By Katie Anfinson, Technical Advisor II and Tihut Mulugeta, Project Advisor DMPA-SC Self-Inject, PSI Ethiopia
Imagine a world in which every girl has access, privacy, safety and agency to make informed health decisions. As a generation of healthier women and girls, they use their power to make their own choices about the lives they want to live.
Self-care can help get us there.
Self-care, as defined by the World Health Organization, is the ability of individuals, families, and communities to promote health, prevent disease, maintain health and cope with illness and disability with or without the support of a health worker.
The idea and practice of self-care is not new, but due to its potential to improve health inequities and strengthen health systems, self-care is receiving growing global attention. And with the proper enabling environment, people can exercise their power to practice self-care, and countries can take the next steps toward achieving universal health coverage (UHC).
Self-administration of injectable contraceptive, or DMPA-SC for self-inject, is a type of self-care intervention recommended by the WHO as a contraceptive option. Not only does it improve access to contraceptives, it gives women and girls autonomy and alleviates demand on an increasingly overstretched health system. This self-care intervention is also ideal in times of emergencies. During pandemics like COVID-19, clients can use DMPA-SC as a way to manage their sexual health even when they are unable to visit health facilities.
A ROADMAP FOR INTEGRATING SMART START IN ETHIOPIA (RISE)
In July 2021, PSI Ethiopia through the RISE (Roadmap for Integrating Smart Start in Ethiopia) project with funds from the Children’s Investment Fund Foundation (CIFF) began running a pilot study on DMPA-SC for self-inject. RISE aims to decrease unwanted pregnancy among married adolescent girls 15-19 in rural Ethiopia by scaling up an approach called Smart Start. This approach uses financial planning as an entry point to engage young married couples while they plan their futures and reach financial stability. By helping couples understand how delayed first birth and spaced pregnancies can facilitate improved savings and capital, they are equipped with the information they need to pursue their shared life goals.
In collaboration with the Ethiopian Ministry of Health, Ethiopian Public Health Institute, Addis Ababa City Administration Health Bureau, Marie Stopes International Ethiopia, and FHI 360, this pilot study on DMPA-SC for self-inject currently takes place in six selected public health care facilities in six sub-cities of Addis Ababa.
This first-of-its-kind study in Ethiopia aims to determine the competence of clients to self-inject DMPA-SC, to assess their experiences and to document the experiences of Family Planning providers who train clients to self-inject through enrollment and follow up phases. The hope is that the study’s findings will encourage the Ethiopian Ministry of Health to rollout DMPA-SC for self-inject throughout Ethiopia – giving women and girls access to a new contraceptive method and the power to control their health and wellbeing.
THE PILOT STUDY'S STRUCTURE
The study engages young researchers with backgrounds in health data collection to directly interact with clients during their family planning visits. To ensure they are confident in the data collection process, these researchers are trained on the study protocols, tools, research ethics and on DMPA-SC. The training offers these researchers the chance to explore a range of different scenarios that they might face during the enrollment phase, giving them ample time to develop responses to the questions women raise when first learning about DMPA-SC.
Because these research officers are young people themselves, they are uniquely suited to promote self-care practices and support increased contraceptive choices, both for themselves and for those in need.
“DMPA-SC is a great option for women and girls as it keeps their privacy, is easy to use and saves time. Though introducing the idea of self-injection is challenging and frightening, the functionality and benefits from use exceeds these fears” – Young Research Officer
Looking to the Future
The rollout of DMPA-SC for self-inject in Ethiopia would give women and girls more autonomy and choice over their sexual and reproductive health needs. And as we continue to face COVID-19, ensuring women and girls have access to the contraceptive method of their choice is only more important. This pilot study on DMPA-SC for self-inject is one of many crucial steps being taken towards solving the challenges faced by Ethiopian women and girls who are not able to meet their contraceptive needs.
Moving forward, an introduction plan for DMPA-SC for self-inject and a national learning agenda will be co-developed with various stakeholders interested in promoting self-care and rollout of DMPA-SC for self-inject. PSI Ethiopia’s Youth Innovation Champions will also be engaged in the data analysis and development of the introduction plan. And as they create new opportunities to promote and scale-up self-care interventions like DMPA-SC for self-inject, we’re getting one step closer to a world in which every girl has access, privacy, safety and agency to make the informed health decisions she needs to live the life she wants.
