Post-abortion contraceptive use among women purchasing medication abortion from pharmacies vs. clinics: Evidence from Cambodia and Ghana

To understand differences in post-abortion contraceptive use between women accessing medication abortion (MA) in pharmacies compared to clinics. We conducted secondary analysis of data from two non-randomized non-inferiority trials that compared MA outcomes for pharmacy and clinic clients in Cambodi...

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Vydáno v:Contraception (Stoneham) Ročník 153; s. 111243
Hlavní autoři: Pearson, Erin, Menzel, Jamie, Mao, Bunsoth, Agula, Caesar, Antobam, Samuel, Eckersberger, Elisabeth, Bawah, Ayaga, Saphonn, Vonthanak, Kapp, Nathalie
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States Elsevier Inc 01.01.2026
Témata:
Abortion, Induced
Adolescent
Adult
Ambulatory Care Facilities - statistics & numerical data
Cambodia
Clinic
Contraception Behavior - statistics & numerical data
Female
Ghana
Humans
Medication abortion
Pharmacies - statistics & numerical data
Pharmacy
Post-abortion contraception
Pregnancy
Young Adult
Cambodia
Ghana
Clinic
Ghana
Cambodia
Medication abortion
Pharmacy
Post-abortion contraception
ISSN:0010-7824, 1879-0518, 1879-0518
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Shrnutí:To understand differences in post-abortion contraceptive use between women accessing medication abortion (MA) in pharmacies compared to clinics. We conducted secondary analysis of data from two non-randomized non-inferiority trials that compared MA outcomes for pharmacy and clinic clients in Cambodia (2018–2019) and Ghana (2019–2021). A total of 3791 MA clients (clinic: n = 1966, pharmacy: n = 1825) were recruited from 60 urban sites (24 clinics, 36 pharmacies). We used Poisson models to assess differences in post-abortion contraceptive use between pharmacy and clinic clients and mediation analyses to explore the mechanisms through which MA purchase location influences post-abortion contraceptive outcomes. Contraceptive use 30 days post-abortion was reported by approximately half of clinic clients (Cambodia: 51.9%; Ghana 41.3%) and somewhat fewer pharmacy clients (Cambodia: 43.0%; Ghana: 27.0%), but this difference was not statistically significant (Cambodia: adjusted risk difference [aRD] = −6.6%; 95% CI: −16.4% to 3.3%; Ghana: aRD = −10.1%; 95% CI: −23.4% to 3.2%). Though overall post-abortion contraceptive use was comparable, pharmacy clients used less effective contraceptive methods than clinic clients. Offer of contraceptive information and methods at the point of MA purchase were significantly higher in clinics, and mediation analyses demonstrated that this explained differences in post-abortion contraceptive outcomes between pharmacy and clinic clients. Use of more effective post-abortion contraceptive methods may be facilitated by offering contraceptive information and methods in pharmacies at the point of MA purchase, but further research and monitoring is required to ensure that these interventions are client-centered and not coercive. Greater access to contraceptive information and methods in pharmacies at the point of MA purchase may facilitate use of effective post-abortion contraceptive methods for those self-managing their abortions via pharmacy purchase of MA.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:0010-7824
1879-0518
1879-0518
DOI:10.1016/j.contraception.2025.111243