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Reprod Health Matters. 2015 Feb;22(44 Suppl 1):116-24. doi: 10.1016/S0968-8080(14)43794-7.

Using a harm reduction lens to examine post-intervention results of medical abortion training among Zambian pharmacists.

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Senior Research and Evaluation Advisor, Ipas, Chapel Hill, NC, USA. Electronic address:
Independent consultant, Baltimore, MD, USA.
National Reproductive Health Specialist, UNFPA, Lusaka, Zambia.
Research and Evaluation Advisor, Ipas Zambia, Lusaka, Zambia.
Consultant Obstetrician-Gynaecologist, University of Zambia School of Medicine, Department of Obstetrics and Gynaecology, Lusaka, Zambia.
Technical Director of Reproductive and Child Health, AMREF, Nairobi, Kenya.
Research and Evaluation Advisor, Ipas, Chapel Hill, NC, USA.


Despite broad grounds for legal abortion in Zambia, access to abortion services remains limited. Pharmacy workers, a primary source of health care for communities, present an opportunity to bridge the gap between policy and practice. As part of a larger operations study, 80 pharmacy workers, both registered pharmacists and their assistants, participated in a training on medical abortion in 2009 and 2010. Fifty-five of the 80 pharmacy workers completed an anonymous, structured training pre-test, treated as a baseline questionnaire; 53 of the 80 trainees were interviewed 12-24 months post-training in face-to-face interviews to measure the retention of information and training effectiveness. Survey questions were selected to illustrate the principles of a harm reduction approach to unsafe abortion. Bivariate analysis was used to examine pharmacy worker knowledge, attitudes and dispensing behaviours pre-training and at follow-up. A higher percentage of pharmacy workers reported referring women to a health care facility between surveys (47% to 68%, p = 0.03). The number of pharmacy workers who reported dispensing ineffective abortifacients decreased from baseline to end-line (30% to 25%) but the difference was non-significant. However, study results demonstrate that Zambian pharmacy workers have a role to play in safe abortion services and some are willing to play that role.


Zambia; harm reduction; medical abortion; pharmacists

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