.1)	2740 (38.7)
Higher	3027 (25.4)	1243 (17.5)
Missing	81 (0.7)	0 (0.0)
Religion
Christian	5832 (48.9)	6318 (89.2)
Muslim	5969 (50.0)	621 (8.8)
No religion/other/none/missing	128 (1.1)	146 (2.1)
Marital/relationship status
Never married	1835 (15.4)	1584 (22.4)
Married/living together	9703 (81.3)	4884 (68.9)
Divorced/separated	160 (1.3)	505 (7.1)
Widowed	93 (0.8)	108 (1.5)
Missing	139 (1.2)	4 (0.1)
Has at least one living child
No	2353 (19.7)	1510 (21.3)
Yes	9577 (80.3)	5574 (78.7)
Wealth quintile
Poorest	2206 (18.5)	1280 (18.1)
Poor	2434 (20.4)	1352 (19.1)
Middle	2510 (21.0)	1495 (21.1)
Rich	2462 (20.6)	1467 (20.7)
Richest	2319 (19.4)	1491 (21.1)
City (Nigeria/Kenya)
Abuja/Nairobi	1594 (13.4)	5150 (72.7)
Benin City/Mombasa	1564 (13.1)	1325 (18.7)
Ibadan/Kisumu	2487 (20.8)	382 (5.4)
Ilorin/Machakos	1993 (16.7)	103 (1.4)
Kaduna/Kakamega	2853 (23.9)	126 (1.8)
Zaria/NA	1440 (12.1)	NA
Current contraceptive use
No method	7409 (62.1)	3116 (44.0)
Long-acting method	406 (3.4)	508 (7.2)
Short-acting method	2750 (23.1)	3048 (43.0)
Natural/traditional methods	1365 (11.4)	413 (5.8)
Type of short-acting method among short-acting method users
Injectable	722 (26.2)	1511 (49.6)
Oral contraceptive pill	372 (13.5)	860 (28.2)
Emergency contraception	214 (7.8)	87 (2.9)
Condom	1440 (52.4)	589 (19.3)
Spermicide	3 (0.1)	0 (0.0)

Note: All analyses are weighted; unweighted total for Nigeria was 11,873, and for Kenya 7,226.

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TABLE 2.

Method Source Among Surveyed Women Using a Short-Acting Method and Who Had Sex in the Last Year in Selected Urban Areas, by Country and Method, 2010/2011

Source	Nigeria						Kenya
Source	Injectable (n = 722)	OCP (n = 372)	EC (n = 214)	Condom (n = 1440)	Other modern (n = 3)	Total short-acting (N = 2750)	Injectable (n = 1511)	OCP (n = 860)	EC (n = 87)	Condom (n = 587)	Total short-acting (N = 3048)
Public facility	60.5	20.9	2.9	4.6	68.7	21.4	50.8	30.6	10.4	9.2	35.9
Private facility	22.3	4.2	3.3	2.4	31.3	8.0	42.7	25.5	9.0	10.1	30.6
Pharmacy (Nigeria); Pharmacy/drug shop (Kenya)	3.4	22.3	32.6	27.6	0.0	20.9	6.2	43.7	76.5	75.0	32.1
Drug shop/PPMV (Nigeria)	10.6	49.0	52.4	46.4	0.0	37.8	NA	NA	NA	NA	NA
Other	0.6	0.3	1.0	7.5	0.0	4.4	0.0	0.2	0.0	1.4	0.4
Don't know/missing	2.6	3.2	7.8	11.5	0.0	7.8	0.3	0.0	4.1	4.2	1.1
Total	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0

Abbreviations: EC, emergency contraception; OCP, oral contraceptive pill; PPMV, proprietary patent medicine vendor.

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TABLE 3.

