Quality of care offered by health care retail markets for medication abortion self-management: findings from states in Nigeria and India
2025

Quality of Care for Medication Abortion in Nigeria and India

Sample size: 219 publication 15 minutes Evidence: moderate

Author Information

Author(s): Shankar Mridula, Omoluabi Elizabeth, OlaOlorun Funmilola M., Khanna Anoop, Ahmad Danish, Moreau Caroline, Bell Suzanne O.

Primary Institution: Johns Hopkins Bloomberg School of Public Health

Hypothesis

How does the quality of care for medication abortion self-management differ between pharmacies in Nigeria and India?

Conclusion

The study found that while medication abortion pills are available in retail markets, the quality of care provided is generally low in both Nigeria and India.

Supporting Evidence

  • 51% of facilities in Nigeria offered medication abortion pills.
  • 32% of facilities in India provided medication abortion pills.
  • Only 26% of facilities in Nigeria provided correct instructions on pill administration.
  • Client experience scores were high at 90% in Nigeria and 91% in India.

Takeaway

Pharmacies in Nigeria and India sell abortion pills, but they often don't give the right information on how to use them safely.

Methodology

Simulated client approach to assess the quality of care in pharmacies and chemist shops across three Nigerian states and one Indian state.

Potential Biases

Potential bias due to the simulated client method, as staff were unaware of the study.

Limitations

The small sample size of facilities limits the generalizability of the findings.

Participant Demographics

Reproductive-aged women (15-49 years) in urban areas of Nigeria and India.

Statistical Information

P-Value

0.001

Confidence Interval

95% CI: 15.8–21.1

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1371/journal.pgph.0003971

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