Factors associated with sale of medication abortion drugs without a prescription in pharmacies and drugstores in Addis Ababa, Ethiopia: Findings from a mystery client study

Résumé fourni par la source

OBJECTIVES: Little is known about the sale of medication abortion drugs without a prescription in pharmacies and drugstores in Ethiopia. We explored factors associated with sale of abortion pills without a prescription in these settings. STUDY DESIGN: Mystery clients visited 600 outlets in Addis Ababa to request abortion pills without a prescription. We ran tests for association to understand factors associated with sale of medication abortion drugs and descriptively analyzed the reasons mystery clients were not sold the pills. RESULTS: Mystery clients were sold medication abortion drugs in one-quarter of visits (23.5%). In multivariable regression, mystery clients assisted by male staff or outlet managers/owners had significantly higher odds of being sold abortion pills compared to female staff (aOR = 1.61; 95% CI = 1.02-2.54) and to employees/staff (aOR = 1.78; 95% CI = 1.06-2.99). Mystery clients who disclosed their marital status and the reason for wanting an abortion had twice the odds of being sold medication abortion drugs compared to those who were not asked these details (aOR = 2.32; 95% CI = 1.37-3.92; and aOR = 2.05; 95% CI = 1.22-3.46, respectively). The outlet not stocking abortion pills was the main reason mystery clients were not sold pills. CONCLUSIONS: The practice of selling abortion pills without a prescription is already happening, and sale of these medications varies significantly by certain staff and visit characteristics. There is potential for involving pharmacists in the expansion of safe abortion services in Ethiopia. IMPLICATIONS: This study provides crucial insights into factors that affect access to abortion care in pharmaceutical outlets in Addis Ababa, Ethiopia. The practice of selling medication abortion drugs without a prescription is happening, and removing barriers to accessing abortion pills from pharmaceutical outlets would greatly expand access to safe abortion in Ethiopia.

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