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Original Articles
Open Access

Preferences for a potential longer-acting injectable contraceptive: perspectives from women, providers, and policy makers in Kenya and Rwanda

Elizabeth E Tolley, Kevin McKenna, Caroline Mackenzie, Fidele Ngabo, Emmanuel Munyambanza, Jennet Arcara, Kate H Rademacher and Anja Lendvay
Global Health: Science and Practice May 2014, 2(2):182-194; https://doi.org/10.9745/GHSP-D-13-00147
Elizabeth E Tolley
aFHI 360, Durham, NC, USA
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  • For correspondence: btolley@fhi360.org
Kevin McKenna
aFHI 360, Durham, NC, USA
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Caroline Mackenzie
bFHI 360, Nairobi, Kenya
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Fidele Ngabo
cMinistry of Health, Maternal and Child Health Department, Kigali, Rwanda
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Emmanuel Munyambanza
dFHI 360, Kigali, Rwanda
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Jennet Arcara
eUniversity of North Carolina-Chapel Hill, Chapel Hill, NC, USA
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Kate H Rademacher
aFHI 360, Durham, NC, USA
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Anja Lendvay
aFHI 360, Durham, NC, USA
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  • FIGURE 1.
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    FIGURE 1.

    Conceptual Framework: Factors Influencing Acceptability of, Access to, and Use of a Potential Longer-Acting Injectable

    Abbreviations: BF, breastfeeding; CBD, community-based distribution; LAI, longer-acting injectable; TPP, target product profile.

  • FIGURE 2.
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    FIGURE 2.

    Most and Least Important Attributes of a Potential Longer-Acting Injectable, Ranked by Women, Providers, and Policy Makers in Kenya and Rwanda (N = 67)a

    Abbreviations: BF, breastfeeding; CBD, community-based distribution.

    a Rankings are among 46 providers and policy makers from in-depth interviews and 21 groups of women (from 19 focus groups with 2 focus groups further split into 2 groups for their rankings) for a total sample size of 67.

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    TABLE 1. Composition of Focus Group Discussions Among Potential Users of a Longer-Acting Injectable, by Country
    FGD NumberLocationFacility TypeExperience With Injectable UseNo. of ParticipantsMean Age (Range)
    Kenya
    1UrbanPublic health centerCurrent and past users1028.1 (21–38)
    2UrbanPublic health centerNever users836.7 (18–45)
    3Peri-urbanPublic hospitalCurrent and past users1127.7 (21–37)
    4Peri-urbanPublic health centerCurrent and past users825.2 (20–32)
    5UrbanNGO health centerCurrent and past users1031.0 (23–40)
    6UrbanNGO health centerCurrent and past users829.4 (25–37)
    7UrbanNGO health centerNever users930.3 (23–36)
    8Peri-urbanPublic health centerCurrent and past users1029.9 (22–40)
    9Peri-urbanPublic health centerCurrent and past users1129.4 (25–38)
    10Peri-urbanPublic hospitalNever users831.6 (20–42)
    Total93
    Rwanda
    1RuralPublic CBDCurrent, past, and never users1032.4 (24–50)
    2RuralPublic health centerCurrent and past users730.7 (26–39)
    3Peri-urbanPublic health centerNever users1328.0 (20–39)
    4UrbanPublic hospitalNever and past users1128.4 (21–37)
    5RuralPublic CBDCurrent users837.7 (28–44)
    6RuralPublic health centerCurrent and past users931.3 (21–40)
    7RuralPublic CBDCurrent and past users934.8 (21–44)
    8UrbanPublic hospitalCurrent users728.6 (22–35)
    9UrbanNGO health centerCurrent, past, and never users1031.9 (25–44)
    Total84
    • Abbreviation: CBD, community-based distribution.

    • View popup
    TABLE 2. Three Most and Least Important Attributes of a Potential Longer-Acting Injectable, by Participant Type and Countrya
    AttributesMost ImportantLeast Important
    Potential UsersProvidersPolicy MakersPotential UsersProvidersPolicy Makers
    KenyaRwandaKenyaRwandaKenyaRwandaKenyaRwandaKenyaRwandaKenyaRwanda
    99% effective121211
    Safe for BF and new mothers312
    Immediate return to fertility22322
    Storage without refrigeration13
    Prepackaged, single dose, disposable322
    Cost around US$4/year322213
    Side effects no worse than current methods33323
    Suitable for all women33333
    6-month duration with 1-month window3223
    Can be administered in arm331311
    Can be provided by CBD1121
    • Abbreviations: BF, breastfeeding; CBD, community-based distribution.

    • ↵a In Kenya, rankings are among 10 groups of potential users, 15 providers, and 12 policy makers. In Rwanda, rankings are among 9 groups of potential users, 12 providers, and 7 policy makers.

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Global Health: Science and Practice: 2 (2)
Global Health: Science and Practice
Vol. 2, No. 2
May 01, 2014
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Preferences for a potential longer-acting injectable contraceptive: perspectives from women, providers, and policy makers in Kenya and Rwanda
Elizabeth E Tolley, Kevin McKenna, Caroline Mackenzie, Fidele Ngabo, Emmanuel Munyambanza, Jennet Arcara, Kate H Rademacher, Anja Lendvay
Global Health: Science and Practice May 2014, 2 (2) 182-194; DOI: 10.9745/GHSP-D-13-00147

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Preferences for a potential longer-acting injectable contraceptive: perspectives from women, providers, and policy makers in Kenya and Rwanda
Elizabeth E Tolley, Kevin McKenna, Caroline Mackenzie, Fidele Ngabo, Emmanuel Munyambanza, Jennet Arcara, Kate H Rademacher, Anja Lendvay
Global Health: Science and Practice May 2014, 2 (2) 182-194; DOI: 10.9745/GHSP-D-13-00147
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