Family planning leaders and implementers can draw from an established evidence base to integrate DMPA-SC in efforts to address unmet need and increase access to contraception through a range of delivery channels.
Based on growing demand among stakeholders, providers, and family planning clients, as well as increased investment from the donor community, countries across sub-Saharan Africa and Asia are pursuing introduction and scale-up of DMPA-SC and self-injection. Through these country experiences, partners have generated evidence and practical guidance for ministries of health, nongovernmental implementing partners, and policymakers working to introduce and scale up DMPA-SC or similar products.
The Access Collaborative provides free 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.
This customizable DMPA-SC Advocacy Pack template provides a brief description of DMPA-SC; an overview of evidence on how the product expands access through multiple delivery channels; and policy and advocacy recommendations for country decision-makers.
One-third of contraceptive users in low- and middle-income countries access their method from a private sector source. Momentum is growing to ensure that contraceptive injectables, including DMPA-SC/self-injection, are among the range of methods offered through private channels. Speakers shared the latest evidence regarding pharmacy and drug shop provision of DMPA-SC/self-injection, updates on the release of a generic product, reflections on packaging for the private sector, and tensions between equity and financial sustainability in a changing landscape for contraceptive procurement financing. Speakers and participants discussed innovations to improve private sector channel economics and advance both equity and sustainability.
This healthy markets framework assessment highlights market opportunities for intramuscular (IM) and subcutaneous (SC) injectables and makes several recommendations on how to sustain and expand access.
The three primary takeaways from the assessment are:
The lack of funding for procurement remains the main barrier to meeting global demand for injectables. This is also limiting demand across SRH products in general.
IM injectables still dominate the injectables market. Shipments of SC injectables have been relatively modest over the last few years, with evidence of challenges to fulfill country orders. An increase is projected in the demand for SC injectables over time with secure, diversified supply, particularly if the price premium of SC versus that of IM injectables is reduced. The arrival of a generic SC injectable could make a significant difference when it comes to pricing, however uncertainties remain as to whether SC injectables will be able to fully realize their potential.
Structural problems such as the lack of provider capacity and supportive policies to enable access are hindering the growth of the market for SC injectables and require special attention.
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 global family planning handbook provides high-quality, up-to-date guidance for health care professionals working in low- and middle-income countries. “Chapter 4: Progestin-Only Injectables” includes information and guidance for DMPA-SC administration and self-injection.
The Training Resource Package (TRP) for Family Planning’s Progestin-Only Injectable module includes sessions V and VI which are focused on DMPA-SC and self-injection, as well as a number of related handouts and resources. Developed in partnership with the Access Collaborative, these materials are intended for training health care providers who offer progestin-only injectable contraception (“injectables”) in the public or private sector.
The TRP website features training information and materials for a wide range of family planning methods. This includes curriculum components and tools for trainers to design, implement, and evaluate family planning and reproductive health training.
DMPA-SC is a three-month injectable contraceptive that is easy to use and uniquely suited for self-injection. Demonstration and practice injections are a key part of training programs for both health workers and self-injection clients. Based on lessons learned in five countries, this memo summarizes PATH’s recommendations regarding devices for injection demonstration and practice, injection practice models, and waste disposal.