Knowledge and willingness of community pharmacy staff and women living with HIV to integrate family planning into differentiated service delivery : Kampala

Abstract

Background: HIV continues to be a major global health issue with 39.9 million People Living With HIV (PLHIV) in 2023. In Uganda, HIV prevalence is 5.1% among adults aged 15-49 years disproportionately affecting women. Unintended pregnancies among women living with HIV (WLHIV) are a pressing concern risking Mother to Child Transmission (MTCT) and Maternal mortality (MM). Unintended pregnancies can be reduced by availability and access to FP options (Contraceptive options). This can be done by integration of FP into Community Pharmacy Drug Distribution Point (CRPDDP) model. Objective: This study aimed at assessing the knowledge and willingness of community pharmacy staff and WLHIV to integrate FP into differentiated service delivery models in community pharmacies. Methodology: This cross-sectional study was conducted in Kampala district at the Infectious Disease Institute (IDI) Mulago and in community pharmacies enrolled in the DSD program in April 2025. The study population included WLHIV aged 18-49 years in the DSD program and community pharmacy staff. A sample of 155 WLHIV and 52 community pharmacy staff were selected by consecutive and universal sampling respectively. Data was collected using semi-structured questionnaires and analyzed using STATA V14. Results: The mean age for the 155 WLHIV was 34.3 years (SD= 7.3); of the 52 community pharmacy staff, the majority (73.08%, n=37) were aged between 21 and 30 years. Only 42.31% (n=22) of pharmacy staff had adequate FP knowledge. A large majority, 147 WLHIV (94.84%), reported having heard of at least one contraceptive method. A substantial proportion of community pharmacy staff (76.92%, n=40) expressed willingness to integrate FP into CRPDDP model. Similarly, majority of the WLHIV, 120 (77.42%), expressed willingness to receive family planning services integrated in CRPDDP program. Conclusion: There was a low level of knowledge of FP among community pharmacy staff. WLHIV had high FP knowledge ( had heard at least one contraceptive method) . Both WLHIV and community pharmacy staff expressed high willingness to integrate FP into the CRPDDP model. MOH should consider use integration of FP community pharmacies as delivery points for women living with HIV enrolled in CRPDDP .However they should consider continuous training programmes for community pharmacy staff on the different contraceptive methods to improve on the level of knowledge and skills of FP.