The Access Collaborative provides data-driven technical assistance (TA), coordination, resources, and tools to ensure that women and girls have increased access to DMPA-SC and self-injection as part of an expanded range of contraceptive methods, delivered through informed choice programming.

In addition to general information and evidence on DMPA-SC, partners can access the support outlined in the menu below by submitting a request through the technical assistance request form, also linked below. Your request can be submitted by emailing the completed form to FPoptions@path.org.

On March 21, 2023, the DMPA-SC Access Collaborative hosted this webinar highlighting the strengths and gaps of monitoring scale-up in the context of efforts to institutionalize DMPA-SC and self-injection in national family planning programs. The discussion focused on findings from Madagascar, Nigeria, Uganda, and Zambia, touching upon national goals for DMPA-SC, in-country perspectives on the value proposition of DMPA-SC, and suggested indicators for use in tracking the scale-up of a new product.

The DMPA-SC Update is a periodic newsletter from the PATH-JSI DMPA-SC Access Collaborative highlighting global efforts to expand access to the self-injectable DMPA-SC in the context of a full range of family planning options. Click here to subscribe. For more information, please contact FPoptions@path.org.

An in-depth look at DMPA-SC and self-injection introduction in Zambia

The DMPA-SC Access Collaborative (AC) hosted this virtual discussion on February 16, 2023 to explore the challenges of introducing new contraceptive methods in the context of informed choice programming. This webinar focused on findings from a recent study conducted in Zambia which aimed to determine:

• The barriers to clients’ ability to exercise autonomy in their choice of family planning methods and modes of administration.
• The extent to which provider perceptions and method bias affect access to self-injection as a new contraceptive option.

This research was conducted as part of the AC’s broader learning agenda and focused on the potential risks to informed choice that could arise as new products or service innovations are integrated in family planning programs. While a new intervention is intended to expand contraceptive access and options, its introduction may inadvertently convey to providers that it is inherently better than existing products or practices. In the case of DMPA-SC, providers may promote self-injection over provider administration. Alternatively, providers may feel hesitant about a new method and withhold information. In either case, the client’s right to receive accurate information about a variety of methods and to make an informed choice about her reproductive health care is compromised. To explore these questions, the AC conducted a literature review and study interviewing both clients and providers to understand how DMPA-SC and self-injection are being offered in Zambia’s Copperbelt Province.

The DMPA-SC Access Collaborative has produced the brief and program design guide linked below to support countries and partners that are planning and rolling out DMPA-SC self-injection as part of an expanded range of contraceptive methods delivered through informed choice programming.

The Recommendations for Contraceptive Self-Injection brief summarizes the latest key findings, insights and recommendations the AC has accumulated through six years of technical assistance to ministries and partners engaged in self-injection program introduction and scale-up. These practices should be universally considered and implemented to increase family planning program success.

The Contraceptive Self-Injection Program Design Guide is a comprehensive tool that outlines optimal program models for DMPA-SC self-injection. It was originally developed in 2020 based on the self-injection program rollout in Uganda, the first country in sub-saharan Africa to offer contraceptive self-injection outside of a research setting. The guide has been updated in 2022 to reflect subsequent learnings, evidence, and data from scale-up efforts. The program design guide:

• Walks users through each step of a self-injection program, including all components related to health workers and clients.
• Highlights essential evidence on self-injection program design.
• Establishes areas where more research is needed.
• Draws attention to key moments for program design decision-making.
• Links users to additional resources and tools for program development.

Please contact FPoptions@path.org for further information or requests for assistance.

Lessons learned from training and support for health workers in the public and private sectors

Malawi has made significant progress in scaling up DMPA-SC and self-injection in the public sector with 100% of service delivery points activated. The country has also learned valuable lessons through private sector pilots and is in the process of finalizing new guidelines to authorize pharmacies and drugstores to provide self-injection training to clients. The country’s approach is widely appreciated as an example of effective government-led and partner-supported scale-up involving both the public and private sector.

