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.

An Excel skill-building workshop series

In March 2022, the DMPA-SC Access Collaborative Learning and Action Network (LAN) hosted an interactive skill-building workshop series on creating effective data visualizations to support family planning decision-making. This series was a hands-on skill-building opportunity using materials from the Access Collaborative’s Monitoring Learning and Evaluation (MLE) toolkit.

In this sequential series, each week’s session built upon the content of the previous session. For more information, please contact FPoptions@path.org.

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
• Advocacy
• Demand generation

The discussion was moderated by Allen Namagembe, Deputy Project Director, Uganda DMPA-SC Access Collaborative, PATH.

Panelists:

• 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.

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.

Featured panelists:

• 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.

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.

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 including self-injection in Senegal and Uganda. During 2019-2020, 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.