Other Titles
Emergency Contraception Use Among Adolescent Girls and Young Women Seeking SRH Services at Retail Pharmacies in Kenya [Title Slide]
Other Titles
PechaKucha Presentation
Abstract
Background: Unintended pregnancy remains a public health challenge for adolescent girls and young women (AGYW) worldwide. Among AGYW in Kenya, sexual and reproductive health (SRH) services are often accessed in retail pharmacies, including emergency contraception (EC) and other family planning methods. Understanding factors associated with purchasing EC among AGYW at retail pharmacies in Kenya could inform pharmacy-delivered SRH services for this population.
Methods: We analyzed data from an ongoing cluster-randomized trial comparing pharmacy-based PrEP delivery models among AGYW at 20 retail pharmacies in Kisumu, Kenya (NCT05467306). All AGYW (15-24 years) purchasing contraception (EC, oral pills, injectables, implants, condoms) at retail pharmacies were eligible. Data on sociodemographic characteristics, sexual behaviors, and reproductive health knowledge, attitudes, and practices were ascertained by trained study staff. Intimate partner violence (IPV) was assessed using the Hurt, Insult, Threaten (HIT) scale (0-10 points), using scores >10 to indicate IPV. We used Chi-square tests to compare the characteristics of AGYW purchasing EC versus other contraceptive products.
Results: As of October 2024, 1,453 AGYW were enrolled in the trial; the median age was 21 years (IQR 19-23) and 11% were <18 years. Most AGYW (83%) were unmarried, 31% reported ≥1 sexual partner, and 54% reported a prior pregnancy. Overall, 12% had ever experienced IPV. EC was the most frequently purchased contraceptive method (48%), followed by injectables (22%), oral pills (15%), and condoms (13%). Among AGYW purchasing EC, 95% knew about long-acting reversible contraceptives (LARC) methods. There was no difference in frequency of EC purchase among AGYW who were <18 versus ≥18 years (48% vs. 48%, p=0.974) or who experienced versus did not experience IPV (43% vs. 48%, p=0.594). AGYW enrolled in school more frequently purchased EC compared to those not currently enrolled in school (60% vs. 40%, p<0.001), as did AGYW who reported no prior pregnancy compared to those who reported a prior pregnancy (61% vs. 34%, p=0.001) and those who were unemployed versus employed (50% vs. 42%, p=0.01).
Conclusion: AGYW seeking contraception at retail pharmacies often purchase EC, especially those attending school, unemployed, and without prior pregnancy. Retail pharmacies have the potential to reach AGYW seeking EC with other SRH services, including counseling on LARC, to address unmet SRH needs among AGYW.
Notes
References:
1. Critical considerations and actions for achieving universal access to sexual and reproductive health in the context of universal health coverage through a primary health care approach. (n.d.). Retrieved October 16, 2024, from https://www.who.int/publications/i/item/9789240052659
2. Mchunu, G., Peltzer, K., Tutshana, B., & Seutlwadi, L. (2012). Adolescent pregnancy and associated factors in South African youth. African Health Sciences, 12(4), 426–434. https://doi.org/10.4314/ahs.v12i4.5
3. Bearak, J., Popinchalk, A., Alkema, L., & Sedgh, G. (2018). Global, regional, and subregional trends in unintended pregnancy and its outcomes from 1990 to 2014: Estimates from a Bayesian hierarchical model. The Lancet. Global Health, 6(4), e380–e389. https://doi.org/10.1016/S2214-109X(18)30029-9
4. Pintye, J., Odoyo, J., Nyerere, B., Achieng, P., Araka, E., Omondi, C., Ortblad, K. F., Mugambi, M. L., Baeten, J. M., & Bukusi, E. A. (2023). Nurse-facilitated preexposure prophylaxis delivery for adolescent girls and young women seeking contraception at retail pharmacies in Kisumu, Kenya. AIDS (London, England), 37(4), 617–623. https://doi.org/10.1097/QAD.0000000000003447
5. Vera, M., Bukusi, E., Achieng, P., Aketch, H., Araka, E., Baeten, J., Beima-Sofie, K., John-Stewart, G., Kohler, P., Mugambi, M., Nyerere, B., Odoyo, J., Omom, C., Omondi, C., Ortblad, K., & Pintye, J. (2023). “Pharmacies are Everywhere, and You can get it at any Time”: Experiences With Pharmacy-Based PrEP Delivery Among Adolescent Girls and Young Women in Kisumu, Kenya. Journal of the International Association of Providers of AIDS Care, 22, 23259582231215882. https://doi.org/10.1177/23259582231215882
6. Corroon, M., Kebede, E., Spektor, G., & Speizer, I. (2016). Key Role of Drug Shops and Pharmacies for Family Planning in Urban Nigeria and Kenya. Global Health, Science and Practice, 4(4), 594–609. https://doi.org/10.9745/GHSP-D-16-00197
7. Harrington, E. K., Hauber, B., Ouma, D. C., Kimanthi, S., Dollah, A., Onono, M., & Bukusi, E. A. (2024). Priorities for contraceptive method and service delivery attributes among adolescent girls and young women in Kenya: A qualitative study. Frontiers in Reproductive Health, 6. https://doi.org/10.3389/frph.2024.1360390
