title: Getting closer to people: family planning provision by drug shops in Uganda.
abstract: BACKGROUND
  Private-sector drug shops are often the first point of health care in sub-Saharan Africa. Training and supporting drug shop and pharmacy staff to provide a wide range of contraceptive methods and information is a promising high-impact practice for which more information is needed to fully document implementation experience and impact.
  
  
  METHODS
  Between September 2010 and March 2011, we trained 139 drug shop operators (DSOs) in 4 districts of Uganda to safely administer intramuscular DMPA (depot medroxyprogesterone acetate) contraceptive injections. In 2012, we approached 54 of these DSOs and interviewed a convenience sample of 585 of their family planning clients to assess clients' contraceptive use and perspectives on the quality of care and satisfaction with services. Finally, we compared service statistics from April to June 2011 from drug shops, community health workers (CHWs), and government clinics in 3 districts to determine the drug shop market share of family planning services.
  
  
  RESULTS
  Most drug shop family planning clients interviewed were women with low socioeconomic status. The large majority (89%) were continuing family planning users. DMPA was the preferred contraceptive. Almost half of the drug shop clients had switched from other providers, primarily from government health clinics, mostly as a result of more convenient locations, shorter waiting times, and fewer stock-outs in drug shops. All clients reported that the DSOs treated them respectfully, and 93% trusted the drug shop operator to maintain privacy. Three-quarters felt that drug shops offered affordable family planning services. Most of the DMPA clients (74%) were very satisfied with receiving their method from the drug shop and 98% intended to get the next injection from the drug shop. Between April and June 2011, clinics, CHWs, and drug shops in 3 districts delivered equivalent proportions of couple-years of protection, with drug shops leading marginally at 36%, followed by clinics (33%) and CHWs (31%).
  
  
  CONCLUSIONS
  Drug shops can be a viable and convenient source of short-acting contraceptive methods, including DMPA, serving as a complement to government services. Family planning programs in Uganda and elsewhere should consider including drug shops in the network of community-based family planning providers.
authors.affiliation: FHI 360 Uganda, Kampala, Uganda aakol@fhi360.org.
authors.forename: Angela
authors.initials: A
authors.lastname: Akol
authors.affiliation: FHI 360, Durham, NC, USA.
authors.forename: Dawn
authors.initials: D
authors.lastname: Chin-Quee
authors.affiliation: FHI 360 Uganda, Kampala, Uganda, Now with the Clinton Health Access Initiative, Kampala, Uganda.
authors.forename: Patricia
authors.initials: P
authors.lastname: Wamala-Mucheri
authors.affiliation: FHI 360 Uganda, Kampala, Uganda.
authors.forename: Jane Harriet
authors.initials: JH
authors.lastname: Namwebya
authors.affiliation: FHI 360, Durham, NC, USA.
authors.forename: Sarah Jilani
authors.initials: SJ
authors.lastname: Mercer
authors.affiliation: FHI 360, Durham, NC, USA.
authors.forename: John
authors.initials: J
authors.lastname: Stanback
mesh_terms: D000328:Adult; D003150:Community Health Workers / Q000193:education; D003267:Contraception / Q000379:methods* / Q000706:statistics & numerical data; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D005193:Family Planning Services / Q000193:education / Q000458:organization & administration* / Q000592:standards; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage*; D008875:Middle Aged; D017060:Patient Satisfaction; D010593:Pharmaceutical Services / Q000458:organization & administration / Q000592:standards; D017149:Private Sector; D011787:Quality of Health Care / Q000592:standards; D014454:Uganda; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female; D017258:Medroxyprogesterone Acetate