Pharmacies enabling youth ‘self-care’ in sexual and reproductive health

Older adolescents and young adults between the ages of 15–24 years (collectively termed ‘youth’) face a variety of barriers when trying to access sexual and reproductive health (SRH) services – particularly contraceptive services – from health facilities.1 Policy restrictions and community norms which deem youth access ‘inappropriate’ can dissuade young people from going to a facility. Those who do go often encounter ‘unfriendly’ staff, and facilities with inconvenient opening hours or a lack of confidentiality and privacy.1

In recent years, evidence on the safety and efficacy of contraceptives, coupled with global commitments by countries and donors to address health systems barriers and expand access to contraception (eg, Family Planning 20202), have resulted in key services and products being made available outside of health facilities.3 As a result, certain contraceptive products, including emergency contraception and daily contraceptive pills, are now available through retail pharmacies and drug shops (lower-tier establishments which do not employ a trained pharmacist, and are limited in the drugs they can dispense4).5 Additionally, the recent advance of self-administered injectable contraception reflects a trend towards broader ‘self-care’ (individuals addressing their own health needs, with or without the support of a healthcare provider) and user autonomy in accessing and using modern contraceptive methods.6 7

Pharmacies and drug shops, therefore, could be considered an important alternate contraception source for young people, especially in low- and middle-income countries (LMICs).4 Yet they …