Author(s): Huda FA, Ngo TD, Ahmed A, Alam A, Reichenbach L
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Abstract OBJECTIVE: To explore the availability and provision of misoprostol and other medicines for menstrual regulation (MR) among pharmacies in Bangladesh. METHODS: Between March and November 2011, a cross-sectional study using mystery client visits was conducted among pharmacy workers in Dhaka and Gazipur Districts, Bangladesh. Mystery clients were trained to present 1 of 4 pre-developed situations to pharmacy workers to elicit information on the regimen, adverse effects, and complications of misoprostol use. RESULTS: Mystery clients visited 331 pharmacies. Among the 331 pharmacy workers, 45.8\% offered the mystery clients misoprostol and/or other medicines for MR; 25.7\% referred them to private clinics or hospitals. Only 7\% recommended an effective regimen of misoprostol for MR; 65\% suggested administering vaginal and oral misoprostol together. Overall, 72.4\% did not provide any advice on complications; the remainder suggested visiting trained providers for complications. Counseling on excessive bleeding as a danger sign was provided by 46\% of pharmacy workers. Most (94\%) did not provide or refer for post-MR family planning. CONCLUSION: Pharmacy workers in urban Bangladesh are providing ineffective drugs and regimens for MR. A training package is needed to strengthen service delivery by providing accurate information, high-quality products, and referral mechanisms for women seeking MR through pharmacies. © 2013.
This article was published in Int J Gynaecol Obstet
and referenced in Journal of Pharmaceutical Care & Health Systems