Introduction of DMPA-SC self-injection in Ghana: A feasibility and acceptability study using Sayana® Press

Nai, Dela; Aboagye, Patrick; Fuseini, Kamil; Tobey, Elizabeth; Jain, Aparna; Maresh, Nora; Fertziger, Rebecca

doi:10.31899/rh11.1050

Cited by 4 publications

(8 citation statements)

References 11 publications

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“…Reasons for opting for home self-injection include not having to travel to the facility (71%), injecting in the comfort of one's home (53%), and privacy (42%). 11 The pilot study also found that selfinjection clients safely stored and disposed of the Uniject following effective counseling by health providers. 23 On the other hand, previous FP users may already be used to the routine of their contraceptive method being administered at the facility.…”

Section: Discussionmentioning

confidence: 90%

“…A reason for this tendency may be that new FP users are attracted to the touted benefits of self-injection, including reduced visits to the facility and increased privacy. 11,21,22 Previous analyses of the DMPA-SC pilot study in Ghana found high acceptability among those who chose home self-injection for the third injection based on satisfaction (98%), comfort (100%), and intention to continue home self-injection (97%). Reasons for opting for home self-injection include not having to travel to the facility (71%), injecting in the comfort of one's home (53%), and privacy (42%).…”

Section: Discussionmentioning

confidence: 99%

“…Additional information is available elsewhere. 11 This variable was used to adjust the multivariate model for random effects at the regional/residence level since earlier analyses (not shown) using the health facility level perfectly predicted selfinjection for one of the facilities.…”

Section: Variablesmentioning

confidence: 99%

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What Distinguishes Women Who Choose to Self-Inject? A Prospective Cohort Study of Subcutaneous Depot Medroxyprogesterone Acetate Users in Ghana

Nai¹,

Tobey²,

Fuseini³

et al. 2022

Glob Health Sci Pract

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At their third injection, or 6 months into using subcutaneous depot medroxyprogesterone acetate (DMPA-SC), 73% of these users chose selfinjection, an increase from 42% who chose selfinjection at the first injection.n Clients who were new family planning users, never married, or attended high school/attained higher education were significantly more likely to self-inject by the third injection compared to their respective counterparts. Expanding method choice through this new mode of injection administration may help to meet these users' needs.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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What Distinguishes Women Who Choose to Self-Inject? A Prospective Cohort Study of Subcutaneous Depot Medroxyprogesterone Acetate Users in Ghana

Nai¹,

Tobey²,

Fuseini³

et al. 2022

Glob Health Sci Pract

Self Cite

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“… 2018 ; Nai et al. 2020 ). These approaches may also provide more equitable access for women who cannot easily access a public health facility.…”

Section: Discussionmentioning

confidence: 99%

“…Approaches such as task shifting, where community health workers and pharmacists offer more methods, should be explored in Senegal, despite legal and policy barriers, as evidence from others, settings have shown feasibility (Prata et al 2011;Hoke et al 2012;Mané, Diop, and RamaRao 2015;Cover et al 2017;Burke et al 2018;Hernandez et al 2018). Self-care options such as self-injection of Sayana Press have also been shown to be acceptable in other settings (Cover et al 2017;Burke et al 2018;Nai et al 2020). These approaches may also provide more equitable access for women who cannot easily access a public health facility.…”

Section: Discussionmentioning

confidence: 99%

Did COVID‐19 Impact Contraceptive Uptake? Evidence from Senegal

Fuseini

Jarvis

Ankomah

et al. 2022

Studies in Family Planning

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This study assessed the impact of the COVID‐19 pandemic on the number of new contraceptive acceptors in Senegal overall and by method. Monthly service data from March 2019 to December 2020 were extracted for the number of new contraceptive users of IUDs, implants, injectables, and oral contraceptive pills (OCPs). Data were analyzed using descriptive statistics and interrupted time series analysis for trend analyses overall and by the contraceptive method. Following the announcement of the first COVID‐19 case in Senegal in March 2020, there was an immediate significant decrease in the number of new acceptors overall, and for new users of implants and injectables. From March–December 2020, the trend in monthly new family planning acceptors increased overall, mainly driven by significant increases in new IUD and implant acceptors. Compared to the period before the onset of COVID‐19, there was a statistically significant shift from shorter‐acting methods (OCPs, injectables) to long‐acting reversible methods (IUDs, implants). Despite the immediate adverse impact of COVID‐19‐related restrictions, the number of new acceptors rebounded, trends in the number of new monthly acceptors significantly increased, and there was a significant shift to longer‐acting methods.

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Benefits, anxieties, acceptance, and barriers to the new injectable contraceptive DMPA-SC (Sayana Press): Clients’ perceptions in Sindh, Pakistan

Veesar,

Lashari,

Fida

et al. 2023

Gates Open Res

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Background: Injections are Pakistan's third most preferred contraceptive method because of their convenience. They represent a 2.5% share of the contraceptive prevalence rate (CPR) and contribute 10% to the current CPR. However, injections require a clinical setting or a healthcare provider for administration. A new method of subcutaneous presentation of depot medroxyprogesterone acetate (DMPA-SC), namely Sayana Press in Uniject™, has been introduced, which can be administered in nonclinical settings or self-administered by trained women. This study examined clients’ perceptions of the current depot medroxyprogesterone acetate-intramuscular injection (DMPA-IM) and its accessibility, availability, affordability, advantages, and disadvantages. In addition, it explored the benefits, barriers, and challenges regarding the new method of DMPA-SC (Sayana Press), especially considering self-injection. Methods: The study was conducted in Sindh, Pakistan. Three focus group discussions were conducted with 9–13 female participants with different demographic characteristics. A semi-structured questionnaire was used. The discussion was recorded, transcribed, and translated from Urdu or Sindhi to English. Transcripts were coded precisely, and data analysis was performed using NVivo software. Results: Participants expressed moderate fear of self-injection and risk of an inaccurate prick, suggesting that DMPA-SC acceptance may not be challenging at a community level. They appreciated free services at public health facilities, as the affordability of private facilities may be challenging for those with low income. Most participants agreed to pay PKR 50–300 (approximately 1 USD or less) as service charges for a private facility, while some agreed to pay for transportation costs when lacking alternative methods. Conclusions: DMPA-SC is a valuable alternative, provided its challenges are adequately addressed. Information about self-injection contraceptives is currently limited, and shared self-administration may be difficult without adequate training and counseling. Nevertheless, clients prefer the self-injection method for family planning to avoid transportation and private service charges.

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Introduction of DMPA-SC self-injection in Ghana: A feasibility and acceptability study using Sayana® Press

Cited by 4 publications

References 11 publications

What Distinguishes Women Who Choose to Self-Inject? A Prospective Cohort Study of Subcutaneous Depot Medroxyprogesterone Acetate Users in Ghana

What Distinguishes Women Who Choose to Self-Inject? A Prospective Cohort Study of Subcutaneous Depot Medroxyprogesterone Acetate Users in Ghana

Did COVID‐19 Impact Contraceptive Uptake? Evidence from Senegal

Benefits, anxieties, acceptance, and barriers to the new injectable contraceptive DMPA-SC (Sayana Press): Clients’ perceptions in Sindh, Pakistan

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