title: Injected with controversy: sales and administration of injectable contraceptives in drug shops in Uganda.
abstract: BACKGROUND
  Informal drug shops are the first line of health care in many poor countries. In Uganda, these facilities commonly sell and administer the injectable contraceptive depot medroxyprogesterone acetate (DMPA), even though they are prohibited by law from selling any injectable drugs. It is important to understand drug shop operators' current practices and their potential to provide DMPA to hard-to-reach populations.
  
  
  METHODS
  Between November 2007 and January 2008, 157 drug shops were identified in three rural districts of Uganda, and the operators of the 124 facilities that sold DMPA were surveyed. Data were analyzed with descriptive methods.
  
  
  RESULTS
  Only 35% of operators reported that the facility in which they worked was a licensed drug shop and another 9% reported that the facility was a private clinic; all claimed to have some nursing, midwifery, or other health or medical qualification. Ninety-six percent administered DMPA in the shop. Operators gave a mean of 10 injections (including three of DMPA) per week. Forty-three percent of those who administered DMPA reported disposing of used syringes in sharps containers; in the previous 12 months, 24% had had a needle-stick injury and 17% had had a patient with an injection-related abscess. Eleven percent said they had ever reused a disposable syringe. Overall, contraceptive knowledge was low, and attitudes toward family planning reflected common traditional biases.
  
  
  CONCLUSIONS
  Provision of DMPA is common in rural drug shops, but needs to be made safer. Absent stronger regulation and accreditation, drug shop operators can be trained as community-based providers to help meet the extensive unmet demand for family planning in rural areas.
authors.affiliation: Family Health International, Durham, NC, USA. jstanback@fhi.org
authors.forename: John
authors.initials: J
authors.lastname: Stanback
authors.forename: Conrad
authors.initials: C
authors.lastname: Otterness
authors.forename: Martha
authors.initials: M
authors.lastname: Bekiita
authors.forename: Olivia
authors.initials: O
authors.lastname: Nakayiza
authors.forename: Anthony K
authors.initials: AK
authors.lastname: Mbonye
mesh_terms: D001291:Attitude of Health Personnel; D003280:Contraceptives, Oral, Synthetic / Q000008:administration & dosage* / Q000009:adverse effects; D005193:Family Planning Services; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology* / Q000706:statistics & numerical data*; D006801:Humans; D007267:Injections / Q000009:adverse effects; D007407:Interviews as Topic; D008297:Male; D008525:Medroxyprogesterone / Q000008:administration & dosage* / Q000009:adverse effects; D008880:Midwifery; D016602:Needlestick Injuries / Q000453:epidemiology; D009726:Nurses / Q000523:psychology; D010594:Pharmacies; D012424:Rural Population; D014454:Uganda / Q000453:epidemiology
chemical_list: D003280:Contraceptives, Oral, Synthetic; D008525:Medroxyprogesterone