A new injectable contraception is transforming the way women and adolescent girls access and use family planning.
Manufactured by Pfizer, Sayana Press combines one dose of the widely used contraceptive depot medroxyprogesterone acetate (DMPA-SC) and a single-use needle Uniject device.
One dose lasts three months and, so far, women have found the drug easier to use than the separate vials and syringes of other makes.
The single-use, self-injectable contraceptive is under trial in Uganda by PATH.
Fiona Walugembe, PATH’s Sayana Press co-ordinator in Uganda said women have been reporting fewer side effects and less pain injecting the self-injectable which has a lower dosage of DMPA-SC, a shorter needle and is injected into fatty tissues rather than muscles.
“The device is prefilled and ready to inject; it is small and light and its user-friendly design makes it possible for women to self-inject with proper training,” said Ms Walugembe.
Monica Apili from Gulu district of northern Uganda was almost giving up on the use of the pill because of the side effects when she was introduced to Sayana Press.
“I used to bleed a lot, had constant headaches but with the injecta plan I don’t experience any of these symptoms,” said Ms Apili.
Annet Akullu, the community health worker on the Path project has been encouraging women to take up the self-injection method. The target age for the contraceptive is between 18 and 40 years.
She said that after the women are given the go ahead to use the contraceptive, the community health workers then make a follow up every three months.
“A dose lasts three months and has a window of four weeks before the next shot. If they miss it they are likely to get pregnant,” she said.
Ms Akullu, however, said that the community perception towards family planning remains a challenge.
“Convincing the women that the self-injection method is safe is a problem because they have been told that it causes diseases like cancer,” she said, adding that for some women it is even harder because the men have to give consent.
Sayana Press pilot was launched in 2014, by PATH, the Ugandan Ministry of Health and partners. About one year later, PATH and the Health Ministry launched a study in which nurses taught 380 women how to self-inject.
The study trials showed that 88 per cent of the women could self-inject with competence and 98 per cent wanted to continue. The trials are being funded by the Melinda Gates Foundation.
The product is registered for self-injection in the UK, a number of European countries, and in an increasing number of Family Planning (FP) 2020 countries, including Ghana, Mali, Myanmar, Niger, Nigeria, Uganda, and Zambia.
FP2020 is a global partnership that supports the rights of women and girls to decide, freely, and for themselves, whether, when, and how many children they want to have.
DMPA is offered at $0.85 per dose for qualified purchasers like health ministries and donors in the FP2020 countries.