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Author: Anthony K Mbonye


A prospective cohort study of the feasibility and acceptability of depot medroxyprogesterone acetate administered subcutaneously through self-injection

Evidence on contraceptive self-injection from the United States and similar settings is promising, and the practice may increase access. There are no published studies on the feasibility of contraceptive self-injection in sub-Saharan Africa to date. The purpose of this study was to assess feasibility of subcutaneous depot medroxyprogesterone acetate self-injection in Uganda, with specific objectives to (a) measure the proportion of participants who self-injected competently, (b) measure the proportion who self-injected on time 3 months after training (defined conservatively as within 7 days of their reinjection date) and (c) assess acceptability. In this prospective cohort study, 380 18–45-year-old participants completed self-injection training by licensed study nurses, guided by a client instruction booklet, and practiced injection on prosthetics until achieving competence. Nurses supervised participants’ self-injection and evaluated injection technique using an observation checklist. Those judged competent were given a Sayana® Press unit, instruction booklet and reinjection calendar for self-injection at home 3 months later. Participants completed an interview before and after self-injection. Nurses visited participants at home following reinjection dates; during the follow-up visit, participants demonstrated self-injection on a prosthetic, injection technique was reevaluated, and a post reinjection interview was completed.

Institutional Author(s): PATH, Uganda Ministry of Health
Individual Author(s): Jane Cover, Allen Namagembe, Justine Tumusiime, Jeanette Lim, Jennifer Kidwell Drake, Anthony K Mbonye
Publication date: October, 2016

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Observational study of the acceptability of Sayana® Press among intramuscular DMPA users in Uganda and Senegal

This study measured acceptability of DMPA-SC (Sayana® Press) among intramuscular DMPA (DMPA-IM) users. Current DMPA-IM users in Senegal and Uganda accepted DMPA-SC, and most preferred DMPA-SC over DMPA-IM. DMPA-SC can be safely introduced into family planning programs and administered by trained community health workers, with expectation of client uptake.

Contraception. 2014. May;89(5):361-7. Epub 2014 Feb 6. https://doi.org/10.1016/j.contraception.2014.01.022

 

 

Institutional Author(s): FHI 360
Individual Author(s): Holly M Burke, Monique P. Mueller, Brian Perry, Catherine Packer, Leonard Bufumbo, Daouda Mbengue, Ibrahima Mall, Bocar Mamadou Daff, Anthony K Mbonye
Publication date: February, 2014

Journal Article Observational study of the acceptability of Sayana® Press among intramuscular DMPA users in Uganda and Senegal

Provider acceptability of Sayana® Press: results from community health workers and clinic-based providers in Uganda and Senegal.

Sayana® Press (SP), a subcutaneous formulation of depot medroxyprogesterone acetate (DMPA) in Uniject™, has potential to be a valuable innovation in family planning (FP) because it may overcome logistic and safety challenges in delivering intramuscular DMPA (DMPA IM). However, SP’s acceptability is unknown. We measured acceptability of SP among clinic-based providers (Senegal only) and community health workers. This open-label observational study was conducted in clinics in three districts in Senegal and community-based services in two districts in Uganda. Providers administered SP to clients seeking reinjection of DMPA IM. We conducted in-depth interviews with 86 providers (52 in Senegal, 34 in Uganda) to assess their experiences providing SP to clients.

Institutional Author(s): FHI 360, Centre de Formation et de Recherche en Santé de la Reproduction (CEFOREP), Senegal Ministry of Health and Social Action, Uganda Ministry of Health
Individual Author(s): Holly M Burke, Monique P. Mueller, Catherine Packer, Brian Perry, Leonard Bufumbo, Daouda Mbengue, Bocar Mamadou Daff, Anthony K Mbonye
Publication date: January, 2014

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