In July 2017, the Ugandan National Drug Authority (NDA) Board authorized the stocking of injectable contraceptives in private drug shops in 20 select districts.
Until now, local drug shops—often women’s closest healthcare establishment—offered a limited range of family planning methods: pills, condoms, and emergency contraception, alongside other medical products. However, evidence from Uganda and elsewhere indicates that drug shop operators can provide safe and effective injectable contraception.[1] With nearly 10,000 drug shops registered throughout the country[2], advocates saw potential to expand service offerings to include injectable contraception, a popular contraceptive that 6.3% of married modern method users in Uganda now choose.[3]
Beginning in June 2016, Advance Family Planning local partner Reproductive Health Uganda and Opportunity Fund recipient FHI 360 Uganda’s Advancing Partners & Communities project employed a collaborative approach to attain buy-in on the objective of allowing drug shop operators to offer injectable contraceptives. Crucial to the advocacy win was a taskforce comprised of the NDA, the Ministry of Health’s Reproductive Health and Pharmacy Divisions, the Uganda Family Planning Consortium, the Uganda Health Marketing Group, Jhpiego Uganda, the Uganda Nurses and Midwives Council, the Allied Health Professionals’ Council, the Pharmaceutical Board and the Uganda National Medical Council. Before approaching the NDA, the taskforce obtained a key endorsement from the Senior Management Committee of the Ministry of Health.
Navigating the complex structure of a regulatory body like the NDA required flexibility. With the NDA’s guidance, the taskforce developed a scale-up implementation plan, detailed a risk management strategy, and adjusted their strategy to avoid the cumbersome parliamentary process required for legal reclassification.
The taskforce presented its implementation plan to the NDA Board Committee for Essential Medicines and later to the full Board, which approved the plan in July 2017. This authorization allows the Ministry of Health and implementing partners to scale-up provision of injectable contraceptives in drug shops in 20 districts over a one-year period, and is a crucial step toward achieving the long-term goal of full legal reclassification.
To ensure successful implementation, advocates will continue to work with the Ministry of Health to establish a drug shop scale-up committee, hold meetings with implementing partners, review and develop accreditation content, and engage district stakeholders to introduce the implementation.
The Opportunity Fund, managed by PAI with funding from AFP, is a small grants program that helps advocates seize opportunities to accelerate Family Planning 2020’s success at district, state, national, and regional levels.
[1] Drug Shops and Pharmacies: Sources for family planning commodities and information. HIPNET 2017.
[2] NDA, 2016
[3] Uganda: Highlights from Rounds 1-5. PMA2020 2017.