To evaluate the 12-month total direct costs (medical and nonmedical) of delivering subcutaneous depot medroxyprogesterone acetate (DMPA-SC) under three strategies – facility-based administration, community-based administration and self-injection – compared to the costs of delivering intramuscular DMPA (DMPA-IM) via facility- and community-based administration. We conducted four cross-sectional microcosting studies in three countries from December 2015 to January 2017. We estimated direct medical costs (i.e., costs to health systems) using primary data collected from 95 health facilities on the resources used for injectable contraceptive service delivery. For self-injection, we included both costs of the actual research intervention and adjusted programmatic costs reflecting a lower-cost training aid. Direct nonmedical costs (i.e., client travel and time costs) came from client interviews conducted during injectable continuation studies. All costs were estimated for one couple year of protection. One-way sensitivity analyses identified the largest cost drivers.
Institutional author(s): PATH, University of Washington
Individual author(s): Laura Di Giorgio, Mercy Mvundura, Justine Tumusiime, Allen Namagembe, Amadou Ba, Danielle Belemsaga-Yugbare, Chloe Morozoff, Elizabeth Brouwer, Marguerite Ndour, Jennifer Kidwell Drake
Publication date: May, 2018