Based on evidence and experience, countries worldwide are adding the option of DMPA-SC self-injection to their contraceptive method mix.
Self-injection has the potential to reduce access-related barriers for women, increase contraceptive continuation rates, and enhance women’s autonomy. There are strong data that women, including women in low-resource settings, can self-administer DMPA-SC safely and effectively, and that they like doing so.
The DMPA-SC Access Collaborative has published a collection of briefs on countries where we have provided focused technical assistance between 2017 and 2021. This includes the Democratic Republic of the Congo, Kenya, Madagascar, Nigeria, Uganda, and Zambia. Each brief describes the country’s introduction and scale-up experiences for DMPA-SC and self-injection, including accomplishments, challenges, innovations, key lessons, factors for success, and plans for the way forward.
On September 15, 2021, the PATH-JSI DMPA-SC Access Collaborative hosted this virtual launch and walk-through of the redesigned DMPA-SC Country Data Dashboard and new monitoring, learning, and evaluation (MLE) tools.
The AC data dashboard is an interactive tool that presents available data collected during DMPA-SC self-injection (SI) introduction and scale-up. The dashboard visualizes SI uptake, tracks implementation of key policies, and integrates data use practices to support data-driven decision making. Information presented on the dashboard has changed over time to reflect shifting needs of stakeholders. After undergoing a human centered design exercise to better understand information needs surrounding SI introduction and scale-up, the Access Collaborative recently redesigned the DMPA-SC Country data dashboard. This webinar introduced new data available and demonstrated new features on the dashboard.
The webinar also included an overview of the Access Collaborative’s new MLE toolkit developed to help meet the needs of ministries of health and implementing partners. This toolkit features three tools for dynamic decision-making: a data visualization principles guide, an Excel dashboard how-to guide, and a data use and indicators guide. The tools are primers in how to create dynamic and visually compelling SI program data displays (e.g., dashboards, presentations) that facilitate comprehension and use of SI data for family planning program decision-making. While the toolkit was developed with SI in mind, many of the principles could be applied to data visualization needs across family planning programs and methods.
Institutional Author(s): PATH, JSI, Inc.
Publication date: September, 2021
Costed implementation plans play an important role in transforming family planning commitments into concrete programs and policies by informing budget creation and management as well as funding allocations and tracking. As part of introduction and scale-up planning across countries, the DMPA-SC Access Collaborative has worked with ministries of health and partners to create costed implementation plans for DMPA-SC specifically and map commitments or available budgets against costed plans to understand funding gaps. This brief describes the Access Collaborative’s costed implementation plan approach as well as costing tools available to enable countries to estimate their own plan’s requirements and potential funding gaps. For more information or assistance, please visit the Access Collaborative technical assistance page or contact FPoptions@path.org.
Using eLearning to train health workers on family planning counseling can be an effective training approach, particularly when carefully planned and coordinated to maximize the benefits. On August 26, 2021, the DMPA-SC Access Collaborative hosted this webinar on eLearning for health workers learning to counsel clients on DMPA-SC self-injection in Senegal and Uganda. During the COVID-19 pandemic in 2020, this approach was launched and evaluated in four regions of Senegal and four districts in Uganda.
The findings and recommendations from the experiences in Senegal and Uganda may offer lessons for other countries wishing to implement digital learning approaches. The webinar presenters raised important considerations about stakeholder coordination, internet and technology access, eLearning platforms, establishing training targets, training content, and the important role of post-training supervision.
Institutional Author(s): PATH, JSI, Inc.
Publication date: August, 2021
Data has the power to convey the lived experiences of women and adolescents, highlighting the importance and potential of expanding choices to reduce unmet need for contraception. This monitoring, learning, and evaluation (MLE) toolkit features three tools for dynamic decision-making: A data visualization principles guide, an Excel dashboard how-to guide, and a data use and indicators guide. These are primers on how to create dynamic and visually compelling self-injection program data displays (e.g., dashboards, presentations) that facilitate comprehension and use of self-injection data for family planning program decision-making. While the MLE toolkit was developed with self-injection in mind, many of the principles could be applied to data visualization needs across family planning programs and methods.
We want to hear from you! By completing this short survey, you can help us ensure the tools are meeting the needs of key stakeholders during new product introduction and scale-up. Please contact FPoptions@path.org with any questions or request for assistance.
