Perceptions of home and self-injection of Sayana® Press in Ethiopia: a qualitative study

Objective: Sayana® Press,(1) a new subcutaneous formulation and presentation of a popular injectable contraceptive, has the potential to expand non-clinic access to contraception, including home and self-injection (HSI). This study collected information from potential users and stakeholders on their perceptions and preferences, the feasibility of an HSI of Sayana Press program and key policy considerations.

Study design: PATH conducted 62 interviews and 7 focus groups with family planning users, non-users, physicians, other health care providers and key informants in the Oromia region of Ethiopia. Participants watched a demonstration and tested the device on a model mid-interview. The study did not involve product use in humans.

Results: Women found the product easy to use, liked the simple design and valued the time and expense that could be saved through HSI of Sayana Press (HSI-SP). Of those with inhibitions about their ability to self-inject, most shifted their opinion favorably after demonstration. The majority of other stakeholders also supported HSI-SP and thought it could increase contraceptive use in Ethiopia, and they suggested that any successful program must include proper training and supervision, particularly regarding product storage and waste management.

Conclusion: The data provide findings to stimulate further research and support future planning. They suggest that HSI-SP may meet the needs of many women if key requirements and challenges are met. It may also be necessary to revise policies and guidelines to integrate the approach with national family planning strategies.

Implications: This study provides the first available data on perceptions, feasibility and requirements for HSI of Sayana Press in a low-resource setting. Findings provide insights that may guide future implementation strategies, strengthen non-clinic family planning access programs and stimulate continued research.