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Pharmacokinetics of subcutaneous depot medroxyprogesterone acetate injected in the upper arm

This study evaluated the pharmacokinetic profile of medroxyprogesterone acetate (MPA) following injection of Depo-SubQ Provera 104 (DMPA-SC) in the upper arm, a preferred injection site in developing countries. Injection of Depo-SubQ Provera 104™ in the upper arm provided sufficient MPA levels for contraceptive protection for 3 months (13 weeks). The uptake and metabolism of MPA when injected in the upper arm may be different from the abdomen and thigh.


Institutional author(s): FHI 360
Individual author(s): Vera Halpern, Stephanie L Combes, Laneta J Dorflinger, Debra H Weiner, David F Archer
Publication date: July, 2013

Journal article Pharmacokinetics of subcutaneous depot medroxyprogesterone acetate injected in the upper arm

Acceptability of depo-subQ in Uniject

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.

Institutional author(s): FHI 360
Publication date: June, 2013

Operational Assessment: Administration and Management of Sayana® Press in Clinics and Communities in Uganda

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

Feasibility of Administering Sayana® Press in Clinics and Communities: Summary Findings From an Operational Assessment in Senegal

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

Optimizing health worker roles to improve access to key maternal and newborn health interventions through task shifting

Human resource shortages in the health services are widely acknowledged as a threat to the attainment of the health related Millennium Development Goals (MDGs). Attempts to optimize the potential of the existing health workforce are therefore crucial. A more rational distribution of tasks and responsibilities among cadres of health workers is seen as a promising strategy for improving access and cost effectiveness within health systems. For example, access to care may be improved by training and enabling ‘mid-level’ and ‘lay’ health workers to perform specific interventions that might otherwise be provided only by cadres with longer (and sometimes more specialized) training. Such task shifting strategies might be particularly attractive to countries that lack the means to improve access to care within short periods of time. Strategies to optimize tasks and roles for the implementation of effective interventions have achieved variable success. This is partly because the effects of these strategies are dependent on varying local health contexts and are shaped by a range of often very different social, political and cultural systems. However, the question of which health-care providers can deliver effective interventions is also linked to wider global discussions about whether health workers with lower levels of training can safely deliver key interventions. Within the arena of maternal and newborn health, for example, the implementation of contraceptive programmes and specific maternal health interventions (such as the use of uterotonics) is linked to wider debates about how task and role optimization can be achieved through task shifting. Consensus has emerged that there is a need to define which key interventions can safely and effectively be delivered by different cadres.

Institutional author(s): World Health Organization (WHO)
Publication date: 2012

Logistics and Waste Management Benefits of depo-subQ in Uniject

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.

Institutional author(s): PATH, JSI
Publication date: February, 2011

Global Experience of Community Health Workers for Delivery of Health Related Millennium Development Goals: A Systematic Review, Country Case Studies, and Recommendations for Integration into National Health Systems

Participation of community health workers (CHWs) in the provision of primary health care has been experienced all over the world for several decades, and there is an amount of evidence showing that they can add significantly to the efforts of improving the health of the population, particularly in those settings with the highest shortage of motivated and capable health professionals. With the overall aim of identifying CHWs programs with positive impact on Millennium Development Goals (MDGs) related to health or otherwise, a global systematic review was undertaken of such interventions, as well as eight in-depth country case studies in Sub-Saharan Africa (Ethiopia Mozambique and Uganda), South East Asia (Bangladesh, Pakistan and Thailand) and Latin America (Brazil and Haiti). The focus was on key aspects of these programs, encompassing typology of CHWs, selection, training, supervision, standards for evaluation and certification, deployment pat­terns, in-service training, performance, and impact assessment.

Institutional author(s): Global Health Workforce Alliance, World Health Organization (WHO)
Publication date: 2010

Reproductive Health Supplies Coalition

The Reproductive Health Supplies Coalition (RHSC) is a global partnership of public, private, and non-governmental organizations dedicated to ensuring that all people in low- and middle-income countries can access and use affordable, high-quality supplies to ensure their better reproductive health. The Coalition brings together diverse agencies and groups with critical roles in providing contraceptives and other reproductive health supplies. These include multilateral and bilateral organizations, private foundations, governments, civil society, and private-sector representatives.

Institutional author(s): Reproductive Health Supplies Coalition (RHSC)
Publication date: 2004