Self-Injectable Family Planning: A Solution For The Busy, Working Woman.

The injectable family planning method (Depo-Provera) is the most used contraceptive among women in Uganda as per the Uganda Demographic Health Survey 2016/2017. The health worker injects it deep into the muscle (intramuscular) mostly on the upper arm.  However, traveling to a clinic to receive this contraceptive injection every three months is not possible for many women. Women face challenges such as high costs of transport, lack of transport means especially during Covid19 lockdowns, long waiting lines at the health centres/clinics, and the much time spent away from family or work.

This leads to high rates of discontinuation of this family planning method thus increasing the risk of unplanned pregnancies. Therefore, the World Health Organization (WHO) recommends that self-administered injectable contraception should be made available as an additional approach to deliver injectable contraception in women of reproductive age.

Evidence from research done in rural and urban Uganda shows that the self-injectable method (sayana press) is highly feasible and highly acceptable among women. Its active ingredient and side effects do not differ from the usual Depo-Provera injection and it is also injected every three months (12 weeks). It only differs from Depo-Provera by the site of injection, which is just below the skin (subcutaneous) of the abdomen, thigh, or upper arm.  

Sayana Press comes specially packaged in a small, less painful, prefilled syringe that is easy to use, easy to store, and easy to dispose of once used. This makes it easy for women to self-inject at a time and place of their choice. Therefore, this form of family planning empowers women to be in control of their fertility and removes the barrier of having to go periodically to a health facility every time to be injected. This in the long run increases contraceptive continuation rates and enhances women’s autonomy thus making family planning sustainable among all women. More to note, self-injectable contraception is an addition to the family planning options available for women and even for the cooperates who have busy work schedules. 

The good news is that the Uganda National Drug Authority (NDA) approved the self-injection brand Sayana Press in 2014; it is available at the government health centers and other private healthcare providers in Uganda. The Ministry of Health can increase uptake of this method through extensive health awareness, training of health workers, and training women at different Health facilities on its use and relevance.

The article was co-written by Leah Mbabazi a nurse (BSN), Public Health Specialist (MPH), and Research Coordinator at Infectious Diseases Institute, Makerere University. and Mathius Amperiize, Environmental Health Scientist, and Project Administrator at Infectious Diseases Institute, Makerere University.