8. Lagat, H. K., Pintye, J., Harrington, E., Houck, S., Kwena, Z., Lenn, M., Mogaka, F., Momanyi, V., Mugambi, M., Nyerere, B., Odoyo, J., Omollo, V., Ortblad, K. F., Rota, G., Sharma, M., & Bukusi, E. A. (2024). Enhancing HIV pre-exposure prophylaxis outcomes among Kenyan adolescent girls and young women with a novel pharmacy-based PrEP delivery platform: Protocol for a cluster-randomized controlled trial. Trials, 25(1), 394. https://doi.org/10.1186/s13063-024-08206-6
9. Larsen, A., Pintye, J., Marwa, M. M., Watoyi, S., Kinuthia, J., Abuna, F., Richardson, B. A., Gomez, L., Dettinger, J. C., & John-Stewart, G. (2022). Trajectories and predictors of perinatal depressive symptoms among Kenyan women: A prospective analysis from pregnancy through 9 months postpartum. The Lancet. Psychiatry, 9(7), 555. https://doi.org/10.1016/S2215-0366(22)00110-9
Sigma Membership
Non-member
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Health Equity or Social Determinants of Health, Implementation Science, Sustainable Development Goals, Unintended Pregnancies, Emergency Contraceptive Use, Kenya
Recommended Citation
Lagat, Harison Kiplimo; Nyerere, Bernard; Katz, David; Kwena, Zachary; Lenn, Meena; Mogaka, Felix; Mugambi, Melissa; Odoyo, Josephine; Omollo, Victor; Ortblad, Katrina F.; Rono, Benard; Rota, Greshon; Sharma, Monisha; Bukusi, Elizabeth Anne; and Pintye, Jillian, "EC Use Among Adolescent Girls and Young Women Seeking SRH Services at Retail Pharmacies in Kenya" (2025). International Nursing Research Congress (INRC). 245.
https://www.sigmarepository.org/inrc/2025/presentations_2025/245
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
EC Use Among Adolescent Girls and Young Women Seeking SRH Services at Retail Pharmacies in Kenya
Seattle, Washington, USA
Background: Unintended pregnancy remains a public health challenge for adolescent girls and young women (AGYW) worldwide. Among AGYW in Kenya, sexual and reproductive health (SRH) services are often accessed in retail pharmacies, including emergency contraception (EC) and other family planning methods. Understanding factors associated with purchasing EC among AGYW at retail pharmacies in Kenya could inform pharmacy-delivered SRH services for this population.
Methods: We analyzed data from an ongoing cluster-randomized trial comparing pharmacy-based PrEP delivery models among AGYW at 20 retail pharmacies in Kisumu, Kenya (NCT05467306). All AGYW (15-24 years) purchasing contraception (EC, oral pills, injectables, implants, condoms) at retail pharmacies were eligible. Data on sociodemographic characteristics, sexual behaviors, and reproductive health knowledge, attitudes, and practices were ascertained by trained study staff. Intimate partner violence (IPV) was assessed using the Hurt, Insult, Threaten (HIT) scale (0-10 points), using scores >10 to indicate IPV. We used Chi-square tests to compare the characteristics of AGYW purchasing EC versus other contraceptive products.
Results: As of October 2024, 1,453 AGYW were enrolled in the trial; the median age was 21 years (IQR 19-23) and 11% were <18 years. Most AGYW>(83%) were unmarried, 31% reported ≥1 sexual partner, and 54% reported a prior pregnancy. Overall, 12% had ever experienced IPV. EC was the most frequently purchased contraceptive method (48%), followed by injectables (22%), oral pills (15%), and condoms (13%). Among AGYW purchasing EC, 95% knew about long-acting reversible contraceptives (LARC) methods. There was no difference in frequency of EC purchase among AGYW who were <18 versus>≥18 years (48% vs. 48%, p=0.974) or who experienced versus did not experience IPV (43% vs. 48%, p=0.594). AGYW enrolled in school more frequently purchased EC compared to those not currently enrolled in school (60% vs. 40%, p<0.001), as did AGYW who reported no prior pregnancy compared to those who reported a prior pregnancy (61% vs. 34%, p=0.001) and those who were unemployed versus employed (50% vs. 42%, p=0.01).
Conclusion: AGYW seeking contraception at retail pharmacies often purchase EC, especially those attending school, unemployed, and without prior pregnancy. Retail pharmacies have the potential to reach AGYW seeking EC with other SRH services, including counseling on LARC, to address unmet SRH needs among AGYW.
Description
Adolescent girls and young women (AGYW) in Kenya often access sexual and reproductive health services including emergency contraception and other family planning methods. Our study highlights the factors associated with purchasing EC among AGYW at retail pharmacies and how the findings can help inform pharmacy delivered SRH services. The study findings summarizes the socio-demographic characteristics and sexual behaviors, reproductive health knowledge and attitudes among AGYW in Kenya.