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Is contraceptive self-injection cost-effective compared to contraceptive injections from facility-based health workers? Evidence from Uganda

To assess the cost-effectiveness of self-injected subcutaneous depot medroxyprogesterone acetate (DMPA-SC) compared to health-worker-administered intramuscular DMPA (DMPA-IM) in Uganda. We developed a decision-tree model with a 12-month time horizon for a hypothetical cohort of approximately 1 million injectable contraceptive users in Uganda to estimate the incremental costs per pregnancy averted and per disability-adjusted life year (DALY) averted. The study design derived model inputs from DMPA-SC self-injection continuation and costing research studies and peer-reviewed literature. We calculated incremental cost-effectiveness ratios from societal and health system perspectives and conducted one-way and probabilistic sensitivity analyses to test the robustness of results.

Institutional Author(s): PATH
Individual Author(s): Laura Di Giorgio, Mercy Mvundura, Justine Tumusiime, Chloe Morozoff, Jane Cover, Jennifer Kidwell Drake
Publication date: August, 2018

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