‘Mr pharmacist give me Postinor’, a line from a hit rap song by the popular Nigerian artist M.I. The Song entitled ‘Bullion van’, references a demand for the emergency contraception pill postinor in anticipation of sexual intercourse. This demand succinctly captures the attitude of many young Nigerians to sexual health and contraception. This attitude leaves a lot to be desired and some would even label it as reckless but as health professionals, it is not in our place to judge.
Now to the question Mr Pharmacist, what would be your response when a patient comes through requesting postinor. Well in some jurisdictions, the appropriate response is scripted by law. Some states in the, for example, require a prescription, others demand a specific pre-requisite training, while some others have specific laid down procedures a pharmacist must follow. Similar variations exist in European jurisdictions.
In Nigeria however there is no specific law or regulation guiding emergency contraception administration, at least not to my knowledge (I’m happy to be educated here). Hence a pharmacist can simply dole out postinor and move on the next client. Doesn’t the pharmacist however have a professional responsibility to encourage more responsible sexual health? Especially in the context of recent news that 3.4 million Nigerians are living with HIV. In my opinion they do.
There is a need at the very least to educate the client and provide more reliable contraception such as a regular oral contraceptive or other barrier methods that have the added advantage of reducing STD’s.
This can of course be difficult in the average Nigerian pharmacy setting. To help I suggest one memorable maxim
Always give a ‘PIL’ before the pill
PIL stands for ‘Patient Information Leaflet. PIL’s have been shown to be tremendous in educating patients on health issues and can often instigate behaviour change. If the PIL is written and delivered well, you will certainly see clients returning with more questions on better options for contraception. This will result in better pharmaceutical care and may even mean converting an occasional visitor to your pharmacy to a monthly client who attends for refills of their regular oral contraceptive. So the next time a patient attends for Postinor, remember to get your PIL ready to help them choose a better option in the future.
Example of contraception PIL you may adapt for your own use: http://www.fpa.org.uk/