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FIELD ACTION REPORT
Open Access

Pilot Research as Advocacy: The Case of Sayana Press in Kinshasa, Democratic Republic of the Congo

Arsene Binanga and Jane T Bertrand
Global Health: Science and Practice December 2016, 4(4):542-551; https://doi.org/10.9745/GHSP-D-16-00236
Arsene Binanga
Tulane International LLC, Kinshasa, Democratic Republic of the Congo.
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Jane T Bertrand
Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA.
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  • For correspondence: bertrand@tulane.edu
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The pilot study obtained Ministry of Health approval to allow medical and nursing students to provide the injectable contraceptive Sayana Press and other methods in the community, paving the way for other task-shifting pilots including self-injection of Sayana Press with supervision by the students as well as injection by community health workers.

ABSTRACT

In the Democratic Republic of the Congo (DRC), the Ministry of Health authorizes only physicians and nurses to give injections, with one exception—medical and nursing students may also give injections if supervised by a clinical instructor. The emergence of the injectable contraceptive Sayana Press in some African countries prompted the DRC to test the acceptability and feasibility of distributing Sayana Press and other contraceptive methods at the community level through medical and nursing students. Sayana Press is similar in formulation to the injectable contraceptive Depo-Provera but contains a lower dose and is administered subcutaneously using a single-use syringe with a short needle called the Uniject system. The Uniject system allows Sayana Press to be administered by community health workers without clinical training or by self-injection. In this pilot, the advocacy objective was to obtain approval from the Ministry of Health to allow medical and nursing students to inject Sayana Press, as a first step toward authorization for community health workers to provide the method. The pilot described in this article documents a process whereby an innovative approach moved from concept to implementation to replication in less than 2 years. It also paved the way for testing additional progressive strategies to increase access to contraception at the community level. Because the pilot project included a research component designed to assess benefits and challenges, it provided the means to introduce the new task-shifting approach, which might not have been approved otherwise. Key pilot activities included: (1) increasing awareness of Sayana Press among family planning stakeholders at a national conference on family planning, (2) enlisting the support of key decision makers in designing the pilot, (3) obtaining marketing authorization to distribute Sayana Press in the DRC, (4) implementing the pilot from July to December 2015, (5) conducting quantitative and qualitative studies to assess acceptability and feasibility, and (6) disseminating the findings to family planning stakeholders. Before the pilot, Sayana Press was relatively unknown in the DRC, and there was no precedent for medical and nursing students providing family planning methods or giving injections at the community level. In less than 12 months, the approach gained legitimacy and acceptance. The key Ministry of Health decision maker orchestrated the closing session of the dissemination meeting on next steps, paving the way for pilot tests of 3 new task-shifting approaches: insertion of Implanon NXT by medical and nursing students, self-injection for Sayana Press with supervision by students, and injection of Sayana Press by community health workers with no formal clinical training.

  • Received: 2016 Jul 23.
  • Accepted: 2016 Oct 28.
  • Published: 2016 Dec 23.
  • © Binanga and Bertrand.

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit http://creativecommons.org/licenses/by/3.0/. When linking to this article, please use the following permanent link: http://dx.doi.org/10.9745/GHSP-D-16-00236

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Global Health: Science and Practice: 4 (4)
Global Health: Science and Practice
Vol. 4, No. 4
December 23, 2016
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Pilot Research as Advocacy: The Case of Sayana Press in Kinshasa, Democratic Republic of the Congo
Arsene Binanga, Jane T Bertrand
Global Health: Science and Practice Dec 2016, 4 (4) 542-551; DOI: 10.9745/GHSP-D-16-00236

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Pilot Research as Advocacy: The Case of Sayana Press in Kinshasa, Democratic Republic of the Congo
Arsene Binanga, Jane T Bertrand
Global Health: Science and Practice Dec 2016, 4 (4) 542-551; DOI: 10.9745/GHSP-D-16-00236
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  • Article
    • ABSTRACT
    • BACKGROUND
    • THE ADVOCACY OBJECTIVE OF THE DRC PILOT STUDY
    • PLANNING PHASE
    • IMPLEMENTATION
    • KEY FINDINGS FROM THE RESEARCH COMPONENT
    • DISSEMINATION OF THE FINDINGS
    • RAPID DIFFUSION, REPLICATION, AND TESTING
    • KEY SUCCESS FACTORS
    • LESSONS LEARNED
    • FINAL REFLECTIONS
    • Acknowledgments
    • Notes
    • References
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  • Evolution of a Large-Scale Community-Based Contraceptive Distribution Program in Kinshasa, DRC Based on Process Evaluation
  • Time to Evolve Beyond Prototypical Community-Based Distribution (CBD) of Contraception?
  • Family Planning in the Democratic Republic of the Congo: Encouraging Momentum, Formidable Challenges
  • Scopus (6)
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