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.
These short training videos are intended for both self-injection clients and health workers learning to administer the contraceptive DMPA-SC. The 5-minute self-injection training video is intended for women who have made the decision to self-inject DMPA-SC in the context of informed choice counseling. The 7-minute training video is for health workers who are giving injections to women who have chosen to use DMPA-SC in the context of informed choice counseling.
If you are interested in customizing these videos for your family planning program, we can make the voiceover scripts and video files available. To request these files please email FPoptions@path.org.
This article compares results from interviews with DMPA-SC providers in two separate pilot studies: 1) 53 medical and nursing school students teaching women how to self-inject (2016–2017); and 2) 34 lay community health workers providing DMPA-SC in rural areas of Lualaba (2017). All providers gave information on socio-demographic characteristics, recruitment,) training, supervision, experience and satisfaction with the provision of DMPA-SC. The paper examines variations in responses from the different provider cadres.
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.
This webinar held on February 23, 2022 was hosted by Expanding Effective Contraceptive Options (EECO) led by WCG Cares with PSI and the DMPA-SC Access Collaborative led by PATH in partnership with JSI. The discussion focused on the introduction and scale up of self-care family planning methods in sub-Saharan Africa, highlighting lessons and best practices from DMPA-SC scale-up and Caya® diaphragm pilot introductions in French-speaking West Africa. Presenters from Benin, Niger, and Senegal shared successes and challenges. This webinar was offered in French.
The private sector holds great potential to reduce unmet need for family planning, and many countries are poised to adopt a total market approach for increasing contraceptive access through private pharmacies and drug shops. Policies supporting scale-up of family planning service provision and expanding method options such as DMPA-SC self-injection, must be prioritized in these entities.
The PATH-JSI DMPA-SC Access Collaborative and partners have gained valuable insights with relevance to private sector engagement on self-injection. This webinar held February 15, 2022 highlighted lessons learnt, challenges, recommendations, and considerations for policies supporting private sector engagement in self-injection in different country contexts. Specific topics included:
Financing and commodity production ecosystems
Procurement and supply chains
Service delivery and programming
Data reporting and monitoring
The discussion was moderated by Allen Namagembe, Deputy Project Director, Uganda DMPA-SC Access Collaborative, PATH.
Dr. Kayode Afolabi, Director and Head, Reproductive Health Division, Federal Ministry of Health, Nigeria
Dr. Daniella Munene, Member, National Executive Committee, Pharmaceutical Society of Kenya
Dr. Hortense Randrianaivo, President, Association of Pharmacists of Madagascar
Mr. Célestin Compaore, Regional Project Director, DMPA-SC, Jhpiego, Burkina Faso
Updating family planning and reproductive health preservice training is an important approach to make an impact on the health workforce and foster successful programs. In 2021, the DMPA-SC Access Collaborative, in collaboration with Uganda’s Ministry of Health and Ministry of Education and Sports, conducted a regional training for clinical and health training institutions on the topic of DMPA-SC including self-injection. This training integrated DMPA-SC content into the health provider preservice curriculum, trained tutors, and helped advance national scale-up of self-injection. As a result, 92 Ugandan health training institutions included self-injection content in their preservice curriculum for nurses, midwives, and clinical officers, and 190 tutors were trained—which will help ensure training of many more providers in the future.
During this process, the Access Collaborative gained valuable insights with relevance to other country contexts. This webinar held on January 27, 2022 highlighted lessons learnt, challenges, recommendations, and considerations for the inclusion of self-injection content in provider preservice training. In the Ugandan context, these include:
How inclusion of self-injection in preservice training can help reach FP2030 country commitments.
Virtual preservice training approaches during the COVID-19 pandemic.
Costs for the inclusion of self-injection in preservice training.
The role of regulators and the Ministry of Health in ensuring availability of DMPA-SC for preservice training.
Institutional Author(s): PATH, JSI, Inc.
Publication date: January, 2022
Humanitarian crises and disease outbreaks exacerbate the barriers that women face when seeking reproductive health services. They also highlight a timeless truth: women must be able to manage their own sexual and reproductive health—especially in a crisis when health systems are at their weakest.
On November 17, 2021, the PATH-JSI DMPA-SC Access Collaborative hosted this webinar on making self-care interventions available, including DMPA-SC self-injection, in humanitarian settings. Through this virtual discussion, we addressed key challenges in humanitarian settings that need to be addressed in order to leverage the potential of self-injection as an option to ease access to family planning in the context of a full method mix.
Discussion highlights included:
Programmatic or regulatory actions that need to be implemented
Country-specific cultural barriers affecting demand generation in humanitarian settings
Supply systems and processes in humanitarian settings compared to national systems
Collaboration and data sharing between agencies
This discussion was moderated by George Barigye, Regional Technical Advisor, DMPA-SC Access Collaborative, PATH, Uganda. The keynote introduction was given by Dr. Adewole Adefalu, Country Coordinator, DMPA-SC Access Collaborative, JSI, Nigeria.
Lilian Ndinda, Maternal and Child Health Coordinator, International Rescue Committee, South Sudan
Dr. Arsenia Nhancale, Program Analyst, Family Planning and HIV, United Nations Population Fund, Mozambique
Dr. Ronald Nyakoojo, Assistant Public Health Officer, Reproductive Health/HIV, United Nations High Commissioner for Refugees, Uganda
Roselline Achola, National Programme Analyst, Family Planning, United Nations Population Fund, Uganda
This discussion encouraged all stakeholders—program implementers, researchers, government officials, health providers, and members of civil society—to consider humanitarian sector perspectives when advocating for policies that advance self-care behaviors and commodities essential to improving health outcomes in crisis settings.
Institutional Author(s): PATH, JSI, Inc.
Publication date: November, 2021
This report distills more than a year of programmatic research findings, looking at self-injection from a user journey perspective to analyze what drives consumer and provider decisions and attitudes. It reflects the unique perspectives of DMPA-SC self-injection early adopters and prospective users across Uganda and Nigeria. The report outlines how women perceive their own power, what makes self-injection convenient for them, who they trust as partners in their de-medicalized contraceptive experience, and more.
These training videos from Global Health Media cover a variety of family planning and other health topics. In addition to DMPA-SC (referred to as Depo SubQ), topics include: contraceptive methods, family planning learning aids, contraceptive method skills (“how-to” films), counseling, reproductive health, and clinic-based infection prevention and control. Videos are tailored for health workers, women, or their partners, and many are available in English, French, Spanish and other languages.
The videos for health workers are also available in the Family Planning Videos app which can be downloaded from Google Play or the App store. Videos for women and partners are available in the Birth & Beyond app, also on Google Play and the App store. If you would like to narrate any videos in your local language, please contact Global Health Media.