CONTRACEPTIVE KNOWLEDGE AND COMPLIANCE WITH GUIDELINES FOR PROVIDING CONTRACEPTIVE SERVICES BY PATENT MEDICINE VENDORS IN IBADAN NORTH LOCAL GOVERNMENT AREA, NIGERIA

Abstract

Previous studies conducted in Nigeria have shown that Patent Medicine Vendors (PMVs) provide a substantial proportion of contraceptive services. Although the Federal Ministry of Health (FMOH) has provided guidelines for the delivery of contraceptives services by PMVs, few studies exist on the use of this guidelines and the types of contraceptives dispense PMVs dispense. This study was therefore designed to identify the types of contraceptives dispensed by PMVs and determine their level of compliance with the FMOH guidelines in Ibadan North Local Government Area. This survey was conducted from March to May 2009 and all the 282 registered PMVs in the Local Government Area were interviewed. An observational check-list and a validated interviewer administered questionnaire containing a 47- point knowledge scale were used for data collection. The check-list was used to document compliance with FMOH guidelines and availability of the following: the FMOH guidelines, approved patent medicine booklet produced by the Pharmacist Council of Nigeria (PCN), referral forms and availability of PMV license. Data were analysed using descriptive, Chi-square and t-lest statistics. Respondents' mean age was 32.8±7.0 years, 80.9% were females and 63.5% were West African School Certificate holders. Most of the respondents (98.2%) were trained through the apprenticeship system. Only 17.4% were formally trained on the provision of contraceptive services. Contraceptive- related services offered by PMVs as stipulated by the guidelines were: counselling (96.5%), community sensitization (46.3%) and referral (96.4%). Virtually all (98.6%) of the respondents had ever dispensed contraceptives. A large proportion (72.7%) of the respondents dispensed oral contraceptives contrary to the FMOH guidelines. The contraceptives ever dispensed by respondents included the following: male condoms (96.1%), female condoms (4.3%). doufem (72.3%), pregnon (18.8%), spermicide (4.9%) and intrauterine device (1.8%), Duofem (62.8-%) topped the list of contraceptives sold in the week preceding the study. Respondents' mean knowledge score was 25.9±5.8. Mean knowledge score on the provision of contraceptives services among males and females were 27.7±5.9 and 25.6 ± 5.7 respectively. Respondents' with bachelors degree had the highest mean knowledge score on the provision of contraceptive services (29.9±5.3) followed by those with WASC (25.6±5.9) (p<0.05). The level of compliance with the FMOH guideline on the provision of contraceptive services was higher (65.0%) among respondents' aged 40 years and above compared with those aged 30-39 years (62.0%), and those aged less than 30 years (57.5%) (p<0.05). Compliance rates by years of practice were as follows: 15 and above (64.0%), 10-14 (50.0%), 5-9 (49.5%) and less than live (31.0%) (p<0.05). Over half (53.9%) of respondents had no copy of the FMOH guideline, 54.6% had no booklet produced by PCN which contained approved patent medicine list and 50.7% were not licensed. Compliance with stipulated guidelines by the Federal Ministry of Health on the provision of contraceptive services was low among the study population. The patent medicine licensing authorities should ensure that all patent medicine vendors are provided with the Federal Ministry of Health guidelines relating to the dispensing of contraceptives. In addition, patent medicine vendors should be trained on the effective use of the guidelines.