RT Journal Article
SR Electronic
T1 Service Delivery Considerations for Introducing New Injectable Contraceptives Lasting 4 and 6 Months in Nigeria and Uganda: A Qualitative Study
JF Global Health: Science and Practice
JO GLOB HEALTH SCI PRACT
FD Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs
SP e2300214
DO 10.9745/GHSP-D-23-00214
VO 11
IS 6
A1 Callahan, Rebecca L.
A1 Burke, Holly M.
A1 Lawton, Anna
A1 OlaOlorun, Funmilola M.
A1 Mubiru, Fredrick
A1 Anyasi, Helen
A1 Wong, Christina M.
A1 Bidashimwa, Dieudonné
A1 Velarde, Marissa
A1 Ruderman, Lucy W.
YR 2023
UL http://www.ghspjournal.org/content/11/6/e2300214.abstract
AB Key FindingsFamily planning (FP) stakeholders, including providers, policymakers, and program implementers, are interested in the possibility of new injectables lasting 4 and 6 months for expanding the method mix and broadening contraceptive choice.FP stakeholders are most excited at the prospect of a 6-month injectable coming to market.FP stakeholders do not view self-injection as a key requirement for new injectable methods.Key ImplicationsThis research provides insight into specific opportunities and concerns that stakeholders from across the FP community in Nigeria and Uganda identify for the introduction of new contraceptive injectables.Background:New family planning (FP) product introduction requires understanding the target market and support from stakeholders from across the health sector. We aimed to understand the perspectives of FP providers and other stakeholders on the potential introduction of new subcutaneous (SC) depot medroxyprogesterone acetate (DMPA) injectable contraceptives lasting 4 and 6 months in Nigeria and Uganda.Methods:Between July 2021 and February 2022, we conducted 48 in-depth interviews (IDIs) and 11 focus group discussions (FGDs) with FP providers and other stakeholders involved with service delivery, program management, and policymaking in Lagos and Abuja in Nigeria and Kampala and Luwero in Uganda. IDIs and FGDs explored respondents' reactions to and preferences for the new injectables lasting 4 and 6 months.Results:Most respondents liked the idea of longer-acting DMPA-SC products, noting the potential for reduced facility visits for clients and workloads for providers, cost savings for users and the health system, and potential for improved commodity logistics. Some nonproviders raised concerns about confusion among providers and clients with the availability of multiple injectable products; however, providers did not share this concern. The greatest interest among all groups was for the 6-month injectable, even without the option for self-injection. Several respondents reported that self-injection is not widespread in either context, and some noted that contact with a provider would be important for products with longer durations. Respondents' acceptability of the new injectables assumed that side effects would be no worse than the existing 3-month product.Conclusions:Family planning stakeholders in Nigeria and Uganda are supportive of expanding the method mix with new injectables, which they see as having the potential to meet the needs of more users. Concerted engagement of health providers, policymakers, and the community will be necessary for successful introduction once these new contraceptive products are available.