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Depot medroxyprogesterone acetate (DMPA; Depo-Provera) is a highly effective and convenient contraceptive method that has been used worldwide for many decades. Recently, a new lower dose of DMPA, administered as a subcutaneous injection, has been approved for use in the USA as a contraceptive and a treatment for pain associated with endometriosis. The newer formulation has a similar efficacy to the older version and, more importantly, has fewer side effects, with improved user tolerability. Similar to the intramuscular DMPA injection (Depo-Provera intramuscular or contraceptive injection), the subcutaneous injection provides effective contraceptive and pain-management therapy for endometriosis, with a 3-monthly injectable protocol for women who seek long-term and reversible contraception without the need for a daily pill or a more frequent dosing regimen.
Depo-Provera (depot medroxyprogesterone acetate, or DMPA) is an important contraceptive option for women worldwide. Currently, it is only available in intramuscular form requiring regular quarterly routine attendance at a health facility. A new subcutaneous preparation has been developed. This is self-administrable and could potentially reduce need for routine attendance to an annual visit.
In a questionnaire survey of 176 women currently using DMPA, 67% would prefer to self-administer. Of the 33% who did not wish to self-administer, the most common reasons were a fear of needles (62%) and concern regarding incorrect administration (43%). In a second survey of 313 women not currently using DMPA, 64% of women said they would prefer to attend less often for contraceptive supplies. Twenty-six percent of women who had never used DMPA and 40% of ex-users would seriously consider DMPA if self-administration were possible.
Our findings would suggest that the advent of subcutaneous self-administrable Depo-Provera with appropriate training and reminder system is likely to be beneficial and popular with many women.
The Reproductive Health Supplies Coalition (RHSC) is a global partnership of public, private, and non-governmental organizations dedicated to ensuring that all people in low- and middle-income countries can access and use affordable, high-quality supplies to ensure their better reproductive health. The Coalition brings together diverse agencies and groups with critical roles in providing contraceptives and other reproductive health supplies. These include multilateral and bilateral organizations, private foundations, governments, civil society, and private-sector representatives.
This 16-page paper provides an overview of the debate about how developing country drug regulation agencies are funded and the extent to which they should build local capacity or rely on regulators in developed countries.
The purpose of this strategic communication field guide is to provide practical guidance to those who are in a position to design, implement, or support a strategic health communication effort. The emphasis of the guide is on developing a comprehensive, long-term approach to health communication that responds appropriately to audience needs.
The objective of this study was to evaluate women’s acceptance of and ability to self-administrate the injectable contraceptive Cyclofem® using prefilled UniJect® devices. A total of 102 women were invited to participate in the study. Fourteen women (13.7%) refused to participate. Of the remaining 88 women, 32 women (31.4%) consented to participate and were trained using oranges but were still afraid of the procedure and ultimately refused to self-administer the injections. Only 56 women (55%) ultimately self-injected Cyclofem with UniJect. They performed a total of 144 injections, all of them on the ventral side of the thigh. When nurses evaluated women’s ability to activate the devices, they found that more than 80% were successful in both the group of women that later self-administered the injections and the group that did not. The evaluation of the self-administered injection technique showed that more than 90% of the women correctly self-administered the contraceptive using UniJect. With respect to the opinion of the women about the self-administration of the contraceptive, more than 50% (32 of 56) of women who self-injected preferred to self-administer the injection and said that they wished to continue with the self-administration, one-third (17) reported that they were afraid, and seven women (12.5%) expressed the opinion that the injection in the thigh was more painful than the administration in the buttocks or arm. In conclusion, our study showed that women can be trained to successfully self-administer the monthly injectable contraceptive Cyclofem and generally respond positively to UniJect.
