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How self-injection contributes to contraceptive autonomy and the power of making self-injection count

This opening plenary of the Making Self-Injection Count workshop highlighted how self-injection data can help close the gender data gap by providing key information and insights on the experiences of women and adolescents. Presenters discussed how self-injection can contribute to contraceptive autonomy by enabling women and girls to make and actualize their own decisions. The session featured personal stories from a self-injection ambassador, self-injection provider, and self-injection client.

Objectives

By the end of this session, participants were able to:

  • Describe the importance of self-injection for contraceptive autonomy, and self-injection in the context of self-care.
  • Describe the landscape of self-injection data availability.
  • Understand experiences of self-injection from the lens of a provider, user, and advocate.

Key takeaways

  • While progress is being made, self-injection data availability is still limited compared to other contraceptive data sets.
  • Disaggregation by client age, district, and DMPA-SC delivery mode (self-injected vs. provider-administered DMPA-SC) is essential to DMPA-SC data tracking.
  • High-quality data systems give us insight into women’s and girls’ preferences, client access to family planning, provider training needs, and global supply management opportunities.

Presenters

  • Caitlin Corneliess, MPH, Project Director, DMPA-SC Access Collaborative
  • Fannie Kachale, Director Reproductive Health Services, Ministry of Health, Malawi
  • Briana Lucido, WHO Department of Sexual and Reproductive Health and Research
  • Dr. George Swomen, MD, Programme Officer of Special Projects, Planned Parenthood Federation of Nigeria (PPFN)
  • Fatimata Deme, President, Senegalese Women’s Network for the Promotion of Family Planning
  • Matilda, Volunteer, Kibalinga Health Centre in Uganda

Institutional Author(s): PATH, JSI, Inc.
Publication date: March, 2021

Self-injected subcutaneous DMPA: A new frontier in advancing contraceptive access and use for women

This brief details the strong body of evidence and experience with self-injection of DMPA-SC in low-resource settings, including how the practice can reduce access-related barriers, improve contraceptive continuation, and enhance women’s autonomy.

Institutional Author(s): PATH
Publication date: October, 2019

WHO Consolidated Guideline on Self-Care Interventions for Health

This guidance aims to provide a people-centred, evidence-based normative guideline that will support individuals, communities, and countries with quality health services and self-care interventions, based on PHC strategies, comprehensive essential service packages and people-centredness. The guidance includes a “strong” recommendation for self-administered injectable contraception, stating that this should be made available as an additional approach to deliver injectable contraception for individuals of reproductive age.

Institutional Author(s): World Health Organization (WHO)
Publication date: 2019

The “why” and the “how” of routine data collection: Real world examples of using data from routine HMISs in policy and programming

In this session from the Making Self-Injection Count workshop, presenters discussed challenges to data use for decision-making and shared examples of how countries and programs have made data actionable in other health areas, specifically Malaria and immunization. The presentation included an example of an application of routine family planning data, including a new analysis of self-injection data from Senegal, and wrapped up with a panel Q&A focused on solutions.

Objectives

By the end of this session, participants were able to:

  • Understand key principles for fostering data use for decision-making.
  • Understand how countries and programs have used routine health data for decision-making.
  • Identify strategies to overcome challenges to data use.
  • Consider data quality and understand how it can be evaluated.

Key takeaways

  • Better data will lead to better decision-making and better health outcomes.
  • Data should:
    • be subjected to quality audits.
    • be delivered in a form that works for each intended audience and in alignment with their goals.
    • be shared with those who contributed the data and who have control over how services are offered.
    • include visualizations that effectively convey key details.
    • be iterative and ongoing.
  • There is a need for standardized metrics that allow for comparability among countries.

Presenters

  • Jonathan Drummey, Data Visualization Specialist, PATH
  • Fred Njobvu, Technical Advisor, Center for Digital & Data Excellence, PATH
  • Marie-Reign Rutagwera, Strategic Information Advisor, PAMO Plus, PATH
  • Jessica Williamson, Data Analyst, Track20 Project, Avenir Health

Institutional Author(s): PATH, JSI, Inc.
Publication date: March, 2021

Adolescent and covert family planning users’ experiences self-injecting contraception in Uganda and Malawi: implications for waste disposal of subcutaneous depot medroxyprogesterone acetate

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.

Institutional Author(s): FHI 360
Individual Author(s): Holly M Burke, Catherine Packer, Laura Wando, Symon Peter Wandiembe, Nelson Muwereza, Subarna Pradhan, Akuzike Zingani, Bagrey Ngwira
Publication date: August, 2020

Journal Article Adolescent and covert family planning users’ experiences self-injecting contraception in Uganda and Malawi: implications for waste disposal of subcutaneous depot medroxyprogesterone acetate

Costs and cost-effectiveness of subcutaneous DMPA through different delivery channels: What new evidence tells us

This brief summarizes recent evidence from African countries on the costs and cost-effectiveness of DMPA-SC. Key findings include that DMPA-SC may help reduce service delivery costs by catalyzing expansion of channels closest to women and that self-injected DMPA-SC is cost-saving as compared to clinic-administered DMPA-IM when accounting for costs to women and health systems.

Institutional Author(s): PATH
Publication date: October, 2019

DMPA-SC self-injection supports women to use injectable contraception longer

This research brief describes research findings that women who self-inject DMPA-SC continue to use contraception longer than women who use intramuscular DMPA (DMPA-IM) administered by a health worker.

Institutional Author(s): PATH
Publication date: July, 2018

Brief DMPA-SC self-injection supports women to use injectable contraception longer

Self-Injection Feasibility and Acceptability

This brief provides an overview of PATH’s research studies assessing the feasibility and acceptability of self-injection in Uganda and Senegal.

Institutional Author(s): PATH
Publication date: January, 2018

Brief Self-Injection Feasibility and Acceptability