Designing a global monitoring system for pilot introduction of a new contraceptive technology, subcutaneous DMPA (DMPA-SC)

Stout, Anna L.; Wood, Siri; Namagembe, Allen; Kaboré, Alain; Siddo, Daouda; Ndione, Ida

doi:10.1016/j.evalprogplan.2018.03.004

Cited by 5 publications

(6 citation statements)

References 8 publications

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“…In collaboration with stakeholders from each country, we employed a 4-phase approach to monitoring DMPA-SC pilot introduction 16 : Develop and define global indicators Integrate global indicators into country data collection tools Facilitate consistent reporting and data management Analyze and interpret data and share results …”

Section: Methodsmentioning

confidence: 99%

“…A detailed report on design and implementation of this monitoring system, including lessons learned, is presented elsewhere. 16 Results from the pilot introductions are described below and can help stakeholders in other countries make informed decisions on whether and how to include this contraceptive option in their family planning programs.…”

Section: Introductionmentioning

confidence: 99%

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Expanding Access to Injectable Contraception: Results From Pilot Introduction of Subcutaneous Depot Medroxyprogesterone Acetate (DMPA-SC) in 4 African Countries

Stout¹,

Wood²,

Barigye³

et al. 2018

Glob Health Sci Pract

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Nearly half a million doses of DMPA-SC were administered over 2 years in Burkina Faso, Niger, Senegal, and Uganda, with 29% of doses provided to first-time family planning users and 44% (in 3 countries) to adolescent girls and young women under age 25. Switching from intramuscular DMPA (DMPA-IM) was not widespread and generally decreased over time. Community health workers provided a higher proportion of DMPA-SC than DMPA-IM injections. Stock-outs in 2 countries hindered product uptake, highlighting the need to strengthen logistics systems when introducing a new method.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Expanding Access to Injectable Contraception: Results From Pilot Introduction of Subcutaneous Depot Medroxyprogesterone Acetate (DMPA-SC) in 4 African Countries

Stout¹,

Wood²,

Barigye³

et al. 2018

Glob Health Sci Pract

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“…The KPIs focused on four key areas of program delivery: (1) product distribution, (2) provider training and CBD model, (3) users' profiles and (4) provider and user experience with DMPA-SC. KPIs were a combination of indicators used in other DMPA-SC pilot programs, for comparability, and program-specific indicators to monitor unique features of the Nigeria introduction (see Supplementary materials for a full list) [15] . Three sources of data were used to calculate KPIs: Program documents, reports and internal sales data extractions, supplemented with direct communications with program staff for further clarification and context; A phone survey administered to DMPA-SC users to collect information on users' sociodemographic profiles and their experiences with obtaining DMPA-SC; In-depth interviews (IDIs) with both DMPA-SC users and providers to gain a richer understanding of their receptivity toward the product, challenges encountered and concerns about continued use or provision (i.e., aspects that could not be adequately captured in the short, quantitative phone survey).…”

Section: Methodsmentioning

confidence: 99%

Introducing the subcutaneous depot medroxyprogesterone acetate injectable contraceptive via social marketing: lessons learned from Nigeria's private sector

et al. 2018

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ObjectivesThe subcutaneous depot medroxyprogesterone acetate (DMPA-SC) injectable contraceptive was introduced in South West Nigeria in 2015 through private sector channels. The introduction included community-based distribution and was supported by a social marketing approach. From program monitoring and evaluation, aimed at understanding performance, market reach and other process measures, we identify lessons learned to inform future scale-up efforts.MethodsWe synthesized the findings from a core set of key performance indicators collected through different methods: (1) implementer performance indicators, (2) phone survey of DMPA-SC users (n=541) with a follow-up after 3 months (n=342) and (3) in-depth interviews with 57 providers and 42 users of DMPA-SC.ResultsDistribution of DMPA-SC to private providers was concentrated in states with large urban populations. A shift toward focusing on high-volume family planning facilities coincided with a rapid increase in distribution in late 2016. Users reached in the phone survey were generally older and married with children; few were under age 25. Users and providers reported favorable opinions of DMPA-SC. Many users reported choosing DMPA-SC due to recommendations from providers and friends, and the hope of experiencing reduced side effects compared to other methods. While users reported positive experiences interacting with community-based distributors, the delivery model encountered a number of challenges — high turnover, low motivation, lack of an appropriate compensation package and logistical costs — and was ultimately disbanded.ConclusionsIn the DMPA-SC introductory program in Nigeria, distribution was amplified when focused on high-volume contraceptive providers. Although community-based distribution can be one effective service delivery model for reaching underserved populations, more consideration for balancing cost recovery and public health goals through private sector approaches are needed in the context of South West Nigeria. Additional communications and outreach efforts are needed to reach younger, unmarried users with contraceptive services.

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“…Stakeholders' opinions on these questions led to the formation of a global monitoring system that provided relevant information for decisions around investments in and scale-up of DMPA-SC in those countries. 14 In Uganda, stakeholders identified DMPA-SC's introduction as an opportunity to improve general FP access, including strengthening supply and service quality and thus better meeting clients' needs. 15 Engagement with local stakeholders was also instrumental in generating demand for DMPA-SC.…”

Section: Introductionmentioning

confidence: 99%

Service Delivery Considerations for Introducing New Injectable Contraceptives Lasting 4 and 6 Months in Nigeria and Uganda: A Qualitative Study

Callahan,

Burke,

Lawton

et al. 2023

Glob Health Sci Pract

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Family planning (FP) stakeholders, including providers, policymakers, and program implementers, are interested in the possibility of new injectables lasting 4 and 6 months for expanding the method mix and broadening contraceptive choice. n FP stakeholders are most excited at the prospect of a 6-month injectable coming to market. n FP stakeholders do not view self-injection as a key requirement for new injectable methods.

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Designing a global monitoring system for pilot introduction of a new contraceptive technology, subcutaneous DMPA (DMPA-SC)

Cited by 5 publications

References 8 publications

Expanding Access to Injectable Contraception: Results From Pilot Introduction of Subcutaneous Depot Medroxyprogesterone Acetate (DMPA-SC) in 4 African Countries

Expanding Access to Injectable Contraception: Results From Pilot Introduction of Subcutaneous Depot Medroxyprogesterone Acetate (DMPA-SC) in 4 African Countries

Introducing the subcutaneous depot medroxyprogesterone acetate injectable contraceptive via social marketing: lessons learned from Nigeria's private sector

Service Delivery Considerations for Introducing New Injectable Contraceptives Lasting 4 and 6 Months in Nigeria and Uganda: A Qualitative Study

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