Observational study of the acceptability of Sayana® Press among intramuscular DMPA users in Uganda and Senegal

Holly M Burke; Monique P Mueller; Brian Perry; Catherine Packer; Leonard Bufumbo; Daouda Mbengue; Ibrahima Mall; Bocar Mamadou Daff; Anthony K Mbonye

doi:10.1016/j.contraception.2014.01.022

Observational study of the acceptability of Sayana® Press among intramuscular DMPA users in Uganda and Senegal

Contraception. 2014 May;89(5):361-7. doi: 10.1016/j.contraception.2014.01.022. Epub 2014 Feb 6.

Authors

Holly M Burke¹, Monique P Mueller², Brian Perry², Catherine Packer², Leonard Bufumbo³, Daouda Mbengue⁴, Ibrahima Mall⁴, Bocar Mamadou Daff⁵, Anthony K Mbonye⁶

Affiliations

¹ FHI 360, Durham, NC, USA. Electronic address: hburke@fhi360.org.
² FHI 360, Durham, NC, USA.
³ FHI 360, Kampala, Uganda.
⁴ Centre de Formation et de Recherche en Santé de la Reproduction (CEFOREP), Senegal.
⁵ Ministry of Health and Social Action, Senegal.
⁶ Ministry of Health, Uganda.

PMID: 24631328
DOI: 10.1016/j.contraception.2014.01.022

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 DMPA IM users.

Study design: This open-label observational study was conducted in clinics in three districts in Senegal and community-based distribution services in two districts in Uganda. Experienced DMPA IM users were offered SP by community health workers (CHWs) or clinic-based providers. SP decliners were asked to discuss their reasons. Those who received SP were interviewed pre- and postinjection and 3 months later, when they were asked if they would select SP over DMPA IM if it were available.

Results: One hundred twenty women in Uganda and 242 in Senegal received SP (117 and 240 were followed up, respectively). Nine Ugandan and seven Senegalese SP decliners were interviewed. Three months after receiving SP, 84% [95% confidence interval (CI)=75%-93%] of Ugandan participants and 80% (95% CI=74%-87%) of Senegalese participants said they would select SP over DMPA IM. Main reasons for selecting SP were fewer side effects, liking the method, fast administration, less pain and method effectiveness. Thirty-four adverse events were reported but were not serious. No pregnancies were reported.

Conclusion: Current DMPA IM users in Senegal and Uganda accepted SP, and most preferred SP over DMPA IM. SP can be safely introduced into FP programs and administered by trained CHWs, with expectation of client uptake.

Implications: We found SP acceptable and safe in diverse settings among current intramuscular DMPA users, including those who received SP from CHWs. This provides evidence that SP would be used and could therefore reduce unmet family planning needs if introduced into family planning programs.

Trial registration: ClinicalTrials.gov NCT01667276.

Keywords: Community health worker; Contraception; Depot medroxyprogesterone acetate; Subcutaneous injection.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Contraceptive Agents, Female / administration & dosage*
Female
Humans
Injections, Subcutaneous
Medroxyprogesterone Acetate / administration & dosage*
Patient Acceptance of Health Care / statistics & numerical data*
Senegal
Uganda
Young Adult

Substances

Contraceptive Agents, Female
Medroxyprogesterone Acetate

Associated data

ClinicalTrials.gov/NCT01667276