Over the counter: The potential for easing pharmacy provision of family planning in Senegal

Background: This research assessed the potential for expanding access to family planning through pharmacies in Senegal, by examining the quality of the services provided through pharmacies, and pharmacy staff and client interest in pharmacy-based family planning services. Methods: This was a cross-sectional, descriptive study conducted in eight urban districts in and around Dakar employing an audit of 250 pharmacies, a survey with 486 pharmacy staff and a survey with 3,569 women exiting pharmacies. Results: Most (54%) pharmacies reported offering method-specific counseling to clients. Family planning  commodities were available in all pharmacies, and 72% had a private space available to offer counseling. Three quarters (76%) did not have any counseling materials available. 49% of pharmacists and 47% of assistant pharmacists reported receiving training on family planning during their professional studies. Half had received counseling training. Few pharmacists met pre-determined criteria to be considered highly knowledgeable of the oral contraceptive pill (OCP) and injectable contraceptive provision (0.6% and 1.1%). Overall, 60% of women surveyed were current family planning users; of these, 11% procured their method through the pharmacy. Among non-users of family planning, and current users who did not obtain their method through a pharmacy, 47% said they would be interested in procuring a method through a pharmacy. Conclusions: Senegal’s urban pharmacies are well-positioned to meet the country’s increasing desire for modern contraception. With proper training, pharmacy staff could better provide effective counseling and provision of OCPs and injectables, and lifting the requirement for a prescription could help support gains in contraceptive prevalence.