Original research article| Volume 89, ISSUE 5, P379-384, May 2014

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



      Sayana® Press,
      Sayana Press is a registered trademark of Pfizer Inc.
      1Sayana Press is a registered trademark of Pfizer Inc.
      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.


      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.


      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.


      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.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Contraception
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


      1. United Nations, Department of Economic and Social Affairs, Population Division [Internet]. World Contraception Use 2011. New York: United Nations; 2011. Available from:

        • MacQueen K.M.
        • McLellan-Lemal E.
        • Barthalow K.
        • Milstein B.
        Team-based codebook development: structure, process, and agreement.
        in: Guest G. MacQueen K.M. Handbook for team-based qualitative research. AltaMira Press, Lanham (MD)2008: 119-136
        • Bahamondes L.
        • Marchi N.M.
        • Nakagava H.M.
        • de Melo M.L.
        • Cristofeletti Mde L.
        • Pellini E.
        • et al.
        Self-administration with Uniject of the once-a-month injectable Cyclofem.
        Contraception. 1997; 56: 301-304
        • Prabhakaran S.
        • Sweet A.
        Self-administration of subcutaneous depot medroxyprogesterone acetate for contraception: feasibility and acceptability.
        Contraception. 2012; 85: 453-457
        • Cameron S.T.
        • Glasier A.
        • Johnstone A.
        Pilot study of home self-administration of subcutaneous depo-medroxyprogesterone acetate for contraception.
        Contraception. 2012; 85: 458-464
        • Williams L.
        • Hensel J.
        • Fortenberry D.
        Self-administration of subcutaneous depot medroxyprogesterone acetate by adolescent women.
        Contraception. 2013; 88: 401-407
        • Beasley A.
        • O'Connell White K.
        • Cremers S.
        • Westhoff C.
        Randomized clinical trial of self versus clinical administration of subcutaneous depot medroxyprogesterone acetate.
        Contraception. 2014; 89: 352-356
        • Burke H.M.
        • Mueller M.P.
        • Packer C.
        • Perry B.
        • Bufumbo L.
        • Mbengue D.
        • et al.
        Provider acceptability of Sayana® Press: results from community health workers and clinic-based providers in Uganda and Senegal.
        Contraception. 2014; 89: 368-373
        • Burke H.M.
        • Mueller M.P.
        • Perry B.
        • Packer C.
        • Bufumbo L.
        • Mbengue D.
        • et al.
        Observational study of the acceptability of Sayana® Press among intramuscular DMPA users in Uganda and Senegal.
        Contraception. 2014; 89: 361-367