Exploring the availability and accessibility of medication abortion pills in Nepal pharmacies: Reported versus actual provision practices

IF 2.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Contraception Pub Date : 2026-02-01 Epub Date: 2025-10-10 DOI:10.1016/j.contraception.2025.111254

Nished Rijal , Angel M. Foster

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引用次数: 0

Abstract

Objectives

The Nepal government allows medication abortion pills to be dispensed from pharmacies if the patient has a prescription. We aimed to assess the availability of medication abortion pills, with and without a prescription, from pharmacies and the provision practices of pharmacy workers in Eastern Nepal.

Study design

We conducted a cross-sectional survey among 489 pharmacy workers to document knowledge, availability, and provision practices related to medication abortion pills. After a month, we revisited 180 pharmacies using a mystery client approach to understand actual provision practices. We analyzed these data with descriptive statistics.

Results

Pharmacy workers in about 16% (n = 28/180) of surveyed pharmacies reported selling medication abortion pills. In contrast, mystery clients obtained these pills without a prescription in more than one-third (n = 69/180, 38%) of their visits. All mystery clients obtained mifepristone and misoprostol either through combination packages (n = 59/69, 86%) or in separate packages (n = 10/69, 14%). Mystery clients paid an average of 1062 Nepali Rupees (NRS) (approximately USD8), about 1.6 times more than the NRS654 (approximately USD5) price reported during the survey. Pharmacy workers asked mystery clients questions about gestational age to confirm pregnancy status and provided information on the timing of use and possible side effects.

Conclusions

Despite the current regulatory status, our findings suggest mifepristone and misoprostol are available without a prescription in about two out of five community pharmacies in Eastern Nepal. Supporting efforts to ensure women seeking medication abortion pills from pharmacies have up-to-date and medically accurate information appears warranted.

Implications

Pharmacies are increasingly becoming key players in the community-based distribution of mifepristone/misoprostol in Nepal. Supporting pharmacy workers to provide medication abortion pills without a prescription at scale could advance equitable access to abortion care. Ensuring appropriate training for pharmacy workers is essential to safeguard service quality and safety.

查看原文本刊更多论文

探索尼泊尔药房堕胎药的可得性和可及性：报告与实际提供做法。

目的：尼泊尔政府允许在病人有处方的情况下从药店配发堕胎药。我们的目的是评估有处方和没有处方的堕胎药的可获得性，以及尼泊尔东部药房工作人员的提供做法。研究设计：我们对489名药房工作人员进行了横断面调查，以记录与药物流产药相关的知识，可获得性和提供实践。一个月后，我们使用神秘客户方法重新访问了180家药店，以了解实际的供应实践。我们用描述性统计分析了这些数据。结果：约16%（28/180）的受访药店有药学工作人员销售药物流产药。相比之下，神秘客户在没有处方的情况下获得这些药片的次数超过三分之一（n=69/ 180,38%）。所有神秘患者通过联合包装（n=59/ 66,86%）或单独包装（n=10/ 66,14%）获得米非司酮和米索前列醇。神秘客户平均支付1062尼泊尔卢比（约8美元），比调查期间报告的654尼泊尔卢比（约5美元）高出约1.6倍。药房工作人员询问神秘客户有关孕龄的问题，以确认怀孕状况，并提供有关使用时间和可能的副作用的信息。结论：尽管目前的监管状况，我们的研究结果表明，在尼泊尔东部约五分之二的社区药房，米非司酮和米索前列醇无需处方就可以获得。支持努力确保从药店寻求堕胎药物的妇女获得最新和准确的医学信息似乎是必要的。含义：尽管药物流产药的监管地位，药店越来越多地成为在尼泊尔社区分配米非司酮/米索前列醇的关键参与者。通过药房工作人员在没有处方的情况下大规模提供药物流产药方面分担任务，可以促进公平获得流产护理。确保对药房工作人员进行适当的培训和支持对于保障服务质量和安全至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Contraception 医学-妇产科学

CiteScore

4.70

自引率

17.20%

发文量

211

审稿时长

69 days

期刊介绍： Contraception has an open access mirror journal Contraception: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal Contraception wishes to advance reproductive health through the rapid publication of the best and most interesting new scholarship regarding contraception and related fields such as abortion. The journal welcomes manuscripts from investigators working in the laboratory, clinical and social sciences, as well as public health and health professions education.