Report Explores Introduction of DMPA-SC in Zambia

A new client-centered approach to provide DMPA-SC self-injection through private providers demonstrates new opportunities to advance scale-up in Zambia.

In 2018, the Zambian government approved the introduction of Sayana Press®, generically known as DMPA-SC, into its family planning program. DMPA-SC is the first injectable contraceptive that can be self-administered, offering women greater access, choice and agency over their contraceptive needs. 

After a successful pilot demonstrated the acceptability of the new product through community health workers in Zambia, the Zambian Ministry of Health launched a  strategy to scale up DMPA-SC through a variety of new channels, including private providers. Limited evidence was available globally, however, on the overall systems considerations for offering self-injection through the private health sector. 

JSI, through Advancing Partners & Communities and USAID | DISCOVER-Health projects, conducted a pilot study to introduce DMPA-SC self-injection through private health providers in Zambia, taking a client-focused, systems approach to the design. The primary objectives of the activity were to: 1) understand experiences with the new client-centered DMPA-SC self-injection training model, including clients’ willingness to pay for the product; and 2) identify health system relationships, barriers, and solutions for national scale-up in Zambia.

A new report, The Next-generation Injectable, A Next-generation Approach Introducing DMPA-SC Self-injection Through Private Providers in Zambia, presents findings and operational considerations of the study, based on a total market approach

Over four months, the team enrolled private sector family planning clients interested in DMPA-SC self-injection, and assessed their experience and willingness to pay for the product. The approach used human-centered design (HCD) process to gather insights from a wide array of market actors (e.g., policymakers, donors, private health providers, clients) and engage them in generating policy and program solutions based on learning from the DMPA-SC self-injection findings.

This activity demonstrated that a shorter DMPA-SC training format was effective for training private providers and their clients in self-injection, and that most women who participated in the pilot are willing to pay a price similar to or higher than the negotiated donor price of $0.85 per unit. This study is intended to advance country and global efforts to engage the private sector in DMPA-SC scale-up, as part of a total market approach. 

Read the report.