Abstract
INTRODUCTION: This study examines women's pathways to medication abortion (MA) and post-MA contraception, including how they source information on the services, their choices and preferences regarding these services and their experiences obtaining the services from community pharmacies in two counties of Kenya. METHODS: Data are from the baseline of a mixed-methods prospective intervention study conducted in two counties of Kenya (Nakuru and Kericho) between May 2024 and June 2025. We recruited women from 43 community pharmacies (27 in Nakuru and 16 in Kericho county). Data collection involved a quantitative survey and in-depth interviews with women. RESULTS: A total of 524 women aged 17-48 years completed the quantitative survey while another 42 women aged 19-40 years (not in the quantitative survey) completed in-depth interviews at baseline (3-7 days following MA purchase). Most women relied on social networks (63% in Nakuru, 85% in Kericho) or pharmacies (35% in Nakuru, 56% in Kericho) for information on MA services. However, women themselves made the final decision to obtain MA. Women valued privacy, confidentiality and trust in pharmacy staff, with 94% of those in Nakuru and 88% of those in Kericho preferring the same pharmacy for post-MA contraceptive methods. Women generally preferred obtaining MA and post-MA contraceptive services separately to allow for the abortion process to be complete and to avoid potential adverse reactions from MA and contraception. They were also generally satisfied with the services they received from the pharmacy, mainly because of privacy, friendliness of the provider, quality of information provided, effectiveness of the medications provided and follow-up conducted by pharmacy staff. CONCLUSION: Community pharmacies are critical points of care for MA and post-MA contraception, providing privacy and convenience to underserved populations. Capacity-strengthening for pharmacists should focus on rights-based, comprehensive counselling to improve sexual and reproductive health outcomes.