Assessing the Medication Abortion Drug Dispensing Practices of Private Sector Chemists through Mystery Client surveys in Nepal

Assessing the Medication Abortion Drug Dispensing Practices of Private Sector Chemists through Mystery Client surveys in Nepal

Background: Unplanned pregnancies remain a common problem in Nepal, despite a decline in the total fertility rate from 5.1 births per woman in 1984-1986 to 2.6 births in 2008-2010. Specifically, 27.5% of currently married women of reproductive age (WRA) have an unmet need for family planning. Furthe...

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Format: Technical Report
Language:en_US
Published: Population Services International Nepal, Dhobighat, Lalitpur 2016
Subjects:
drug dispensing practices
medication abortion
mystery client surveys
Nepal
private sector chemists
Online Access:http://103.69.126.140:8080/handle/123456789/172
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spelling oai:103.69.126.140:123456789-1722022-11-08T10:29:27Z Assessing the Medication Abortion Drug Dispensing Practices of Private Sector Chemists through Mystery Client surveys in Nepal Reproductive Health drug dispensing practices medication abortion mystery client surveys Nepal private sector chemists Background: Unplanned pregnancies remain a common problem in Nepal, despite a decline in the total fertility rate from 5.1 births per woman in 1984-1986 to 2.6 births in 2008-2010. Specifically, 27.5% of currently married women of reproductive age (WRA) have an unmet need for family planning. Furthermore, maternal morbidity and mortality due to unsafe abortions remain high, with estimates that about half of maternal deaths are due to unsafe abortion Methods: In February 2013, PSI/Nepal conducted a Mystery Client (MC) survey with 260 chemists to gather information about MA dispensing practices and counseling behavior amongst chemists. Two scenarios were developed to represent different types of possible clients: in Scenario A, the wife is 6-7 weeks pregnant and in the Scenario B the wife is 13-14 weeks pregnant. Results: Only 14% chemists from Scenario A and 65.4% chemists from Scenario B followed this protocol. Only 5% chemists are selling MA drug for less than Rs 500 (the PSI recommended price is Rs 425).Chemists are still recommending separate pack drugs and Ayurvedic drugs for MA. Only 75.8% clients were given correct counseling on MA drug regimens, 80.7% on route of administration, 72% on possible side effects, 82.8% on symptoms of complications, and 66.1% on adverse events and complications. Many chemists do not use a referral mechanism to government approved Safe Abortion Services (SAS) sites when clients are above 9 weeks of gestation, have adverse events, or experienced complications Conclusions: A stronger market monitoring mechanism and advocacy are needed to ensure that chemists are selling MA drugs, particularly Medabon, within government protocol. A market supervision mechanism should be further improved to monitor adherence to recommended price amongst private sector chemists. Provider Behavior Change Communication (PBCC) activities and program messages should continue to focus on the use of safe MA drugs like Medabon over unsafe MA drugs. Efforts should focus on improving chemists’ knowledge and counseling skills so that they can provide complete and better quality services to their clients. Increase the availability of communication materials like posters to increase client awareness. PBCC efforts should re-emphasize this important aspect of the MA provision. Keywords: drug dispensing practices; medication abortion; mystery client surveys; Nepal; private sector chemists. 2016-11-13T07:11:31Z 2022-11-08T10:10:49Z 2016-11-13T07:11:31Z 2022-11-08T10:10:49Z 2013 Technical Report Population Services International Nepal, Dhobighat, Lalitpur http://103.69.126.140:8080/handle/123456789/172 en_US application/vnd.openxmlformats-officedocument.wordprocessingml.document Population Services International Nepal, Dhobighat, Lalitpur
institution My University
collection DSpace
language en_US
topic drug dispensing practices
medication abortion
mystery client surveys
Nepal
private sector chemists
spellingShingle drug dispensing practices
medication abortion
mystery client surveys
Nepal
private sector chemists
Assessing the Medication Abortion Drug Dispensing Practices of Private Sector Chemists through Mystery Client surveys in Nepal
description Background: Unplanned pregnancies remain a common problem in Nepal, despite a decline in the total fertility rate from 5.1 births per woman in 1984-1986 to 2.6 births in 2008-2010. Specifically, 27.5% of currently married women of reproductive age (WRA) have an unmet need for family planning. Furthermore, maternal morbidity and mortality due to unsafe abortions remain high, with estimates that about half of maternal deaths are due to unsafe abortion Methods: In February 2013, PSI/Nepal conducted a Mystery Client (MC) survey with 260 chemists to gather information about MA dispensing practices and counseling behavior amongst chemists. Two scenarios were developed to represent different types of possible clients: in Scenario A, the wife is 6-7 weeks pregnant and in the Scenario B the wife is 13-14 weeks pregnant. Results: Only 14% chemists from Scenario A and 65.4% chemists from Scenario B followed this protocol. Only 5% chemists are selling MA drug for less than Rs 500 (the PSI recommended price is Rs 425).Chemists are still recommending separate pack drugs and Ayurvedic drugs for MA. Only 75.8% clients were given correct counseling on MA drug regimens, 80.7% on route of administration, 72% on possible side effects, 82.8% on symptoms of complications, and 66.1% on adverse events and complications. Many chemists do not use a referral mechanism to government approved Safe Abortion Services (SAS) sites when clients are above 9 weeks of gestation, have adverse events, or experienced complications Conclusions: A stronger market monitoring mechanism and advocacy are needed to ensure that chemists are selling MA drugs, particularly Medabon, within government protocol. A market supervision mechanism should be further improved to monitor adherence to recommended price amongst private sector chemists. Provider Behavior Change Communication (PBCC) activities and program messages should continue to focus on the use of safe MA drugs like Medabon over unsafe MA drugs. Efforts should focus on improving chemists’ knowledge and counseling skills so that they can provide complete and better quality services to their clients. Increase the availability of communication materials like posters to increase client awareness. PBCC efforts should re-emphasize this important aspect of the MA provision. Keywords: drug dispensing practices; medication abortion; mystery client surveys; Nepal; private sector chemists.
format Technical Report
title Assessing the Medication Abortion Drug Dispensing Practices of Private Sector Chemists through Mystery Client surveys in Nepal
title_short Assessing the Medication Abortion Drug Dispensing Practices of Private Sector Chemists through Mystery Client surveys in Nepal
title_full Assessing the Medication Abortion Drug Dispensing Practices of Private Sector Chemists through Mystery Client surveys in Nepal
title_fullStr Assessing the Medication Abortion Drug Dispensing Practices of Private Sector Chemists through Mystery Client surveys in Nepal
title_full_unstemmed Assessing the Medication Abortion Drug Dispensing Practices of Private Sector Chemists through Mystery Client surveys in Nepal
title_sort assessing the medication abortion drug dispensing practices of private sector chemists through mystery client surveys in nepal
publisher Population Services International Nepal, Dhobighat, Lalitpur
publishDate 2016
url http://103.69.126.140:8080/handle/123456789/172
_version_ 1761500933069471744

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