Cover Jane, Blanton Elizabeth, Ndiaye Dieynaba, Walugembe Fiona, Lamontagne D Scott
PATH, Seattle, Washington.
PATH, Seattle, Washington.
Contraception. 2014 May;89(5):374-8. doi: 10.1016/j.contraception.2014.01.005. Epub 2014 Jan 18.
Sayana® Press (SP) is a unique injectable contraceptive (depot medroxyprogesterone acetate, or DMPA) administered subcutaneously in the Uniject(TM) injection system.(1) SP simplifies the injection process; it requires no assembly of components and is easily disposable. This new technology appears to be well suited for community-based delivery of injectable contraception. The study objective was to evaluate SP management and administration in low-resource settings, focusing on how the delivery logistics, administration time, storage and waste-management requirements compare to the traditional intramuscular DMPA injectable (DMPA IM).
We conducted 58 semistructured interviews with clinic providers and community health workers in Senegal and Uganda to identify the merits, challenges and appeal of SP relative to DMPA IM.
Providers identified logistical challenges with the management and administration of DMPA IM, including stock outs, transportation, storage constraints, and, in a few instances, waste disposal. Most providers (between 63% and 88%, depending on the logistics issue) do not expect SP to either aggravate or solve those problems. Some envisioned that SP could facilitate supply management (5%), storage (11%) and waste disposal (22%). The all-in-one packaging of SP was perceived to reduce the incidence of mismatched supplies (syringes and vials), and its smaller size was expected to ease space constraints and reduce the frequency of safety box incineration.
Adding SP to the method mix is unlikely to have a profound impact on clinic operations but may lessen logistical problems related to supply, storage and waste management.
Community health workers and clinic providers who administer SP may see some modest improvements in service delivery logistics. Particularly in settings where service delivery logistical challenges are more pronounced, offering SP may facilitate injectable contraceptive delivery.
Sayana® Press（SP）是一种独特的注射用避孕药（醋酸甲羟孕酮长效注射剂，即DMPA），通过Uniject™注射系统进行皮下注射。（1）SP简化了注射过程；它无需组装部件，且易于丢弃。这项新技术似乎非常适合在社区层面提供注射用避孕药。本研究的目的是评估在资源匮乏地区SP的管理与使用情况，重点关注其配送物流、给药时间、储存及废物管理要求与传统肌肉注射用DMPA（DMPA IM）相比有何不同。
我们对塞内加尔和乌干达的诊所医护人员及社区卫生工作者进行了58次半结构化访谈，以确定SP相对于DMPA IM的优点、挑战及吸引力。
医护人员指出了DMPA IM管理与使用方面的物流挑战，包括缺货、运输、储存限制，以及在少数情况下的废物处理问题。大多数医护人员（63%至88%，具体取决于物流问题）预计SP不会加剧也不会解决这些问题。一些人设想SP可以促进供应管理（5%）、储存（11%）和废物处理（22%）。SP的一体化包装被认为可减少供应不匹配（注射器和药瓶）的发生率，其较小的尺寸预计可缓解空间限制并减少安全箱焚烧的频率。
将SP添加到方法组合中不太可能对诊所运营产生深远影响，但可能会减少与供应、储存和废物管理相关的物流问题。
使用SP的社区卫生工作者和诊所医护人员可能会看到服务提供物流方面有一些适度改善。特别是在服务提供物流挑战更为突出的环境中，提供SP可能会促进注射用避孕药的配送。
