Online Program

Acceptability of depo-subq in uniject: Results from Uganda and Senegal

Tuesday, November 5, 2013 : 12:30 p.m. - 12:45 p.m.

Holly Burke, PhD, MPH, Reproductive, Maternal, Newborn, and Child Health, FHI 360, Durham, NC
Monique Mueller, MSPH, Social and Behavioral Health Sciences, FHI 360, Durham, NC
Leonard Bufumbo, MSc, FHI 360/Uganda, Kampala, Uganda
Brian Perry, MPH, Social and Behavioral Health Sciences, FHI 360, Durham, NC
Daouda Mbengue, MSc, Centre de Formation et de Recherche en Santé de la Reproduction (CEFOREP), Dakar, Senegal
Catherine Packer, MSPH, Reproductive, Maternal, Newborn, and Child Health, FHI 360, Durham, NC
Bocar Mamadou Daff, MD, MPH, MSc, Office of Reproductive Health and Child Survival (DSRSE), Ministry of Health and Social Action, Dakar, Senegal
Anthony Mbonye, MD, PhD, Ministry of Health / Makerere University School of Public Health, Kampala, Uganda
Depot medroxyprogesterone acetate (DMPA) is a widely used injectable contraceptive given by the intramuscular (IM) route. A subcutaneous formulation of DMPA delivered in a prefilled, auto-disabled injection system called Uniject was developed to address persistent logistics and safety challenges posed by widespread distribution of DMPA IM in low-resource settings. It is anticipated that this new method will be a valuable innovation in family planning service delivery. This outcome hinges on the method being affordable and acceptable to decision makers, family planning providers, and clients. This study assessed acceptability of depo-subQ in Uniject among clients and providers, including community health workers (CHWs). User trials in family planning clinics and with clients of CHWs were conducted in Senegal and Uganda July 2012 through March 2013. Pre- and post-injection questionnaires were administered to 362 continuing DMPA IM clients who received the subcutaneous injection. Participants were followed up three months post-injection to further assess their experience with the method. Eligible DMPA clients who declined to receive depo-subQ in Uniject were invited to complete a questionnaire about their reasons for declining. In-depth interviews were conducted with 66 CHWs and 20 clinic-based providers to assess their experiences providing the method. In this presentation, we will present client and provider preferences for depo-subQ in Uniject compared to DMPA IM and describe the reasons for these preferences. We will present recommendations for the introduction of depo-subQ in Uniject on three levels — country, community, and health facility. The potential for self-injection in these communities will also be discussed.

Learning Areas:

Planning of health education strategies, interventions, and programs

Learning Objectives:
Identify five strategies to consider when introducing depo-subQ in Uniject into an existing family planning program Discuss three factors to consider when introducing depo-subQ in Uniject into a community-based distribution program

Keyword(s): International Family Planning, Community-Based Health Care

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Depot medroxyprogesterone acetate for subcutaneous injection (104 mg/0.65 mL suspension for injection) in the Uniject™ injection system is manufactured by Pfizer, Inc. as SAYANA PRESS®, approved by the UK MHRA, but not yet registered in Uganda or Senegal

Qualified on the content I am responsible for because: I am the principal investigator of the study being presented. Previously, I evaluated a communication campaign in Kenya aimed at increasing contraceptive continuation rates among DMPA users. I also led a study to determine the factors which motivate young women to use implants and what influences their decisions to continue or switch methods. I have over a decade of experience conducting qualitative and quantitative research to expand understanding of complex contraceptive and HIV prevention behaviors.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.