Abstract
Objective
Sayana® Press (SP) is a unique injectable contraceptive (depot medroxyprogesterone
acetate, or DMPA) administered subcutaneously in the UnijectTM injection system.
1Sayana Press and depo-subQ provera 104 in Uniject are registered trademarks of Pfizer
Inc. Uniject is a trademark of BD.
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).Study design
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.
Results
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.
Conclusion
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.
Implications
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.
Keywords
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Article info
Publication history
Published online: January 21, 2014
Accepted:
January 10,
2014
Received in revised form:
November 19,
2013
Received:
August 30,
2013
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
