Provision of FP services by small private outlets in Kinshasa, DRC
Short – title: EC Mystery Client Study
Role: Prime Recipient
Donor: The David and Lucille Packard Foundation
The objective of this research was to build the evidence base on emergency contraceptive services availability and quality in small, private pharmacies operating throughout Kinshasa via a mystery client study.
- Produce new evidence on the capacity of drugstore operators to provide quality emergency contraceptive services to young women living in Kinshasa
- Develop advocacy brief supporting policy changes towards the inclusion of informal drugstore as FP service delivery points in DR Congo.
The objective of this research was to build the evidence base on FP services availability and quality in small, private pharmacies operating throughout Kinshasa. While this type of outlet is the most commonly used (especially by youth and adolescents) as a source of contraceptives, very little is known about the FP methods and counseling they provide. Because almost all of these pharmacies are “informal” (i.e. are operating without prior registration with the Ministry of Health), the general perception among nation FP program officers is that they offer uniformly poor service.
This study built on previously conducted research on perception, use, and access to emergency contraceptive pills (EC) in Kinshasa and used EC as a gateway to observe pharmacy providers’ knowledge and attitudes towards young women asking for help to avoid unintended pregnancies.
The research team used a “mystery clients” (MC, sometimes called “simulated clients”) design to obtain unbiased data on EC provision and additional FP services available at informal pharmacies operating in Kinshasa. Twelve MC (aged 16 to 22) were trained to follow the visit script, which involved posing as a young woman who had unprotected sex “the other night” and wanted a solution to “avoid getting pregnant”. The MCs were specifically instructed not to mention EC by name unless the provider mentioned it first. MCs were also trained to wait for specific questions or additional information the pharmacy personnel may spontaneously provide (about the timing of using EC, dosage, possible side effects, other FP methods) before using questions that might prompt the provider to give this information. Finally, the MCs were trained to observe the provider’s attitude during the interaction.
In total, the MC visited 854 private pharmacies throughout Kinshasa. The key findings of this study were presented in Kinshasa and contributed to the evidence base supporting policy change towards drugstores capacity to provide contraceptive services (See also – CHAI Study)
Results for the study were published in International Perspectives on Sexual and Reproductive Health in 2020.
Hernandez, J. H., Akilimalib, P., & Mbadu, M. F. (2020). Provision of Emergency Contraceptive Pills in Kinshasa’s Informal Drug Shops: Results from a Mystery Client Study. International perspectives on sexual and reproductive health, 46, 89-97.