DMPA-SC (and branded for consumers as “Sayana Press”) is an injectable contraceptive that prevents pregnancy for 3 months. It comes packaged in a self-injectable form. This means that a woman can self-administer the contraceptive herself and from the comfort of her own home, rather than traveling to a health clinic.
The Challenge
Over 200M women globally lack access to family planning products. Many live in sub-Saharan
Africa. For example, 21% of women in Africa who are married or in-union and want family planning products don’t have access.
The poverty implication is staggering. The UNFPA estimates universal access to family planning would decrease maternal death by 25%, and childhood death by up to 20%. 3 Family planning also enables freedom for women to complete education, take a job, and make other life choices.
Contraceptives, and specifically long acting reversible contraceptives (LARCs) are a WHO recommended answer to this problem. 4 LARCs include a suite of products like IUDs and injectable. LARCs are effective, less prone to user error, and often the most affordable option.
However, access is limited. LARCs almost always require travel to a health clinic, and in-house administration by a trained healthcare provider, like a nurse. “Long distances to clinics, long waits for service, and occasional stock outs of syringes mean too many women go home without receiving the family planning method of their choice.”
The pilot to scale up the distribution of self-injection contraceptive-DMPA – SC is being implemented in Mpika district of Muchinga province for three (3) months and will be scaled up to the other six priority rural provinces of Zambia. The pilot phase of the project was launched on November 4, 2020 at Crumach Lodge in Mpika District.
The main barriers to the distribution of self-Injection DMPA-SC (Sayana® Press) in Mpika, Muchinga province in particular are:
- Inadequate trained community-based distributors for self-injection contraceptives
- Long distances to health facilities in rural areas
- Women engagement in seasonal economic activities like caterpillar collection and periodical community open markets (locally referred to as munada) thereby missing out on the valuable time to get to the health centers to access family planning services.
- Limited time to get to the nearest health center for the working women in the central business town.
- Limited transport logistics for the health center staff to conduct routine mobile outreach services to far flung areas.
- Inadequate information on self-Injection contraceptives (Sayana® Press) in the communities.
The organization however intends to implement the pilot Phase using the distribution model below within three 3 months of piloting:
- Placement of a dedicated SIHI staff at the District Health Office
- Using the existing Government supply chain system to access DMPA – SC
- Providing a comprehensive client focused counselling on Family Planning methods available to clients
- Referrals for methods not provided by Community Based Distributors and facility staff
- Engaging already trained and providing DMPA-IM, Community Based Distributors within the community to distribute self- injectable contraceptives
Strategies
Society for Impact Health Initiative employs the following strategies:
- Capacity building of community-based distributors and Ministry of Health facility staff to provide effective self-injection contraceptives using the Ministry of Health/PATH approved training curriculum.
- Targeted Community mobilization and sensitization for increased demand for Sayana® Press
- Deployment of full-time dedicated service providers to be based at the district health offices to execute project activities.
- Use of mobile outreach model to reach the underserved in most rural parts of the communities.
- Building and fostering partnerships at community, facility, district, province and national levels to ensure integration of Health Distribution Plus model and ownership
- Strong and effective resource mobilization both locally and internationally