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Webinar Reading Time: 3 minutes

Implementing DMPA-SC Self-Injection During COVID-19 in Four Francophone Countries

On December 21, 2020, Jhpiego, the IBP Network, and the Ouagadougou Partnership hosted a webinar on high-impact approaches to support the introduction and scale-up of the self-injectable contraceptive, depot-medroxyprogesterone acetate-subcutaneous (DMPA-SC; brand name Sayana Press), in Francophone family planning programs in West Africa. During the session, representatives from Burkina Faso, Guinea, Mali, and Togo shared their experiences—from strategies to results, as well as challenges, lessons learned, and recommendations. These country initiatives were implemented as part of Jhpiego’s regional project Accelerating Access to the DMPA-SC with support from the “Catalytic Opportunities Fund,” an initiative managed by the CHAI Foundation.

Did you miss the webinar? Read our recap below or watch the recording and download the presentation slides.

Pour lire l’article en français, cliquez ici.

Présentateurs : Aguiebina Ouedraogo, Dr Siré Camara, Yalkouyé Haoua Guindo et Dr Madéleine TCHANDANA
Présentateurs : Aguiebina Ouedraogo, Dr Siré Camara, Yalkouyé Haoua Guindo et Dr Madéleine TCHANDANA

High Impact Self-Injection Strategies

The speakers shared their experiences in what strategies their projects used to introduce and scale-up the use of DMPA-SC in key districts in their respective countries at the rural and urban levels. These strategies focused on building the capacity of healthcare providers and other key actors in the public and private systems. More specifically, these strategies included:

  1. Advocacy for the creation of an enabling environment to introduce DMPA-SC, including self-injection
  2. Developing training kits, management tools and other materials, such as training guides, provider reference manuals, checklists, posters, client instructions, and calendars
  3. Providing health sites with contraceptive products, including DMPA-SC
  4. Training healthcare providers on the self-injection technique
  5. Providing guidance to pharmacy vendors
  6. Building virtual and face-to-face skills of public and private health facility providers
  7. Connecting private clinics/NGOs with municipal health departments
  8. Post-training follow-up and supervision
  9. Monitoring and evaluation of family planning data

What Were the Results?

Lessons Learned

All four countries agreed that success would not have been possible without the flexibility and willingness to shift in response to the COVID-19 pandemic. Adapting the trainings to a virtual format, implementing post-training follow-up from a distance, and creating WhatsApp groups were effective alternatives for building capacity and fostering learning exchange among providers offering DMPA-SC. Before each virtual training in Guinea, organizers distributed documents, tools, and materials to facilitate the training. Dr. Tchandana noted that Togo took learnings from the Rapid Response Mechanism (RRM) project of FP2020. This approach focuses on providing close assistance to providers for self-injection introduction. Communication materials, especially videos, also made trainings successful, as representatives from the Burkina and Guinea ministries of health agreed. Other examples include materials such as trainers’ guides, reference manuals, and data management tools.

Representatives from Guinea, Mali, and Burkina discussed the importance of advocacy to create an enabling environment for the introduction of DMPA-SC in the countries. This included creating an enabling environment both at the government level to ensure the availability of guidance and leadership, and with clients to generate demand for self-injection. In Burkina, one lesson learned was to consider provider motivation in client recruitment. Mali continues to advocate for free DMPA-SC services.

Equally important in terms of relationship management, Guinea found, was the relationship between private clinics and the district health management teams to facilitate data reporting. Similarly, based on the Mali experience, Ms. Yalcouye emphasized the importance of ensuring the availability of data input tools and management support in public and private facilities. For all four countries, it was clear that training and supervision on data entry and use of data for decision making contributed to the success of the projects

Conclusion: Two Approaches, Four Countries

As webinar moderator Rodrigue Ngouana noted, Guinea and Mali introduced DMPA-SC/self-injection at the urban level with the idea that the city would influence other regions of the country and foster an environment conducive to future expansion of the method. The Burkina and Togo approach focused on scale-up of self-injectables to different regions to allow for a wider choice of contraceptive methods. With the changing climate of COVID-19, all four countries had to adapt their implementation approaches, including training and knowledge sharing from a distance rather than in-person. These adaptations, and remarkable results, show that the CHAI projects have helped build capacity for the implementation of DMPA-SC/self-injection in the countries.

As programs plan and implement self-injectable contraception scale-up, it is important to note the experiences, lessons learned, and recommendations from these four countries.

Aïssatou Thioye

West Africa Knowledge Management and Partnerships Officer, Knowledge SUCCESS, FHI 360

Aïssatou Thioye est dans la division de l'utilisation de la recherche, au sein du GHPN de FHI360 et travaille pour le projet Knowledge SUCCESS en tant que Responsable de la Gestion des Connaissances et du Partenariat pour l’Afrique de l’Ouest. Dans son rôle, elle appuie le renforcement de la gestion des connaissances dans la région, l’établissement des priorités et la conception de stratégies de gestion des connaissances aux groupes de travail techniques et partenaires de la PF/SR en Afrique de l’Ouest. Elle assure également la liaison avec les partenaires et les réseaux régionaux. Par rapport à son expérience, Aïssatou a travaillé pendant plus de 10 ans comme journaliste presse, rédactrice-consultante pendant deux ans, avant de rejoindre JSI où elle a travaillé dans deux projets d’Agriculture et de Nutrition, successivement comme mass-media officer puis spécialiste de la Gestion des Connaissances.******Aïssatou Thioye is in the Research Utilization Division of the GHPN of FHI 360 and works for the Knowledge SUCCESS project as the Knowledge Management and Partnership Officer for West Africa. In her role, she supports the strengthening of knowledge management in the region, setting priorities and designing knowledge management strategies at the FP/RH technical and partner working groups in West Africa. She also liaises with regional partners and networks. In relation to her experience, Aïssatou worked for more than 10 years as a press journalist, then as an editor-consultant for two years, before joining JSI where she worked on two Agriculture and Nutrition projects, successively as a mass-media officer and then as a Knowledge Management specialist.

Natalie Apcar

Program Officer II, KM & Communications, Knowledge SUCCESS

Natalie Apcar is a Program Officer II at the Johns Hopkins Center for Communication Programs, supporting knowledge management partnership activities, content creation, and communications for Knowledge SUCCESS. Natalie has worked for a variety of nonprofits and built a background in planning, implementation, and monitoring of public health programming, including gender integration. Other interests include youth and community-led development, which she got the chance to engage in as US Peace Corps Volunteer in Morocco. Natalie earned a Bachelor of Arts in International Studies from American University and a Master of Science in Gender, Development, and Globalization from the London School of Economics and Political Science.

Sophie Weiner

Program Officer II, Johns Hopkins Center for Communication Programs

Sophie Weiner is a Knowledge Management and Communications Program Officer II at the Johns Hopkins Center for Communication Programs where she is dedicated to developing print and digital content, coordinating project events, and strengthening capacity for storytelling in Francophone Africa. Her interests include family planning/reproductive health, social and behavior change, and the intersection between population, health, and the environment. Sophie holds a B.A. in French/International Relations from Bucknell University, an M.A. in French from New York University, and a master’s degree in Literary Translation from the Sorbonne Nouvelle.