My previous article touched on some of the pros and cons that Ugandan women balance when using the popular injectable contraceptive Depo-Provera. While severe side effects include heavy bleeding, cramps and aches, and excessive weight loss (among others) the shot is also an affordable, effective method of preventing pregnancy. It is also widely available in most communities – even some areas that are considered more remote.
This article was in response to a study recently published by the Guttmacher Institute on the controversial sale of Depo-Provera in drug shops in Uganda. According to national law, drug shops are not permitted to sell either prescription medication or injectable substances to customers. The reality is that most drug shops do, despite the fact that roughly 30 percent of drug shop attendants lack formal medical training or experience. On one hand, because drug shops are the most widely accessible sites for Ugandans to obtain medical treatment, it is tremendously positive that they sell this form of contraception. On the other hand, keeping in mind the horrifically adverse side effects many women experience while using the Depo shot, the ease with which women can receive this sometimes dangerous drug is disconcerting. Would less women experience negative side effects if the treatment was more closely monitored or provided at only health clinics? Perhaps. Would less women have access to any form of contraception if the treatment was only provided at health clinics? Probably.
In Uganda, drug shops are “considered the front line of health care for the poor,” especially in rural areas. They are not pharmacies, but must be owned by someone with at least a nursing degree. Other non-owner workers who responded to a research survey indicated that they had training in family planning (77 percent), injection safety (62 percent), or infection prevention and control (59 percent). Drug shops are supposed to be registered with the National Drug Authority (NDA), but many are not and still operate openly using a simple trading license or no license at all (56 percent).