title: Using a harm reduction lens to examine post-intervention results of medical abortion training among Zambian pharmacists.
abstract: Despite broad grounds for legal abortion in Zambia, access to abortion services remains limited. Pharmacy workers, a primary source of health care for communities, present an opportunity to bridge the gap between policy and practice. As part of a larger operations study, 80 pharmacy workers, both registered pharmacists and their assistants, participated in a training on medical abortion in 2009 and 2010. Fifty-five of the 80 pharmacy workers completed an anonymous, structured training pre-test, treated as a baseline questionnaire; 53 of the 80 trainees were interviewed 12-24 months post-training in face-to-face interviews to measure the retention of information and training effectiveness. Survey questions were selected to illustrate the principles of a harm reduction approach to unsafe abortion. Bivariate analysis was used to examine pharmacy worker knowledge, attitudes and dispensing behaviours pre-training and at follow-up. A higher percentage of pharmacy workers reported referring women to a health care facility between surveys (47% to 68%, p = 0.03). The number of pharmacy workers who reported dispensing ineffective abortifacients decreased from baseline to end-line (30% to 25%) but the difference was non-significant. However, study results demonstrate that Zambian pharmacy workers have a role to play in safe abortion services and some are willing to play that role.
authors.affiliation: Senior Research and Evaluation Advisor, Ipas, Chapel Hill, NC, USA. Electronic address: fetterst@ipas.org.
authors.forename: Tamara
authors.initials: T
authors.lastname: Fetters
authors.affiliation: Independent consultant, Baltimore, MD, USA.
authors.forename: Keris
authors.initials: K
authors.lastname: Raisanen
authors.affiliation: National Reproductive Health Specialist, UNFPA, Lusaka, Zambia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Mupeta
authors.affiliation: Research and Evaluation Advisor, Ipas Zambia, Lusaka, Zambia.
authors.forename: Isikanda
authors.initials: I
authors.lastname: Malisikwanda
authors.affiliation: Consultant Obstetrician-Gynaecologist, University of Zambia School of Medicine, Department of Obstetrics and Gynaecology, Lusaka, Zambia.
authors.forename: Bellington
authors.initials: B
authors.lastname: Vwalika
authors.affiliation: Technical Director of Reproductive and Child Health, AMREF, Nairobi, Kenya.
authors.forename: Joachim
authors.initials: J
authors.lastname: Osur
authors.affiliation: Research and Evaluation Advisor, Ipas, Chapel Hill, NC, USA.
authors.forename: Sally
authors.initials: S
authors.lastname: Dijkerman
mesh_terms: D000028:Abortion, Induced / Q000379:methods* / Q000523:psychology*; D000029:Abortion, Legal / Q000379:methods; D000328:Adult; D004513:Education, Pharmacy, Continuing / Q000379:methods; D005260:Female; D040261:Harm Reduction; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010594:Pharmacies; D010595:Pharmacists / Q000523:psychology*; D011247:Pregnancy; D011795:Surveys and Questionnaires; D015024:Zambia
keywords: Zambia; harm reduction; medical abortion; pharmacists