Subcutaneous depot medroxyprogesterone acetate (DMPA-SC), also known as Sayana Press, is an all-in-one injectable that can be administered by paraprofessionals or even clients themselves. Dozens of countries are exploring the benefits of adding this new easy-to-use contraception to the mix of currently available family planning methods. HP+ developed the DMPA-SC Impact Model to help project the benefits over five years that could come from the introduction of DMPA-SC, in terms of effects on contraceptive prevalence rate, increased access to family planning through public and private service delivery points, and costs to the health care system and clients.

This document was created to support ministry of health and nongovernmental partners as they develop strategies to introduce and scale up subcutaneous DMPA (DMPA-SC, brand name Sayana® Press) to increase contraceptive options and access. Available in English and French, the publication provides practical guidance based on results, evidence, and learning from the pilot introductions of DMPA-SC in four countries in Africa.

Community-based access to injectable contraceptives (CBA2I) is an important strategy for addressing the reproductive health needs of women and couples wishing to limit or space pregnancies. The resources in this list aim to help stakeholders effectively implement CBA2I programs.

From 2014 to 2016, PATH coordinated pilot introduction of the injectable contraceptive subcutaneous DMPA (DMPA-SC, brand name Sayana® Press) in Burkina Faso, Niger, Senegal, and Uganda. These materials feature guidance for monitoring DMPA-SC introductions, monitoring results, and lessons learned, which can help inform contraceptive introduction programming for DMPA-SC and other methods.

This template is intended for country use and adaptation when developing a plan for the introduction and scale-up of DMPA-SC. It outlines key topics including the country’s family planning landscape and goals, rationale for DMPA-SC introduction and scale-up, description of the introduction strategy, budgeting and costing, scale-up planning, and an operational work plan. Countries introducing self-injection along with provider-administered DMPA-SC can use this template with the DMPA-SC self-injection scale-up plan template. For more information or assistance when developing a country plan for DMPA-SC introduction and scale-up, visit the Access Collaborative technical assistance page or contact FPoptions@path.org.

The bibliography is a curated selection of key peer-reviewed articles, reports, briefs, and other grey literature that address systematic approaches to scaling up and provides key insights to enhance our understanding of the scale-up process. It constitutes literature of relevance to the discussions of the Community of Practice on Systematic Approaches to Scaling Up.

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.