Characteristics of Drug Shops and Pharmacies Surveyed in Selected Urban Areas of Nigeria and Kenya, 2010/2011

	% of Nigerian Pharmacies (n = 433)	% of Nigerian Drug Shops (n = 555)	% of Kenyan Pharmacies/Drug Shops (n = 223)
Number of years open/in operation
Less than 5	19.6	31.9	42.2
5 to 10	31.2	34.8	21.1
11 to 15	15.9	14.8	15.7
More than 15	16.9	12.3	11.7
Don't know	16.2	6.1	9.4
Missing	0.2	0.2	0.0
Number of operating hours per day
Less than 5	0.2	0.5	1.4
5 to 10	13.2	16.6	26.5
11 to 15	73.2	72.4	66.8
More than 15	13.4	9.9	4.0
Missing	0.0	0.5	1.4
Number of operating days per week
5	1.2	0.7	2.7
6	47.1	41.8	45.7
7	51.7	57.3	49.8
Missing	0.0	0.2	1.8
Number of regular, permanent staff
Less than 5	69.8	92.4	79.8
5 to 10	22.6	1.6	11.7
11 to 15	1.9	0.0	5.4
More than 15	3.0	0.0	1.8
Missing	2.8	6.0	1.4
Outlet provides family planning methods
Yes	95.8	87.0	98.2
No	3.0	12.6	1.8
Missing/Don't know	1.2	0.4	0.0
Observed family planning promotional materials on display
Displayed	32.8	20.4	48.9
Not displayed	65.1	78.7	50.7
Missing	2.1	0.9	0.5
Person interviewed ever received training on family planning
Yes	40.7	40.7	57.0
No	59.1	57.7	42.6
Don't know	0.2	1.6	0.0
Missing	0.0	0.0	0.5

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TABLE 4.

Contraceptive Methods Offered in Surveyed Pharmacies and Drug Shops in Selected Urban Areas, by Facility Type and Country, 2010/2011

Method Offered	% of Nigerian Pharmacies (n = 415)	% of Nigerian Drug Shops (n = 483)	% of Kenyan Pharmacies/Drug Shops (n = 219)
Injectable	69.6	20.1	68.0
Combined oral pill	76.6	64.8	98.2
Progestin-only pill	4.3	1.9	14.6
Emergency contraception	70.4	37.9	92.7
Male condom	98.8	98.1	93.6
Female condom	31.8	14.1	5.9
Spermicide	1.5	0.4	NA

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TABLE 5.

Surveyed Facilities Requiring a Prescription for Clients to Receive a Contraceptive Method in Selected Urban Areas, by Facility Type and Country, 2010/2011

	Nigerian Pharmacies	Nigerian Drug Shops	Kenyan Pharmacies/Drug Shops
	No. Providing Method (% Requiring Rx)	No. Providing Method (% Requiring Rx)	No. Providing Method (% Requiring Rx)
Injectable	289 (41.9)	97 (55.7)	149 (56.4)
Combined oral pill	318 (39.3)	313 (39.0)	215 (25.1)
Progestin only pill	18 (55.6)	9 (44.4)	32 (34.4)
Emergency contraceptives	292 (33.2)	183 (29.5)	203 (10.8)
Male condom	410 (14.2)	474 (12.2)	205 (1.0)
Female condom	132 (14.4)	68 (5.9)	13 (0.0)
Spermicide	6 (33.3)	2 (100.0)	NA

Abbreviation: Rx, prescription.

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TABLE 6.

Multinomial Logistic Regression Coefficients (Standard Errors) Comparing Source of Method Among Surveyed Women Using Short-Acting Methods, Selected Urban Areas of Nigeria, 2010/2011 (N=2,565)

