Pathways of Change: How DMPA-SC Introduction May Impact a National Family Planning Program

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Abstract

DMPA-SC, currently sold by Pfizer as Sayana Press, is a new all-in-one injectable that has been heralded as a possible “game changer” for family planning due to its easy administration by paraprofessionals or even clients themselves.i After almost three decades of product development, research, and introduction, there are over a dozen countries looking to pilot new or scale up existing DMPA-SC service delivery approaches. Research has shown it is highly acceptable, with providers and clients reporting a preference for DMPA-SC over DMPA-IM.ii Early introduction studies hint at the possibility of perceived or real lower side effects, which are a major determinant of method satisfaction and continuation.iii DMPA-SC represents an important technological advancement of injectable contraception and may eventually replace DMPA-IM completely. Yet for all its method advantages and posited game changing, it is worthwhile for the family planning community to examine exactly how and through what mechanisms we can expect DMPA-SC to have a programmatic impact. Changing the status quo is challenging and brings up-front costs for provider training, client education, and changes to procurement and distribution systems. Adoption of DMPA-SC also requires advocacy, policy and regulatory changes, and in the case of home and self-injection, additional layperson training.