Providing medical abortion services through pharmacies: Evidence from Nepal

Despite the legalization of abortion in 2002 has made extensive efforts to expand services throughout the country, access to safe abortion care remains a constraint in Nepal, particularly in remote areas where trained providers and equipment are scarce. Expanding access to medical abortion (MA) through pharmacy workers could be a promising avenue to reach such women with safe and convenient care, but neither Nepali law nor the World Health Organization (WHO) recommends pharmacy provision of MA citing the reason of insufficient evidence. This paper examines the pharmacy provision of MA in expanding women's access to safe MA service in Nepal. Available literature between 2005 and 2018 was searched, and relevant information was extracted using a template, and findings were summarized and interpreted according to the objective of this study. We identified 83 studies that were related to MA in Nepal, but only five of them reported about pharmacy workers' involvement in the provision of MA in Nepal. Findings suggest that trained pharmacy workers can safely and effectively provide MA. MA services provided by pharmacy workers are acceptable to women who were satisfied with the service they had received. Therefore, it is essential that the Government of Nepal acknowledges the role pharmacy workers currently play in the provision of MA and formulate polices to permit pharmacy workers to give information about and dispense MA tablets to women in the first trimester of pregnancy.