Distribution of pharmacies and clinics
In total, 56 pharmacies and 15 private clinics were identified in both Kenya and Uganda. Kenya had the highest number of facilities (n = 56, 78.9%), of which 76.1% were pharmacies. On the other hand, Uganda had twice as many private clinics as pharmacies.
Table 1 Distribution of pharmacies and private clinics (n = 71)
MA access and client type
A total of 2,366 women and girls visited the 71 pharmacies and clinics in Kenya and Uganda to purchase MA pills for abortion services during the survey period. Of these, 1,742 (73.6%) received MA pills.
Most of the MA clients (n = 1,029; 59.1%) were walk-ins, i.e., had no referral from a medical practitioner. Kenyan women and girls were more likely than Ugandan women and girls to be referred for MA services; the proportion of Ugandan clients who were referred for MA pills in Uganda (10.1%) was significantly lower than the proportion of referred clients in Kenya (49.9%) (p = 0.005). As a participant from Kenya said, “…. These pharmacists you can’t just go and visit them like that (direct walk-ins) and share your problems, you must find someone to refer you and make the initial connections for you to be served better.“ (MA User, 21 years, Kisumu County).
Table 2 MA Access, referrals, and walk-ins (n = 1,742)
Sources of MA information
More than half (n = 744, 72.3%) of the walk-in MA clients learned about MA from friends, peers, and family members in both Kenya (n = 494, 70.5%) and Uganda (n = 250, 76.1%), while healthcare workers were the source of information for 15.8% of Kenyan and 21.7% of Ugandan clients.
Results from the FGD support the findings. One of the participants in the FGD groups stated,
“……. I work in a hair salon. We usually have a very interesting conversation about women’s health. We learn from personal experiences and challenges, including medical abortion.“ (MA User, 32 years, Vihiga County).
Consistently, some MA users learn about MA from family members, as observed during the FGDs, where one MA user had to say,
“My husband keeps saying that the injection will make me disinterested in sex, so we were not using any family planning method but instead relied on safe days, which I may not be sure of, so one day after realizing that I got pregnant again, I shared with my husband, who asked whether it could be that I counted safe days wrongly! After exploring options, he shared with me about MA, which he also learned from other friends. (MA User, 30 years, Vihiga County)
Similarly, another FGD participant noted,
“That is when I went and shared with my mother that story, and my mother told me perhaps we should go and inquire from the chemist because I don’t want your father to know and I don’t want anyone to know that story; it is between me and you.” (MA User, 20 years, Busia County)
While none of the pharmacists from Uganda reported Ipas’s Nimechanuka website as the source of MA information, 58 (8.3%) pharmacists from Kenya had data indicating that MA users learned about MA from the Nimechanuka Website.
In Kenya, 232 (34.3%) MA users learned about MA from youth champions. The corresponding proportion for Uganda is 75% (n = 28). Other MA users relied on previous clients, the internet, and other pharmacies for MA information.
Table 3 Sources of MA information
Costs of MA services
The median cost of a combi-pack in Kenya (USD 20.5; IQR 12.5–115) outweighs the median cost of a full dose of misoprostol (12 tabs) (USD 18; IQR 9–60). In Uganda, the median cost of a combi-pack is USD 6 (IQR 3–7.5), while the median cost of misoprostol is USD 2.6 (IQR 2–6). The cost of MA in Kisumu County, Kenya, is the highest, with a median of USD 62 (IQR 35–250) for a combi pack and USD 20 (IQR 15.2–24) for misoprostol. The cost of MA is lowest in Siaya County, with median costs of USD 7 (IQR 3.5–USD 10) for combi pack and USD 5 (IQR 4.8–USD 9.1) for misoprostol. In Uganda, the cost of MA is highest in the Kawempe division, with a median cost of USD 4.8 (IQR 4.5–USD 5.5) for the combi pack and USD 4 (IQR 1.8
SDGs, Targets, and Indicators
SDGs, Targets, and Indicators
-
SDG 3: Good Health and Well-being
- Target 3.7: By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programs.
- Indicator 3.7.1: Proportion of women of reproductive age (aged 15-49 years) who have their need for family planning satisfied with modern methods.
-
SDG 5: Gender Equality
- Target 5.6: Ensure universal access to sexual and reproductive health and reproductive rights as agreed in accordance with the Program of Action of the International Conference on Population and Development and the Beijing Platform for Action and the outcome documents of their review conferences.
- Indicator 5.6.1: Proportion of women aged 15-49 years who make their own informed decisions regarding sexual relations, contraceptive use, and reproductive health care.
-
SDG 10: Reduced Inequalities
- Target 10.2: By 2030, empower and promote the social, economic, and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion, or economic or other status.
- Indicator 10.2.1: Proportion of people living below 50 percent of median income, by age, sex, and persons with disabilities.
Analysis
1. Which SDGs are addressed or connected to the issues highlighted in the article?
The issues highlighted in the article are connected to SDG 3 (Good Health and Well-being), SDG 5 (Gender Equality), and SDG 10 (Reduced Inequalities).
2. What specific targets under those SDGs can be identified based on the article’s content?
Based on the article’s content, the specific targets that can be identified are:
– Target 3.7: Ensure universal access to sexual and reproductive health-care services, including for family planning.
– Target 5.6: Ensure universal access to sexual and reproductive health and reproductive rights.
– Target 10.2: Empower and promote the social, economic, and political inclusion of all.
3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?
Yes, there are indicators mentioned or implied in the article that can be used to measure progress towards the identified targets:
– Indicator 3.7.1: Proportion of women of reproductive age (aged 15-49 years) who have their need for family planning satisfied with modern methods.
– Indicator 5.6.1: Proportion of women aged 15-49 years who make their own informed decisions regarding sexual relations, contraceptive use, and reproductive health care.
– Indicator 10.2.1: Proportion of people living below 50 percent of median income, by age, sex, and persons with disabilities.
Table: SDGs, Targets, and Indicators
| SDGs | Targets | Indicators |
|---|---|---|
| SDG 3: Good Health and Well-being | Target 3.7: Ensure universal access to sexual and reproductive health-care services, including for family planning. | Indicator 3.7.1: Proportion of women of reproductive age (aged 15-49 years) who have their need for family planning satisfied with modern methods. |
| SDG 5: Gender Equality | Target 5.6: Ensure universal access to sexual and reproductive health and reproductive rights. | Indicator 5.6.1: Proportion of women aged 15-49 years who make their own informed decisions regarding sexual relations, contraceptive use, and reproductive health care. |
| SDG 10: Reduced Inequalities | Target 10.2: Empower and promote the social, economic, and political inclusion of all. | Indicator 10.2.1: Proportion of people living below 50 percent of median income, by age, sex, and persons with disabilities. |
Behold! This splendid article springs forth from the wellspring of knowledge, shaped by a wondrous proprietary AI technology that delved into a vast ocean of data, illuminating the path towards the Sustainable Development Goals. Remember that all rights are reserved by SDG Investors LLC, empowering us to champion progress together.
Source: bmcwomenshealth.biomedcentral.com
Join us, as fellow seekers of change, on a transformative journey at https://sdgtalks.ai/welcome, where you can become a member and actively contribute to shaping a brighter future.
