Emergency Contraceptive Dispensing Practices and Associated Factors in Community Pharmacies in Ga East Municipal, Greater Accra, Ghana

Abstract

Background: Community pharmacies have been the commonest source of emergency contraceptives for many women in developing countries. Despite the high levels of emergency contraceptive use sourcing from community pharmacies amongst women, studies report misuse of emergency contraceptives. There is currently limited evidence on emergency contraceptive dispensing practices and associated factors in community pharmacies. In particular, no studies have been conducted on the subject in the Ga East Municipality in Accra. This knowledge gap could hamper understanding of dispensing practices by community pharmacy staff when approached by people seeking emergency contraceptives. Objective: The main objective of the study was to examine emergency contraceptive dispensing practices and associated factors in community pharmacies in the Ga East Municipality in the Greater Accra region of Ghana. Method: A cross-sectional quantitative survey, complimented by a mystery client survey, was conducted. Data was collected from community pharmacy staff within community pharmacies in the Ga East Municipality. A total census was done involving all139 community pharmacies within the municipality. Data was collected by research assistants using interviewer-administered questionnaires. Participants were community pharmacy staff who dispense emergency contraceptives, available at the time of data collection and fully consent to partake in the study. Data collected included community pharmacy characteristics, socio-demographic characteristics of respondents and emergency contraceptive dispensing practices. Out of the 139 community pharmacies interviewed, 76 of them were randomly selected and visited by mystery clients to determine what community pharmacy staff do when they see clients for emergency contraceptives services. Data was then descriptively analysed using frequency distribution to describe important characteristics of respondents. Also, bivariate and regression analyses were conducted to investigate factors associated with dispensing practices. This study received ethics approved from the Ghana Health Service Ethics Review Committee. Results: Emergency contraceptives are widely available in community pharmacies within Ga East Municipality. Ninety-five percent (n=132) of community pharmacies had stock of emergency contraceptives as at the time of interview. Only 18% (n=25) of interviewed participants reported to appropriately dispense emergency contraceptives but none of the community pharmacy staff approached by mystery clients appropriately dispensed emergency contraceptives. Attitude of community pharmacy staff towards ECs use (p=0.0064), years of professional practice (p=0.0058) and availability of a counselling area or space within the community pharmacy (p=0.0006) were found to be significantly associated with emergency contraceptive dispensing in community pharmacies. Regression analysis of results from this study showed having a counselling area in the community pharmacy (AOR=5, CI=1.99-12.6, p=0.001) and longer years of professional practice (<10 years) (AOR=5.5, CI=1.13-25.81, p=0.035), increases the odds of appropriate emergency contraceptive dispensing. Conclusion: Emergency contraceptives are being inappropriately dispensed in community pharmacies in Ga East Municipality. This suggests the need for the development of a standard protocol for the dispensing of emergency contraceptives in community pharmacies.