Policy change in Rwanda allows task sharing through private pharmacies
In February 2020, the Minister of Health in Rwanda approved a change in policy that would allow the administration of injectable contraceptives by private community pharmacists. This change in policy was spearheaded by SHOPS Plus and Association des Pharmaciens et Propriétaires d’Officine du Rwanda (APPOR), an association of retail pharmacists in Rwanda.
WHO global task-sharing recommendations suggest that pharmacists can safely administer injectable contraceptives. However, this is limited in practice owing to policies that prohibit “medical services” on pharmacy premises. Since 2019, SHOPS Plus has been working with APPOR to advocate for policy change to allow pharmacists to administer injectable contraceptives. Engagement began with an advocacy plan development workshop in Kigali where members articulated their objectives and actions to meet them. SHOPS Plus supported APPOR to explore how pharmacists could meet all technical considerations required by global guidelines to administer injectables.
According to Danny Mutembe, president of APPOR, “It was a great experience working with SHOPS Plus, which provided the necessary technical support in influencing the policy change in Rwanda that gives pharmacists and nurses operating in private pharmacies a more important role in family planning.”
SHOPS Plus support has helped APPOR conduct several meetings with various stakeholders to understand their perspectives and the opportunities and considerations in expanding access to injectables through pharmacists. The stakeholders included the Pharmacy Council, which regulates the pharmacists’ profession, the Rwanda Food and Drug Authority, which regulates pharmacy premises, and the Rwanda Biomedical Center, which is the implementing body of the Ministry of Health, among other stakeholders.
In November 2019, APPOR formally submitted its request in a letter to the Minister of Health and received a positive response in February 2020. This policy change is groundbreaking in Rwanda where health provision is dominated by the public sector. It shows a commitment by the government to increase participation of the private sector and access to contraception for women in Rwanda.
While the policy has changed, the work is not yet over. The next step is to organize a meeting with all relevant stakeholders on operationalizing the policy. Danny Mutembe, president of APPOR shares his excitement, saying, “Rwanda has taken the lead in Africa in redefining the role of pharmacists from simply dispensing family planning to their administration within private pharmacy premises. And this is just the beginning!”
Toolkit: Expanding Access to Injectable Contraceptives through Pharmacies