This webinar hosted by the PATH-JSI DMPA-SC Access Collaborative Learning and Action Network on August 3, 2022 featured public and private partners’ insights on national scale-up of DMPA-SC and self-injection, with a focus on provider training and supportive supervision as well as strong cross-sectoral partnerships. Speakers included representatives from the Malawi Ministry of Health Reproductive Health Directorate, Clinton Health Access Initiative, FHI 360, and Population Services International.

Drawing from program data and research, panelists discussed practical lessons learned from Malawi’s national scale-up of public-sector provider training, public provider reflections on integrating self-injection, and experiences from a private sector provider training pilot. These lessons may benefit governments and public and private partners in other contexts who are in the process of introducing or scaling up DMPA-SC for self-injection.

In recent years, Ministries of Health and organizations have leveraged the Catalytic Opportunity Fund (COF) to make significant contributions to the national introduction and scale-up of DMPA-SC and self-injection. A rapid funding mechanism that supports short-term DMPA-SC scale-up activities that unlock or generate additional resources, the COF is administered by the Clinton Health Access Initiative (CHAI) and managed by the DMPA-SC Operations Group.*

This DMPA-SC Learning and Action Network (LAN) webinar held on July 7, 2022 featured successful COF grantees in the DRC, Rwanda, and Zambia. Speakers highlighted considerations for pharmacy and drug shop introduction, recommendations, and lessons from the DMPA-SC Access Collaborative’s experience in Zambia, inroads made by Pathfinder and Tulane university in the DRC, and early insights from Kasha’s last-mile family planning services delivery in Rwanda.

*The DMPA-SC Operations Group, convened by the Access Collaborative under the oversight of the DMPA-SC Donor Consortium, is a coordinating mechanism to proactively manage and reactively respond to both operational and service delivery issues arising from efforts to introduce, scale up, and ultimately increase access to DMPA-SC and self-injection.

An Excel skill-building workshop series

In March 2022, the DMPA-SC Access Collaborative Learning and Action Network (LAN) hosted an interactive skill-building workshop series on creating effective data visualizations to support family planning decision-making. This series was a hands-on skill-building opportunity using materials from the Access Collaborative’s Monitoring Learning and Evaluation (MLE) toolkit.

In this sequential series, each week’s session built upon the content of the previous session. For more information, please contact FPoptions@path.org.

This webinar held on February 23, 2022 was hosted by Expanding Effective Contraceptive Options (EECO) led by WCG Cares with PSI and the DMPA-SC Access Collaborative led by PATH in partnership with JSI. The discussion focused on the introduction and scale up of self-care family planning methods in sub-Saharan Africa, highlighting lessons and best practices from DMPA-SC scale-up and Caya® diaphragm pilot introductions in French-speaking West Africa. Presenters from Benin, Niger, and Senegal shared successes and challenges. This webinar was offered in French.

The private sector holds great potential to reduce unmet need for family planning, and many countries are poised to adopt a total market approach for increasing contraceptive access through private pharmacies and drug shops. Policies supporting scale-up of family planning service provision and expanding method options such as DMPA-SC self-injection, must be prioritized in these entities.

The PATH-JSI DMPA-SC Access Collaborative and partners have gained valuable insights with relevance to private sector engagement on self-injection. This webinar held February 15, 2022 highlighted lessons learnt, challenges, recommendations, and considerations for policies supporting private sector engagement in self-injection in different country contexts. Specific topics included:

• Financing and commodity production ecosystems
• Procurement and supply chains
• Service delivery and programming
• Data reporting and monitoring
• Advocacy
• Demand generation

The discussion was moderated by Allen Namagembe, Deputy Project Director, Uganda DMPA-SC Access Collaborative, PATH.

Panelists:

• Dr. Kayode Afolabi, Director and Head, Reproductive Health Division, Federal Ministry of Health, Nigeria
• Dr. Daniella Munene, Member, National Executive Committee, Pharmaceutical Society of Kenya
• Dr. Hortense Randrianaivo, President, Association of Pharmacists of Madagascar
• Mr. Célestin Compaore, Regional Project Director, DMPA-SC, Jhpiego, Burkina Faso