In Nepal, despite policy restrictions, both registered and unregistered brands of mifepristone
and misoprostol can easily be obtained at pharmacies. Since many women visit pharmacies for abortion
information, ensuring that they receive effective care from pharmacy workers remains an important
challenge. We conducted an operations research study to examine whether trained pharmacy workers
can correctly provide information on safe use of mifepristone and misoprostol for early first trimester
medical abortion. Pharmacy workers in one district were given orientation and training using a
harm-reduction approach, and compared with a non-equivalent comparison group in the second district.
Overall, trained pharmacy workers’ knowledge increased substantially, but no increase was found in
the comparison group. Compared to the baseline (65%), 97% of trained pharmacy workers knew up to
what stage of pregnancy and how women should use mifepristone and misoprostol. A higher percentage
of pharmacy workers in the intervention group (77%) compared to the comparison group (49%) were
knowledgeable at follow-up about determining whether an abortion was successful, implying a need for
improving this aspect of training. As many mid-level health providers run their own pharmacies and
offer medical abortion pills, it is important for the government to consider training these providers and
registering their pharmacies as safe medical abortion service outlets.