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.
PATH developed this fact sheet in response to questions about the recommended reinjection time frames for subcutaneous DMPA (DMPA-SC). This document summarizes the World Health Organization (WHO) recommendations for reinjection timing. The brief also explains why clients living with HIV, including those using antiretroviral therapies, can use DMPA on the same schedule as any other client.
Advancing Partners & Communities (APC) advances programs that improve the overall health of communities, especially family planning (FP). The project increases access to community-based family planning (CBFP) services, including Sayana Press, a progestin-only injectable contraceptive that provides three-months of coverage, similar to Depo-Provera. Sayana Press, however, it is unique in that it combines the needle and drug in a small, lightweight, easy-to-use single dose container. APC is working to introduce and scale up community-based distribution of this new commodity in Benin and Uganda. The project is also investigating community-based provision of injectables for home and self-injection in Malawi. Each of these efforts has the potential to dramatically increase the number of contraceptive users at country and global levels, reducing the percentage of women and couples who have an unmet need for contraception.
To describe a demand estimation exercise conducted in response to an initiative to introduce Sayana Press in Sub-Saharan Africa and South Asia. Secondary data sources were used to develop estimates of the number of Sayana Press units needed for countrywide introductions in 12 countries. To estimate uptake, the number of women who had stated an intention to use injectables was calculated. Two sets of assumptions (one conservative, one more ambitious) were used to assess conversion to actual use. Even with the use of very conservative assumptions, and assuming no method switching, Sayana Press was estimated to have the potential to cumulatively reach 3–6 million women by 2016.This projected uptake in a relatively short period and at the very beginning of an adoption curve suggests that Sayana Press has promise for countries looking to expand their list of contraceptive choices.
This study aimed to evaluate DMPA-SC (Sayana Press) management and administration in low-resource settings, focusing on how the delivery logistics, administration time, storage and waste-management requirements compare to the traditional intramuscular DMPA injectable (DMPA-IM).
Cover J, Blanton E, Ndiaye D, Walugembe F, Lamontagne DS. Operational assessments of Sayana® Press provision in Senegal and Uganda. Contraception. 2014 May;89(5):374-8. https://doi.org/10.1016/j.contraception.2014.01.005. Epub 2014 Jan 18. PMID: 24565737.
FHI 360’s PROGRESS project worked with ministries of health and local partners in Senegal and Uganda to conduct an acceptability study of the subcutaneous delivery of injectable contraceptives with the Uniject™ device (DMPA-SC, Sayana® Press). The study assessed acceptability among family planning clients and providers, including community health workers, and offered recommendations for the introduction of this method.
This operational assessment in Uganda examines the extent to which DMPA-SC (brand name Sayana® Press) facilitates the logistics of managing and administering injectable contraception and assesses whether providers in Uganda find benefits in this new presentation.
Institutional author(s): PATH
Publication date: May, 2013
Brief
Operational Assessment: Administration and Management of Sayana® Press in Clinics and Communities in Uganda
This study assessed the extent to which Sayana Press simplifies the logistics of managing and administering injectable contraception and whether providers in Senegal found this new presentation to be more practical and preferable to the standard syringe-vial injectable contraceptive. The operational assessment leveraged the acceptability study conducted by FHI 360 in Thies, Mbour, and Tivaouane by targeting the same 12 clinics from that study and asking providers who participated to reflect on their experience managing and administering Sayana Press. Semi-structured interviews with one provider from each of the 12 clinics and 9 affiliated CBD agents (matrones) for a total of 21 interviews, provided quantitative and qualitative data on the merits, challenges, and appeal of Sayana Press relative to DMPA-IM.
Institutional author(s): PATH
Publication date: April, 2013
An indicator is a measure of program performance that is tracked over time. This document presents potential process and outcome indicators organized according to phase of the community-based access to injectables (CBA2I) pilot along with the related evaluation questions, data sources and measurement tools. The list can be adapted to local context and program goals to assess a pilot’s progress toward intended outputs and achievement of goals.
This four-page brief describes results from three analyses conducted by PATH and John Snow Inc. (JSI) comparing the intramuscular version of depot medroxyprogesterone acetate (DMPA) injectable contraceptive compared with the new DMPA-SC formulation packaged in the Uniject injection system. The analyses focused on waste management implications and identified key quantitative and qualitative differences between the two products.
This 16-page paper provides an overview of the debate about how developing country drug regulation agencies are funded and the extent to which they should build local capacity or rely on regulators in developed countries.