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Background <p>Depot Medroxyprogesterone Acetate (DMPA) in a prefilled auto-disabled subcutaneous injectable contraceptive (Uniject™) can be administered by community health workers and clients. Self-injection of DMPA-SC is an evidence-based practice endorsed globally by the World Health Organization and approved in several countries. The Ethiopian Ministry of Health is interested in introducing DMPA-SC self-injection to expand family planning options. This research aimed to generate information on the safety, acceptability, and feasibility of the introduction and scale-up of DMPA-SC self-injection in Ethiopia.</p> Method <p>We used mixed-method research. Four hundred women aged 18–49 interested in DMPA-SC self-injection were enrolled in the study. Participants were recruited from six public health facilities with high family planning client load in Addis Ababa. In-depth interviews were conducted with 15 family planning providers trained on self-injection and provided DMPA-SC from six public health facilities. Participants’ self-injection competency was assessed using a standardized checklist at enrollment and follow-up (three months post-enrollment). Quantitative data were analyzed using descriptive statistics, and the qualitative data were analyzed using thematic analysis.</p> Results <p>Self-injection competency among women at baseline (95%) was high and at three months follow-up (83%). Competency levels did not differ by sociodemographic characteristics. Participants reported increased confidence and comfort with self-injection during the three-month follow-up compared to baseline; 74% said they were confident to self-inject during enrollment compared with 93% at follow-up. 84% of participants said they were satisfied or very satisfied with DMPA-SC self-injection. Providers saw the benefit of offering DMPA-SC self-injection because it saves clients time, money, and the burden of having to come to a health facility. Providers suggested that DMPA-SC self-injection be added to the method mix and offered through community distribution by health extension workers.</p> Conclusion <p>Results showed that women can competently self-inject DMPA-SC and that it is highly acceptable to clients and providers. If made available, most women would like to continue with the method and would recommend it to others. DMPA-SC self-injection has the potential to support the Ethiopian Ministry of Health in reaching its FP2030 targets. The results from this study further support the introduction and scale-up of DMPA-SC self-injection in Ethiopia.</p>

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Feasibility and acceptability of DMPA-SC self-injection in Addis Ababa, Ethiopia: a mixed-methods study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月31日

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  • Aderaw Anteneh,
  • Megan M. Lydon,
  • Katherine M. Anfinson,
  • Fikreselassie Getachew,
  • Erica Felker-Kantor,
  • Tihut Mulugeta,
  • Teferi Teklu,
  • Rahel Demissew,
  • Holly M. Burke

摘要

Background

Depot Medroxyprogesterone Acetate (DMPA) in a prefilled auto-disabled subcutaneous injectable contraceptive (Uniject™) can be administered by community health workers and clients. Self-injection of DMPA-SC is an evidence-based practice endorsed globally by the World Health Organization and approved in several countries. The Ethiopian Ministry of Health is interested in introducing DMPA-SC self-injection to expand family planning options. This research aimed to generate information on the safety, acceptability, and feasibility of the introduction and scale-up of DMPA-SC self-injection in Ethiopia.

Method

We used mixed-method research. Four hundred women aged 18–49 interested in DMPA-SC self-injection were enrolled in the study. Participants were recruited from six public health facilities with high family planning client load in Addis Ababa. In-depth interviews were conducted with 15 family planning providers trained on self-injection and provided DMPA-SC from six public health facilities. Participants’ self-injection competency was assessed using a standardized checklist at enrollment and follow-up (three months post-enrollment). Quantitative data were analyzed using descriptive statistics, and the qualitative data were analyzed using thematic analysis.

Results

Self-injection competency among women at baseline (95%) was high and at three months follow-up (83%). Competency levels did not differ by sociodemographic characteristics. Participants reported increased confidence and comfort with self-injection during the three-month follow-up compared to baseline; 74% said they were confident to self-inject during enrollment compared with 93% at follow-up. 84% of participants said they were satisfied or very satisfied with DMPA-SC self-injection. Providers saw the benefit of offering DMPA-SC self-injection because it saves clients time, money, and the burden of having to come to a health facility. Providers suggested that DMPA-SC self-injection be added to the method mix and offered through community distribution by health extension workers.

Conclusion

Results showed that women can competently self-inject DMPA-SC and that it is highly acceptable to clients and providers. If made available, most women would like to continue with the method and would recommend it to others. DMPA-SC self-injection has the potential to support the Ethiopian Ministry of Health in reaching its FP2030 targets. The results from this study further support the introduction and scale-up of DMPA-SC self-injection in Ethiopia.