Abstract
Background
Sayana® Press (SP), a subcutaneous formulation of depot medroxyprogesterone acetate
(DMPA) in Uniject™, has potential to be a valuable innovation in family planning (FP)
because it may overcome logistic and safety challenges in delivering intramuscular
DMPA (DMPA IM). However, SP's acceptability is unknown. We measured acceptability
of SP among clinic-based providers (Senegal only) and community health workers.
Study design
This open-label observational study was conducted in clinics in three districts in
Senegal and community-based services in two districts in Uganda. Providers administered
SP to clients seeking reinjection of DMPA IM. We conducted in-depth interviews with
86 providers (52 in Senegal, 34 in Uganda) to assess their experiences providing SP
to clients.
Results
Almost all providers (84/86; 98%) preferred SP over DMPA IM. The main reason Uganda
providers preferred SP was the prefilled/all-in-one design made preparation and administration
easier and faster. Some providers thought the SP all-in-one feature may decrease stock
outs (DMPA IM requires syringe and vial). Providers also felt clients preferred the
shorter SP needle because it is less intimidating and less painful. Similarly, the
main reasons Senegal providers preferred SP were its characteristics (prefilled/all-in-one)
and client preference (especially less pain). They also saw a potential to increase
access to FP, especially through community-based distribution. Providers from both
countries reported SP introduction would be enhanced through client counseling and
community engagement. Providers also said SP must be accessible, affordable and in
stock.
Conclusion
Almost all providers preferred SP over DMPA IM. Provider recommendations should be
considered during SP introduction planning.
Implications
We found that SP was acceptable to both clinic-based FP providers and community health
workers. Providers' positive attitudes towards SP may facilitate introduction and
uptake of this method.
Keywords
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Article info
Publication history
Published online: January 23, 2014
Accepted:
January 14,
2014
Received in revised form:
January 13,
2014
Received:
September 14,
2013
Footnotes
☆Registration number: The trial was registered on Clinicaltrials.gov under the FHI 360 Protocol Record NCT01667276.
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
