Service Delivery Considerations for Introducing New Injectable Contraceptives Lasting 4 and 6 Months in Nigeria and Uganda: A Qualitative Study.


Journal

Global health, science and practice
ISSN: 2169-575X
Titre abrégé: Glob Health Sci Pract
Pays: United States
ID NLM: 101624414

Informations de publication

Date de publication:
22 Dec 2023
Historique:
received: 19 05 2023
accepted: 10 11 2023
medline: 23 12 2023
pubmed: 23 12 2023
entrez: 22 12 2023
Statut: epublish

Résumé

New family planning (FP) product introduction requires understanding the target market and support from stakeholders from across the health sector. We aimed to understand the perspectives of FP providers and other stakeholders on the potential introduction of new subcutaneous (SC) depot medroxyprogesterone acetate (DMPA) injectable contraceptives lasting 4 and 6 months in Nigeria and Uganda. Between July 2021 and February 2022, we conducted 48 in-depth interviews (IDIs) and 11 focus group discussions (FGDs) with FP providers and other stakeholders involved with service delivery, program management, and policymaking in Lagos and Abuja in Nigeria and Kampala and Luwero in Uganda. IDIs and FGDs explored respondents' reactions to and preferences for the new injectables lasting 4 and 6 months. Most respondents liked the idea of longer-acting DMPA-SC products, noting the potential for reduced facility visits for clients and workloads for providers, cost savings for users and the health system, and potential for improved commodity logistics. Some nonproviders raised concerns about confusion among providers and clients with the availability of multiple injectable products; however, providers did not share this concern. The greatest interest among all groups was for the 6-month injectable, even without the option for self-injection. Several respondents reported that self-injection is not widespread in either context, and some noted that contact with a provider would be important for products with longer durations. Respondents' acceptability of the new injectables assumed that side effects would be no worse than the existing 3-month product. Family planning stakeholders in Nigeria and Uganda are supportive of expanding the method mix with new injectables, which they see as having the potential to meet the needs of more users. Concerted engagement of health providers, policymakers, and the community will be necessary for successful introduction once these new contraceptive products are available.

Sections du résumé

BACKGROUND BACKGROUND
New family planning (FP) product introduction requires understanding the target market and support from stakeholders from across the health sector. We aimed to understand the perspectives of FP providers and other stakeholders on the potential introduction of new subcutaneous (SC) depot medroxyprogesterone acetate (DMPA) injectable contraceptives lasting 4 and 6 months in Nigeria and Uganda.
METHODS METHODS
Between July 2021 and February 2022, we conducted 48 in-depth interviews (IDIs) and 11 focus group discussions (FGDs) with FP providers and other stakeholders involved with service delivery, program management, and policymaking in Lagos and Abuja in Nigeria and Kampala and Luwero in Uganda. IDIs and FGDs explored respondents' reactions to and preferences for the new injectables lasting 4 and 6 months.
RESULTS RESULTS
Most respondents liked the idea of longer-acting DMPA-SC products, noting the potential for reduced facility visits for clients and workloads for providers, cost savings for users and the health system, and potential for improved commodity logistics. Some nonproviders raised concerns about confusion among providers and clients with the availability of multiple injectable products; however, providers did not share this concern. The greatest interest among all groups was for the 6-month injectable, even without the option for self-injection. Several respondents reported that self-injection is not widespread in either context, and some noted that contact with a provider would be important for products with longer durations. Respondents' acceptability of the new injectables assumed that side effects would be no worse than the existing 3-month product.
CONCLUSIONS CONCLUSIONS
Family planning stakeholders in Nigeria and Uganda are supportive of expanding the method mix with new injectables, which they see as having the potential to meet the needs of more users. Concerted engagement of health providers, policymakers, and the community will be necessary for successful introduction once these new contraceptive products are available.

Identifiants

pubmed: 38135518
pii: GHSP-D-23-00214
doi: 10.9745/GHSP-D-23-00214
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© Callahan et al.

Auteurs

Rebecca L Callahan (RL)

Product Development and Introduction, FHI 360, Durham, NC, USA. rcallahan@fhi360.org.

Holly M Burke (HM)

Reproductive, Maternal, Newborn, Child Health, FHI 360, Durham, NC, USA.

Anna Lawton (A)

Product Development and Introduction, FHI 360, Durham, NC, USA.

Funmilola M OlaOlorun (FM)

College of Medicine, University of Ibadan, Ibadan, Nigeria.

Fredrick Mubiru (F)

FHI 360, Kampala, Uganda.

Helen Anyasi (H)

FHI 360, Abuja, Nigeria.

Christina M Wong (CM)

Global Health and Population Research, FHI 360, Durham, NC, USA.

Dieudonné Bidashimwa (D)

Global Health and Population Research, FHI 360, Durham, NC, USA.

Marissa Velarde (M)

Product Development and Introduction, FHI 360, Durham, NC, USA.

Lucy W Ruderman (LW)

Reproductive, Maternal, Newborn, Child Health, FHI 360, Durham, NC, USA.

Classifications MeSH