Self-administered subcutaneous depot medroxyprogesterone acetate (DMPA-SC) is poised to increase access to contraception; however, governments are concerned about the waste management of used units. Self-injectors in Malawi and Uganda are currently instructed to store used units in containers and return them to health workers for disposal. However, this may not be feasible in low-resource settings, especially for younger or covert self-injectors. We describe adolescent (15–19 years) and adult (20–49 years) self-injectors’ disposal experiences in Uganda and Malawi. When possible, we compare covert and overt users’ experiences.
Adolescent and covert family planning users’ experiences self-injecting contraception in Uganda and Malawi: implications for waste disposal of subcutaneous depot medroxyprogesterone acetate
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.