Over the counter: The potential for easing pharmacy provision of family planning in urban Senegal.

Background: This research assessed the potential for expanding access to family planning through private sector pharmacies in Senegal, by examining the quality of the services provided through private sector pharmacies, and pharmacy staff and client interest in private sector pharmacy-based family planning services. Methods: This was a cross-sectional, descriptive study conducted in eight urban districts in and around Dakar and two urban districts outside of Dakar employing an audit of 225 pharmacies, a survey with 486 private sector pharmacy staff and a survey with 3,567 women exiting private sector pharmacies. Results: Most (54%) pharmacies reported offering method-specific counseling to clients. Family planning  commodities were available in all pharmacies, and 72% had a private space available to offer counseling. Three quarters (76%) did not have any counseling materials available. 49% of pharmacists and 47% of assistant pharmacists reported receiving training on family planning during their professional studies. Half had received counseling training. Few pharmacists met pre-determined criteria to be considered highly knowledgeable of the oral contraceptive pill (OCP) and injectable contraceptive provision (0.6% and 1.1%). Overall, 60% of women surveyed were current family planning users and 11% procured their method through a private sector pharmacy. Among non-users of family planning, and current users who did not obtain their method through a pharmacy, 47% said they would be interested in procuring a method through a private sector pharmacy. Conclusions: There is both actual and latent demand for accessing family planning through Senegal's urban, private sector pharmacies. With proper training, pharmacy staff could better provide effective counseling and provision of OCPs and injectables, and lifting the requirement for a prescription could help support gains in contraceptive prevalence.