The positive effect of job aids on Patent and Proprietary Medicine Vendor injectable contraceptive knowledge 9 months after training: Longitudinal results from implementation science research in Nigeria

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Abstract Background To increase access to voluntary family planning services, policymakers in Nigeria are debating how to task share the provision of injectable contraceptives to drug shop owners known as Patent and Proprietary Medicine Vendors (PPMVs). Globally, task sharing family planning services to drug shops has been identified as a promising practice, but more evidence is needed on how to support PPMVs in providing family planning, such as injectable services, if policy were changed. Methods Data were collected from 194 PPMVs in Bauchi, Cross River, Ebonyi and Kaduna states at three time points. PPMVs were trained to provide family planning counseling and injectable contraceptive services, including administration. PPMVs were interviewed immediately before, immediately after, and 9 months after the training. Three outcome variables were used to represent knowledge of injectable contraceptives: intramuscular deo-medroxyprogesterone acetate (DMPA) knowledge, subcutaneous DMPA knowledge, and knowledge of 4 or more of 7 common side effects of progestin-only injectables. Unadjusted and adjusted logistic regression models were conducted for each outcome variable to determine which factors affect PPMV knowledge of injectable contraceptives 9 months after the training. Results PPMVs’ intramuscular and subcutaneous DMPA knowledge and side effect knowledge was low before the training and then increased immediately afterwards. Nine months following the training, intramuscular and subcutaneous DMPA knowledge decreased and side effect knowledge remained relatively the same compared to the post-training results. Results from three logistic regression models found that PPMVs who reported using at least 2 of the 3 family planning job aids provided during the training had significantly higher knowledge compared to those who reported using one or no job aids. Conclusion Providing PPMVs with family planning job aids as part of a larger capacity-building strategy should be considered as they may help PPMVs retain knowledge after training. These results contribute to the literature on task sharing family planning services to private sector drug shops and implications for scale-up.

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