TABLE 1.

Overview of DMPA-SC Introduction and Provider Training Strategies by Country

Burkina FasoNigerSenegalUganda
Product launchJuly 2014September 2014January 2015September 2014
Geographic scopeOver 680 public-sector facilities across the 4 most populous regions (23 rural, peri-urban, and urban districts)211 public-sector community health huts in 2 rural districts; 50 CBD sites in 2 rural districts (4 districts total)268 facilities and 637 health huts across the 4 most populous regions (31 rural, peri-urban, and urban districts)CHWs linked to 336 public-sector health facilities across 28 rural and peri-urban districts
Service delivery channelsAll levels of the health system, including public-sector mobile outreach from peripheral health and social promotion centers. Static NGO clinics and mobile outreach by NGO partners (MSI, ABBEF)CHWs via public-sector health huts and private NGO CBD (ANIMAS-Sutura)All levels of the health system, including by CHWs via health huts; NGO static clinics (MSI)Public-sector CHWs; static NGO clinic and outreach in 1 site (Reproductive Health Uganda)
Community-based access to injectablesFirst offering of injectables through community outreachFirst offering of injectables by CHWs at health huts and through CBDInjectable provision previously authorized at health huts, though not widely available prior to DMPA-SC introductionCBD of injectables previously authorized, though not widely available prior to DMPA-SC introduction
DMPA-SC and DMPA-IM offered side by sideYesNoYesYes
Number of providers trained∼1,900∼300∼2,000∼2,100
Training approachRapid, cascade approachGradual, district-by-district approachRapid, cascade approachGradual, district-by-district approach
  • Abbreviations: ABBEF, Association Burkinabè pour le bien-être familiale; CBD, community-based distribution; CHW, community health worker; DMPA-IM, intramuscular depot medroxyprogesterone acetate; DMPA-SC, subcutaneous depot medroxyprogesterone acetate; MSI, Marie Stopes International.