	Pharmacy/Drug Shop vs. Public	Pharmacy/Drug Shop vs. Private	Public vs. Private
	Column 1	Column 2	Column 3
Marital status (Ref: Married)
Never married	1.00 (0.41)^*	0.10 (0.46)	−0.89 (0.57)
Divorced/separated/widowed	0.77 (0.41)⁺	−0.27 (0.45)	−1.04 (0.56)⁺
Religion (Ref: Christian)
Muslim	−0.33 (0.13)^**	−0.11 (0.21)	0.22 (0.22)
No religion	0.54 (0.80)	−1.31 (0.67)	−1.85 (0.91)^*
Age (Ref: Age ≥35)
<25	1.13 (0.21)^***	0.54 (0.31)⁺	−0.59 (0.34)⁺
25–34	0.66 (0.12)^***	0.45 (0.18)^*	−0.21 (0.18)
Education (Ref: None)
Primary	0.06 (0.26)	0.33 (0.38)	0.27 (0.38)
Secondary	0.26 (0.27)	0.12 (0.38)	−0.14 (0.38)
Higher than secondary	0.45 (0.28)	0.49 (0.41)	0.04 (0.42)
Wealth (Ref: Poorest)
Poor	0.31 (0.19)	0.19 (0.28)	−0.11 (0.30)
Middle	0.26 (0.19)	0.14 (0.29)	−0.12 (0.30)
Rich	0.24 (0.20)	0.11 (0.31)	−0.13 (0.31)
Richest	0.42 (0.23)	−0.38 (0.31)	−0.80 (0.35)^*
City (Ref: Ibadan)
Abuja	−1.05 (0.19)^***	0.31 (0.34)	1.37 (0.36)^***
Benin City	−0.15 (0.20)	−0.43 (0.27)	−0.27 (0.31)
Ilorin	0.13 (0.16)	−0.62 (0.26)^*	−0.75 (0.27)^**
Kaduna	−0.86 (0.18)^***	−0.73 (0.28)^**	0.13 (0.29)
Zaria	−1.35 (0.24)^***	−1.32 (0.39)^***	0.03 (0.32)
Any living children	−1.22 (0.43)^**	−1.48 (0.52)^**	−0.26 (0.65)
Constant	1.30 (0.56)^*	2.98 (0.68)^***	1.69 (0.81)^*

Note: Don't know, other, and missing options modeled but not shown in comparisons.
↵+ P≤.10;
↵* P≤.05;
↵** P≤.01;
↵*** P≤.001.

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TABLE 7.

Multinomial Logistic Regression Coefficients (Standard Errors) Comparing Source of Method Among Surveyed Women Using Short-Acting Methods, Selected Urban Areas of Kenya, 2010/2011 (N=3,049)

	Pharmacy/Drug Shop vs. Public	Pharmacy/Drug Shop vs. Private	Public vs. Private
	Column 1	Column 2	Column 3
Marital status (Ref: Married)
Never married	1.17 (0.15)^***	1.13 (0.19)^***	−0.04 (0.17)
Divorced/separated/widowed	0.93 (0.18)^***	0.66 (0.21)^**	−0.26 (0.18)
Religion (Ref: Christian)
Muslim	0.32 (0.23)	0.39 (0.25)	0.08 (0.22)
No religion	0.19 (0.48)	0.21 (0.46)	0.02 (0.47)
Age (Ref: Age ≥35)
<25	−0.26 (0.16)	−0.17 (0.17)	0.09 (0.15)
25–34	−0.20 (0.14)	−0.17 (0.16)	0.02 (0.13)
Education (Ref: None)
Primary	0.02 (0.30)	0.29 (0.31)	0.27 (0.23)
Secondary	0.22 (0.30)	0.52 (0.31)⁺	0.30 (0.22)
Higher than secondary	0.82 (0.32)^*	0.74 (0.34)^*	−0.08 (0.27)
Wealth (Ref: Poorest)
Poor	0.24 (0.16)	0.13 (0.18)	−0.10 (0.14)
Middle	0.35 (0.17)^*	0.12 (0.18)	−0.23 (0.15)
Rich	0.50 (0.16)^**	0.27 (0.19)	−0.23 (0.17)
Richest	1.24 (0.20)^***	0.26 (0.22)	−0.98 (0.20)^***
City (Ref: Kisumu)
Nairobi	0.73 (0.17)^***	−0.17 (0.18)	−0.91 (0.15)^***
Mombasa	0.63 (0.19)^**	−0.67 (0.21)^**	−1.30 (0.18)^***
Machakos	0.13 (0.17)	0.70 (0.22)^**	0.57 (0.20)^**
Kakamega	0.73 (0.19)^***	0.87 (0.24)^***	1.60 (0.22)^***
Any living children	−1.76 (0.19)^***	−1.25 (0.21)^***	0.51 (0.23)^*
Constant	−0.28 (0.38)	0.22 (0.43)	0.50 (0.36)