A quarter to a half of patients in low- and middle-income countries seek care directly in private retail pharmacies, also called chemists or community pharmacies. Pharmacies therefore present a unique avenue for reaching a large population with HIV prevention services by providing the services directly and or referring clients to health facilities for comprehensive services.
Pharmacies have traditionally not been included in HIV prevention policies in Kenya and most other sub-Saharan African countries. Two recent Kenyan policies point towards increasing recognition of the potential of pharmacy-based HIV prevention. The first policy relates to HIV self-testing (HST), while the second relates to pre-exposure prophylaxis (PrEP), the use of ARVs by people who are not infected to block acquisition. Both policies recommend delivery through pharmacies alongside other healthcare and community settings. To enhance implementation and ensure maximum benefit of these policies, it will be important to understand the policy environment surrounding pharmacy delivery of public health interventions and to evaluate the implementation of the two HIV prevention policies.
This studentship will be part of an ongoing 3-year project that aims to examine the policy and implementation of HIV prevention through private retail pharmacies in Kenya. The student will be involved in conducting policy analyses using baseline surveys to assess implementation.
Question to be addressed by the student
- How were the HST and PrEP policies formulated and who were the key actors in the formulation process?
- What are the structures, resources and processes being used for delivery of the two interventions in the pharmaceutical sector?
- What is the level of fidelity to policy guidelines (quality), in terms of dose (components delivered), adaptations (innovations), and deviations (failures and subversions)?
Skills to be acquired by the student
The student will gain skills in health policy research utilising qualitative and quantitative methods, including document reviews, in-depth interviews, simulated client surveys and questionnaire surveys. Student will also gain literature searching skills and insights into implementation science.
- Eades CE, Ferguson JS, O'Carroll RE. Public health in community pharmacy: a systematic review of pharmacist and consumer views. BMC Public Health 2011;11:582.
- Mugo PM, Micheni M, Shangala J, Hussein MH, Graham SM, Rinke de Wit TF, et al. Uptake and Acceptability of Oral HIV Self-Testing among Community Pharmacy Clients in Kenya: A Feasibility Study. PLoS One 2017;12(1):e0170868.
- National AIDS and STI Control Programme (NASCOP). An operational manual for the delivery of HIV Self-Testing services in Kenya. 2017.
Preferred training background of the student
Bachelor degree in Pharmacy, Medicine, Nursing, or Public Health
Application deadline: 11 February 2019