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Tag: Burkina Faso


Self-injected contraceptives: does the investment reflect women’s preferences?

Subcutaneous depot medroxyprogesterone acetate (DMPA-SC) is an innovative contraceptive method aimed at meeting women’s unique circumstances and needs, largely due to its ability to be self-injected. Substantial research and advocacy investments have been made to promote roll-out of DMPA-SC across sub-Saharan Africa. To date, research on the demand for DMPA-SC as a self-injectable method has been conducted largely with healthcare providers, via qualitative research, or with highly specific subsamples that are not population based. Using three recent rounds of data from Performance Monitoring for Action, we examined population-representative trends in demand, use, and preference for self-injection among current non-users in Burkina Faso, the Democratic Republic of Congo (Kinshasa and Kongo Central regions), Kenya, and Nigeria (Lagos and Kano States). We found that while over 80.0% of women had heard of injectables across settings, few women had heard of self-injection (ranging from 13.0% in Kenya to 24.8% in Burkina Faso). Despite initial increases in DMPA-SC prevalence, DMPA-SC usage began to stagnate or even decrease in all settings in the recent three years (except in Nigeria-Kano). Few (0.0%–16.7%) current DMPA-SC users were self-injecting, and the majority instead were relying on a healthcare provider for administration of DMPA-SC. Among current contraceptive non-users wishing to use an injectable in the future, only 1.5%–11.4% preferred to self-inject. Our results show that self-injection is uncommon, and demand for self-injection is very limited across six settings, calling for further qualitative and quantitative research on women’s views on DMPA-SC and self-injection and, ultimately, their contraceptive preferences and needs.

Institutional author(s): Johns Hopkins Bloomberg School of Public Health
Individual author(s): Shannon N Wood, Sophia Magalona, Linnea A Zimmerman, Funmilola OlaOlorun, Elizabeth Omoluabi, Pierre Akilimali, Georges Guiella, Peter Gichangi, Philip Anglewicz
Publication date: July, 2022

Journal article BMJ Global Health

Training supply recommendations for DMPA-SC rollout

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.

Institutional author(s): PATH
Publication date: 2022

Self-injection in the private sector: Promoting policies for progress

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

Institutional author(s): PATH, JSI, Jhpiego, Nigeria Federal Ministry of Health, Pharmaceutical Society of Kenya, Association of Pharmacists of Madagascar
Publication date: February, 2022

How to Introduce and Scale Up DMPA-SC

Practical Guidance from PATH Based on Lessons Learned During Pilot Introduction

This guide 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 Burkina Faso, Niger, Senegal, and Uganda.

Institutional author(s): PATH
Publication date: 2018

Communications Guidance for Introducing DMPA-SC

This guide was created to support ministries of health and nongovernmental implementing partners as they develop communications strategies related to the introduction of the injectable contraceptive subcutaneous DMPA (DMPA-SC, brand name Sayana® Press). Drawing from pilot program experiences in Burkina Faso, Niger, Senegal, and Uganda, the document outlines communication strategies, audiences, key messages, and channels recommended for successful introduction of the product.

Institutional author(s): PATH
Publication date: 2014

DMPA-SC policy and regulatory advocacy landscape

This policy landscape can be leveraged by applicants interested in applying to the DMPA-SC Regulatory Advocacy Catalytic Opportunity Fund (COF). The landscape was originally developed in 2020 to understand policies and regulations, including over-the-counter regulations, that impact women’s access to DMPA-SC and identify short- and long-term advocacy opportunities. In 2022, it was refreshed to understand policy shifts and additional advocacy opportunities in a subset of 12 of the original 18 countries currently eligible for the Regulatory Advocacy COF. Insights from the policy landscape have informed the design and eligibility criteria of the Regulatory Advocacy COF, proactively identified opportunities, and provided frameworks and guidance for interested applicants.

Institutional author(s): Clinton Health Access Initiative (CHAI)
Publication date: 2022

Report

Burkina Faso: In-depth analysis of family planning task sharing and self-care policies, and alignment with WHO guidelines

This report presents an in-depth analysis of Burkina Faso’s policies, regulations, and guidelines, based on an extensive document review followed by key informant interviews. The findings are organized by select family planning methods, including voluntary surgical contraception, implants, injectables, and pills. The report also includes a section describing COVID-19’s effect on task sharing and self-care policies. The authors recommend policy and regulatory revisions and actions to further improve the country’s family planning and regulatory environment and scale implementation of the World Health Organization (WHO) guidelines and note that the Burkina Faso experience may serve as evidence when the WHO next updates its task sharing guidance.

Institutional author(s): USAID, Human Resources for Health in 2030 (HRH2030)
Publication date: August, 2021

DMPA-SC country data dashboard

The country dashboard is a visual presentation of key data for a select list of priority countries; it provides a snapshot of the state and stage of DMPA-SC introduction/scale-up, allowing stakeholders to assess progress, identify roadblocks, guide course corrections, and inform decisions.

Institutional author(s): PATH
Publication date: August, 2020

Continuation of subcutaneous or intramuscular injectable contraception when administered by facility-based and community health workers: findings from a prospective cohort study in Burkina Faso and Uganda

The aim of this study was to examine continuation of subcutaneous and intramuscular depot medroxyprogesterone acetate (DMPA-SC and DMPA-IM) when administered by facility-based health workers in Burkina Faso and Village Health Teams (VHTs) in Uganda. Participants were family planning clients of health centers (Burkina Faso) or VHTs (Uganda) who had decided to initiate injectable use. Women selected DMPA-SC or DMPA-IM and study staff followed them for up to four injections (providing 12 months of pregnancy protection) to determine contraceptive continuation. Study staff interviewed women at their first injection (baseline), second injection, fourth injection and if they discontinued either product.

Institutional author(s): PATH, Makerere University, Institut Africain de Santé Publique (IASP), Institut Supérieur des Sciences de la Population, Centre MURAZ, FHI 360, Institut de Recherche en Sciences de la Santé (IRSS)
Individual author(s): Ellen MacLachlan, Lynn Atuyambe, Tieba Millogo, Georges Guiella, Seydou Yaro, Simon Kasasa, Justine Bukenya, Agnes Nyabigambo, Fredrick Mubiru, Justine Tumusiime, Yentéma Onadja, Lonkila Moussa Zan, Clarisse Goeum/Sanon, Seni Kouanda, Allen Namagembe
Publication date: August, 2018

Journal article Link to Journal Article

DMPA-SC self-injection supports women to use injectable contraception longer

This research brief describes research findings that women who self-inject DMPA-SC continue to use contraception longer than women who use intramuscular DMPA (DMPA-IM) administered by a health worker.

Institutional author(s): PATH
Publication date: July, 2018

Brief DMPA-SC self-injection supports women to use injectable contraception longer