Tracy Orr, Senior Technical Officer, FHI 360
Fredrick Mubiru, Technical Advisor, FHI 360
Victoria Lebrun, Research Associate, FHI 360
Uganda’s National Drug Authority has approved the expansion of family planning services that drug shop operators can provide to include injectable contraceptives, both the intramuscular (IM) and innovative subcutaneous (SC) forms of depot medroxyprogesterone acetate (DMPA). This decision follows the Ministry of Health’s endorsement of the practice in March 2021. The policy change enables women to access the country’s most popular family planning method from Uganda’s most commonly visited community-based health providers. Drug shops are a major source for short-term modern methods, but before this policy change they could provide only condoms and contraceptive pills, including emergency contraceptive pills. Now operators with some medical background can receive training on administering injectables and legally provide them.
This policy decision was based on evidence from several studies that demonstrated the safety, acceptability, suitability, and feasibility of this practice in drug shops. More recently, FHI 360 and partner organizations led a study of this practice’s implementation as it was scaled up in 20 districts, working in close partnership with the National Drug Authority and Ministry of Health. A taskforce of national level stakeholders was formed and they used the scale-up data to successfully advocate with the Ministry of Health and subsequently the National Drug Authority for policy change endorsing national scale-up of injectable contraception provision in drug shops. To encourage implementation of this policy by governments and their partners, FHI 360 developed an orientation package composed of our tools and experiences related to drug shop provision of family planning. A two-part workshop was held in late 2020 to orient implementers to these best practices, and an addendum to the CBA2I Implementation Handbook is forthcoming which provides step-by-step guidance for integrating injectables.
The government of Uganda is developing national self-care guidelines, and the addition of DMPA IM and SC to the method mix that drug shops can offer helps further the ability of these trusted first-line providers to serve as a source of self-care for family planning. This policy change positions drug shops to play a significant role in helping the country reduce unmet need for family planning, improve the maternal health status of women, and reach its goal 39.6% contraceptive prevalence rate by 2025.
“The policy change to allow this practice offers the potential of increasing access of more clients to Family Planning information and services nearer to their places of abode which will further improve on our modern contraceptive prevalence rate as a country.” Dr. Mihayo Placid, Senior Consultant/ Family Planning Focal Person, Reproductive Health and Infant Division, Ministry of Health Uganda
FHI 360 and R4S look forward to continuing to support the provision of quality family planning services in drug shops across Uganda.