Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
BMJ Glob Health. 2022 Jul;7(7). doi: 10.1136/bmjgh-2022-008862.
Subcutaneous depot medroxyprogesterone acetate (DMPA-SC) is an innovative contraceptive method aimed at meeting women's unique circumstances and needs, largely due to its ability to be self-injected. Substantial research and advocacy investments have been made to promote roll-out of DMPA-SC across sub-Saharan Africa. To date, research on the demand for DMPA-SC as a self-injectable method has been conducted largely with healthcare providers, via qualitative research, or with highly specific subsamples that are not population based. Using three recent rounds of data from Performance Monitoring for Action, we examined population-representative trends in demand, use, and preference for self-injection among current non-users in Burkina Faso, the Democratic Republic of Congo (Kinshasa and Kongo Central regions), Kenya, and Nigeria (Lagos and Kano States). We found that while over 80.0% of women had heard of injectables across settings, few women had heard of self-injection (ranging from 13.0% in Kenya to 24.8% in Burkina Faso). Despite initial increases in DMPA-SC prevalence, DMPA-SC usage began to stagnate or even decrease in all settings in the recent three years (except in Nigeria-Kano). Few (0.0%-16.7%) current DMPA-SC users were self-injecting, and the majority instead were relying on a healthcare provider for administration of DMPA-SC. Among current contraceptive non-users wishing to use an injectable in the future, only 1.5%-11.4% preferred to self-inject. Our results show that self-injection is uncommon, and demand for self-injection is very limited across six settings, calling for further qualitative and quantitative research on women's views on DMPA-SC and self-injection and, ultimately, their contraceptive preferences and needs.
皮下储存型醋酸甲羟孕酮（DMPA-SC）是一种创新的避孕方法，旨在满足女性的特殊情况和需求，主要是因为它可以自我注射。已经投入了大量的研究和宣传资金来推动撒哈拉以南非洲地区 DMPA-SC 的推出。迄今为止，关于 DMPA-SC 作为自我注射方法的需求研究主要是通过定性研究在医疗保健提供者中进行的，或者是在不是基于人群的非常特定的亚样本中进行的。我们利用最近三批来自绩效监测行动的数据，研究了布基纳法索、刚果民主共和国（金沙萨和刚果中央地区）、肯尼亚和尼日利亚（拉各斯和卡诺州）目前非使用者中对自我注射的需求、使用和偏好的人群代表性趋势。我们发现，尽管在所有环境中，超过 80.0%的女性听说过注射剂，但很少有女性听说过自我注射（肯尼亚为 13.0%，布基纳法索为 24.8%）。尽管 DMPA-SC 的流行率最初有所增加，但在最近三年中，所有环境中的 DMPA-SC 使用量开始停滞甚至下降（尼日利亚-卡诺州除外）。很少有（0.0%-16.7%）当前的 DMPA-SC 用户进行自我注射，而大多数人则依赖医疗保健提供者来管理 DMPA-SC。在目前希望将来使用注射剂的避孕方法的非使用者中，只有 1.5%-11.4%的人更喜欢自我注射。我们的结果表明，自我注射并不常见，在六个环境中，对自我注射的需求非常有限，因此需要进一步进行关于女性对 DMPA-SC 和自我注射的看法以及最终对其避孕偏好和需求的定性和定量研究。
