Medication Abortion Stock and Willingness to Sell in Pharmacies and Drug Stores in Addis Ababa, Ethiopia

Stephanie Kung, Guttmacher Institute
Alice Cartwright, Guttmacher Institute
Delayehu Bekele, St. Paul Institute for Reproductive Health and Rights (SPIRHR)
Niguse Tadele, Addis Ababa University
Mahari Yidego, Performance Monitoring for Action (PMA)
Kidist Lemma, St. Paul’s Hospital Millennium Medical College
Tesfaye Hurisa, St. Paul’s Hospital Millennium Medical College

Background: In Ethiopia, many women seek abortions outside of health facilities. However, evidence is lacking on pharmacy provision of medication abortion (MA) without a prescription. This study aims to assess the availability of MA drugs in pharmacies and drug stores in Addis Ababa, and staff’s willingness to sell without a prescription. Methods: We conducted a two-phase cross-sectional study. First, we collected stock information from 1,548 pharmacies and drug stores in Addis Ababa. Phase 2 assessed MA provision to mystery clients (MCs) who requested something for a missed period at a purposive sample of 600 pharmacies and drug stores. Results: One-quarter (28.8%) of all pharmacies and drug stores reported stocking MA drugs. During 599 MC visits to date, 142 MCs (23.7%) were offered something to bring back their periods. Most MCs (76.1%) were refused; the most common reasons given for refusal included facilities not selling MA drugs (60.1%), no prescription (28.7%), and concerns about serious complications (14.6%). Conclusion: Preliminary findings indicate that provision of MA without a prescription is a somewhat common practice in Addis Ababa. However, refusals were common – and largely for reasons other than need for prescription – likely resulting in differential access to MA for women in Addis Ababa.

Keywords: Sexual and Reproductive Health and Rights

See extended abstract.