Supportive supervision plays a critical role to ensure high-performing health workers have the appropriate knowledge, skills, and motivation in order to deliver quality family planning (FP) services and informed choice counseling. This package includes three supportive supervision tools that can be used by regional or district health teams when conducting supervision visits at health facilities that offer FP services:
Supportive supervision checklist to assess provision of family planning counseling
Observation checklist to assess health workers counseling clients on DMPA-SC self-injection
Remote supervision of family planning providers (includes family planning and self-injection)
Tools #1 and #2 can be used together or separately, depending on whether or not the supervision visits include follow-up with providers recently trained to counsel clients on DMPA-SC self-injection.
Tool #3 is intended for use in situations where in-person supervision is not possible; the supervision exercise can be conducted through phone or video. This tool includes guidance and instructions for supervisors who plan to conduct supervision remotely.
The tools are intended to serve as guides and can be adapted for specific settings as needed. For more information, contact FPoptions@path.org.
Institutional Author(s): PATH, JSI, Inc.
Publication date: July, 2021
Guidance for using supportive supervision tools
This webinar hosted by the DMPA-SC Access Collaborative Learning and Action Networks (LAN) on July 21, 2021 highlighted important considerations for private pharmacies in data collection and reporting on self-care products such as DMPA-SC self-injection. Presenters shared their experiences and lessons from introducing DMPA-SC self-injection through private delivery channels in their respective countries.
The specific types of self-injection data collected across countries.
Best practices for engaging and motivating private sector pharmacies and drug shops to provide data to the public sector.
Tools used by pharmacies to collect self-injection data.
This virtual discussion encouraged all stakeholders—program implementers, researchers, government officials, health providers, and civil society members—to consider private sector perspectives on data collection and reporting practices, highlighting the importance of good private sector data to inform government policies and strategies for monitoring, regulating health products, and procurement.
This guidance from the World Health Organization (WHO) 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.
The DMPA-SC Access Collaborative hosted this April 21, 2021 webinar highlighting lessons learned to date through four years of data-driven technical assistance and coordination to ensure that women have increased access to self-injection as a contraceptive option, delivered through informed choice programming. The discussion focused on key topics for the introduction and scale-up of self-injection—and self-care interventions more broadly—at the country level including:
Policy and advocacy for new product introduction.
How to coordinate scale-up of a new product.
Using data to inform program introduction and scale-up.
Effective innovations and adaptations in provider training.
This discussion was moderated by Monica Mutesa, Zambia Country Coordinator, DMPA-SC Access Collaborative, PATH. Speakers included:
In this Making Self-Injection Count workshop session, participants were engaged in a lively discussion and interactive collaboration around the important considerations for private sector data collection and reporting on self-care products such as DMPA-SC. This session began with a short presentation to set the stage on the important role of private sector and data within the context of mixed health systems. Participants joined a moderated discussion with three in-country implementers from Nigeria (DKT), Uganda (PSI) and Zambia (JSI) who shared their experiences and lessons from introducing DMPA SC self-injection and other self-care products through private delivery channels. The session concluded with a facilitated, interactive activity to identify and prioritize private sector data needs.
By the end of the session, participants were able to:
Characterize the private sector within the context of the total market for DMPA-SC and other self-care products.
Describe the current landscape for provision of DMPA-SC self-injection through the private sector.
Identify the unique considerations and feasibility for collecting private sector data within mixed health systems.
The private sector is highly diverse and fragmented, comprised of profit and non-for-profit, formal and informal, domestic and global non-state actors. A total market approach (TMA) considers all channels of service delivery–public and private–to increase equitable and sustainable access to health products and services by maximizing the comparative advantage of all sectors. TMA builds upon market segmentation, using various channels to expand the overall market and meet demand for family planning, particularly where the public sector is not meeting women’s preferences/needs.
Aligning and harmonizing data in mixed health systems is complicated. Different types of data are needed at various levels to understand the total market. By taking a holistic perspective–one that considers both the public and private sectors–we can identify the opportunities and gaps that exist at client, provider and systems level to guide policy, program, and investment decisions. Some data is more readily available, such as public sector procurement and distribution trends. However, other data, such as consumer retail price, willingness to pay or volumes of product sold, are often less available due to a variety of reasons, and sometimes require additional research.
It is important to engage and understand the perspectives of the private sector when it comes to data collection/reporting desires and needs of governments and other stakeholders.
Ariella Bock, Senior Technical Advisor, JSI
Mika Bwembya, Health Supply Chain and Total Market Director, USAID DISCOVER Health Project
Kimberly Cole, Private Sector Service Delivery Programs, USAID’s Global Health Bureau’s Office of Population and Reproductive Health
Tanvi Pandit-Rajani, Private Sector & Health Markets Lead, JSI