OPINION: Pharmacies can help deliver reproductive health self-care

In the pharmacies that dot most urban and rural neighbourhoods in the country, selling health, wellness and personal care products, lie an untapped opportunity to buttress the sexual and reproductive health of young people.

These facilities are well-loved for their accessibility as well as efficient dispensing of drugs to treat ailments without the drawn-out processes and long queues that are typical of public hospitals. In many cases, the medicines are also priced fairly. 

These same attributes make them appealing as a trusted source of information and commodities to empower young people to make better choices relating to their sexuality. In many ways, they can help boost individuals' ability to drive their own sexual and reproductive well-being.

While privately owned and run, they can be integrated to support young people to improve their sexual and reproductive health. Through them, young people can access a variety of contraceptives as well as information that will help them make better choices.

They can be empowered to provide the whole gamut of self-care, ranging from self-management (through medication, treatment, examination and administration), self-testing (including screening, diagnosis and monitoring) and self-awareness.

Some of the services the pharmacies can provide include HIV and sexually transmitted infections checkup, screening for cervical cancer, availing contraceptives and advice on healthy sexual behavior.

This can help Kenyan youth enjoy their right to quality healthcare. It also builds clear understanding amongst them when choosing what works best, based on an individual's life plans and overall health. All this builds up towards strengthening acceptance and uptake of sexual and reproductive health self-care.

Being located in their neighborhoods means that young people are likely to trust the pharmacies more than they would other health practitioners and facilities. Mutual trust is the first definitive step towards increasing young people's engagement with reproductive health providers.

It is this suspicion and mistrust that has kept many of them away from health workers, fueling misuse of contraceptives and misconceptions around them as well as negative influence of their peers who may have had bad experience with contraception such as unexpected side-effects or failure.

An effective pharmacy can help encourage young people who are reluctant to go for screening and checkup. It can tackle the feeling of being judged that young people raise as a concern when interacting with healthcare workers.

However, for private pharmacies to effectively play this role, it requires measures to be put in place to strengthen them. At the moment, unhealthy competition has pharmacies focusing more on sales instead of prodding young people and offering them advice. This, coupled with gaps in regulation, risk compromising quality and service delivery. 

Besides selling commodities, pharmacies need to be empowered to build the correct human resource mix, including, but not limited to, nurses and clinicians with training and speciality in sexual and reproductive health, and mastery in contraception.

Ideally, young people should interact with a qualified and certified health practitioner, well trained and versed in matters relating to sexual and reproductive health.

This calls for strategies to integrate pharmacies as a complementary network that effectively meets the needs of young people with the necessary support. This will ensure that products and services are accessible, affordable and innovatively delivered to meet the diverse needs and realities of Kenyan youth.

As an alternative pathway towards generating demand and access to sexual and reproductive health, pharmacies can help spur interest through innovative means of delivering information and enhancing the service experience. Besides, they provide a more reliable, accessible and credible source of information on contraceptives, instead of the current reliance on peers and unverified information on social media.

Empowering the pharmacies to support delivery of self-care to young people calls for collaboration and standardisation of quality of service. The mushrooming pharmacies require a fool-proof way of ensuring that proper stratification and licensing is met with strict criteria when selecting those that would be eligible to provide youth-friendly services based on commodity handling and skilled capacity. 

This will ensure that coverage and access to sexual and reproductive health by young people is significantly boosted and disparities among regions greatly reduced owing to the ubiquity of pharmacies across the country.

With the entrenchment of private-public collaborations, it can even help ensure that medicines and reproductive health services are even more fairly priced to cater for young people. Ultimately, this is more efficient use of healthcare resources and services, freeing facilities to handle other ailments. 

Unlocking this potential also requires cooperation amongst the pharmacies themselves to recognize that supporting young people's sexual and reproductive health self-care serves a greater societal goal with far-reaching consequences. They need to take upon themselves the task of promoting health in the community.

If young people are empowered and supported to avoid sexually transmitted infections and unplanned pregnancies, they are able to plan their lives better and have a better future. All stakeholders must engage, take action and support a more inclusive approach to self-care for young Kenyans, with lessened stigma and stereotyping.

Dr Githinji is a Consultant Obstetrician/Gynaecologist, interested in the youth’s sexual and reproductive health. She is also founder/CEO of Daktari Wa Mtaa Trust, a not-for-profit creating healthy urban and rural communities by providing information.