Trends in subcutaneous depot medroxyprogesterone acetate (DMPA-SC) use in Burkina Faso, the Democratic Republic of Congo and Uganda

Anglewicz, Philip; Akilimali, Pierre; Guiella, Georges; Kayembé, Patrick; Kibira, Simon P. S.; Makumbi, Fredrick; Tsui, Amy O.; Radloff, Scott

doi:10.1016/j.conx.2019.100013

Cited by 6 publications

(12 citation statements)

References 19 publications

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“…Our study observed supply side trends that are consistent with increasing DMPA-SC prevalence across SSA [3] . Results are also consistent with previous research on other modern methods describing the wide variation in contraceptive stock availability across countries, methods, and sectors [16] , [17] , [18] , [19] .…”

Section: Discussionsupporting

confidence: 77%

“…Its benefits include a delivery design that combines the drug and needle in a prefilled system, making it simple to administer and suitable for self-injection [ 1 , 2 ]. Given these attributes, it is not surprising that trends show increasing prevalence of DMPA-SC in many settings [3] . According to the DMPA-SC Access Collaborative—a project led by PATH and John Snow, Inc. that supports countries in the introduction and scale-up of the product—approximately 53 countries offer DMPA-SC as of 2021, and up to 33 are currently either piloting or scaling up DMPA-SC self-injection [4] .…”

Section: Introductionmentioning

confidence: 99%

“…The limited set of studies on supply-side factors mostly explore service provider-related characteristics and behaviors, with minimal or no data on method availability [8] , [9] , [10] , [11] . The Performance Monitoring for Action (PMA) project collects national data on DMPA-SC from service delivery points and a representative sample of women, but the few publications to date have largely focused on user characteristics [ 3 , 5 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

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DMPA-SC stock: Cross-site trends by facility type

et al. 2022

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Section: Discussionsupporting

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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DMPA-SC stock: Cross-site trends by facility type

et al. 2022

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“…Many reproductive health advocates and policymakers believe that self-injection represents the future of contraception within sub-Saharan Africa, and this promise appears to be reinforced by initial evidence showing increased prevalence of DMPA-SC in several sub-Saharan African settings. 13 This promise has led to substantial donor funding and enthusiasm to roll-out DMPA-SC as a method of self-care, 3 14 as well as a promising contraceptive method regardless of its self-injection capability, recognising the benefits of a lower hormone dose, smaller needle, and all-in-one application. Furthermore, large donors, supply coalitions, and governments are heavily invested in successful implementation of DMPA-SC given its potential to ease overburdened healthcare systems given the COVID-19 pandemic.…”

Section: Introductionmentioning

confidence: 99%

Self-injected contraceptives: does the investment reflect women’s preferences?

et al. 2022

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Subcutaneous depot medroxyprogesterone acetate (DMPA-SC) is an innovative contraceptive method aimed at meeting women’s unique circumstances and needs, largely due to its ability to be self-injected. Substantial research and advocacy investments have been made to promote roll-out of DMPA-SC across sub-Saharan Africa. To date, research on the demand for DMPA-SC as a self-injectable method has been conducted largely with healthcare providers, via qualitative research, or with highly specific subsamples that are not population based. Using three recent rounds of data from Performance Monitoring for Action, we examined population-representative trends in demand, use, and preference for self-injection among current non-users in Burkina Faso, the Democratic Republic of Congo (Kinshasa and Kongo Central regions), Kenya, and Nigeria (Lagos and Kano States). We found that while over 80.0% of women had heard of injectables across settings, few women had heard of self-injection (ranging from 13.0% in Kenya to 24.8% in Burkina Faso). Despite initial increases in DMPA-SC prevalence, DMPA-SC usage began to stagnate or even decrease in all settings in the recent three years (except in Nigeria-Kano). Few (0.0%–16.7%) current DMPA-SC users were self-injecting, and the majority instead were relying on a healthcare provider for administration of DMPA-SC. Among current contraceptive non-users wishing to use an injectable in the future, only 1.5%–11.4% preferred to self-inject. Our results show that self-injection is uncommon, and demand for self-injection is very limited across six settings, calling for further qualitative and quantitative research on women’s views on DMPA-SC and self-injection and, ultimately, their contraceptive preferences and needs.

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“…In addition, self-injection of DMPA-SC was found to be more cost-effective than DMPA-IM [ 8 , 9 ]. Given these attributes, it's not surprising that the prevalence of DMPA-SC has increased in recent years [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Characteristics associated with use of subcutaneous depot medroxyprogesterone acetate (DMPA-SC) in Burkina Faso, Democratic Republic of Congo, and Uganda

et al. 2021

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Objectives To what extent is DMPA-SC reaching new users versus encouraging method switching among existing users? Though increasingly-popular, little is known about characteristics of women using DMPA-SC in SSA. We compared characteristics of women using DMPA-SC with those of other modern methods, and identified the extent to which women using DMPA-SC switched from another method or are first-time users of contraception. Study design We used data collected by the Performance Monitoring for Action (PMA) Project between 2016 and 2019 from three countries, Burkina Faso, Democratic Republic of Congo, and Uganda. We tabulated characteristics of DMPA-SC, DMPA-IM, implant, and male condom users, and used multivariate analysis to compare characteristics of women using DMPA-SC those of the other three methods. We also examined previous contraceptive method use (if any) among women currently using DMPA-SC. Results We found that never-married women were more likely to use male condoms instead of DMPA-SC. Women with two or more children (compared to no children or one child) were more likely to use implants instead of DMPA-SC in both Uganda and DRC. DMPA-SC was the first method used by the majority of current users in Burkina Faso and Uganda. DMPA-SC users who previously used another method generally switched from less effective methods. Conclusions Although the characteristics of women using DMPA-SC varied across countries, DMPA-SC appears to be reaching new populations of women instead of inspiring existing modern users to switch to DMPA-SC, and appears to be appealing to first time users of contraception. Implications It appears that DMPA-SC appeals to new contraceptive users in sub-Saharan Africa, which implies that DMPA-SC may have the potential to increase modern contraceptive prevalence in sub-Saharan African countries.

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Trends in subcutaneous depot medroxyprogesterone acetate (DMPA-SC) use in Burkina Faso, the Democratic Republic of Congo and Uganda

Cited by 6 publications

References 19 publications

DMPA-SC stock: Cross-site trends by facility type

DMPA-SC stock: Cross-site trends by facility type

Self-injected contraceptives: does the investment reflect women’s preferences?

Characteristics associated with use of subcutaneous depot medroxyprogesterone acetate (DMPA-SC) in Burkina Faso, Democratic Republic of Congo, and Uganda

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