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

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


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.

Keywords: Zambia; harm reduction; medical abortion; pharmacists.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abortion, Induced / methods*
  • Abortion, Induced / psychology*
  • Abortion, Legal / methods
  • Adult
  • Education, Pharmacy, Continuing / methods
  • Female
  • Harm Reduction*
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Middle Aged
  • Pharmacies
  • Pharmacists / psychology*
  • Pregnancy
  • Surveys and Questionnaires
  • Zambia