(PATH/Will Boase)

The three-month birth control injection you can give yourself

The healthcare organization PATH has introduced a drug called Sayana Press, bringing contraceptives to 300,000 women in Sub-Saharan Africa

In developed countries, significantly fewer women have unwanted pregnancies as abortion rates dropped from 46 percent to below 30 percent between 1990 and 2014. In developing parts of the world, however, abortions insignificantly declined by 2 percent, from 39 to 37 abortions per 1,000 women, according to a study from the World Heath Organization and the Guttmacher Institute.

Yet access to contraceptives could reduce unsafe abortions in developing countries by 74 percent.

Sayana Press is a self-injectable contraceptive that provides three months of contraceptive protection per dose. The contraceptive, manufactured by Pfizer, has a 99 percent success rate and can cost some women who qualify just $1 per dose.

While injectable contraceptives have been widely used around the world, they were usually exclusively available to those with access to clinics and doctors. Women who live in rural communities may not be able to get these contraceptives without traveling long distances, and the commute may not always be available or reliable. Sayana Press comes in small, pre-filled syringes, which means healthcare workers can easily transport it to even the most remote villages, or women can give themselves the injection in their homes.

Jennifer Kidwell Drake, the PATH Assistant Project Director for Sayana Press, spoke with Latterly about self-contraceptive options for women in developing countries and what they mean for family planning.

What’s a self-injectable contraceptive and how does it work?

Self-injection is a new emerging practice that could help overcome access barriers and increase women’s ability to manage their health. Injectable contraceptives are among the world’s most widely used methods for preventing pregnancy, offering women safe and effective protection, convenience and privacy. It’s delivered in the BD Uniject injection system — a small, pre-filled, auto-disable device that was originally developed by PATH. The injectable contraceptive acts by preventing an egg from fully developing and being released from the ovaries during a woman’s menstrual cycle. If an egg is not released it cannot become fertilized by sperm and result in pregnancy.

What’s in Sayana Press?

Sayana Press contains 104 mg of depot medroxyprogesterone acetate (DMPA) per 0.65 mL dose and is administered through subcutaneous injection, just under the skin — instead of an injection into muscle (Depo-Provera is administered with an intramuscular injection). DMPA is similar to the natural hormone progesterone that is produced in the ovaries during the menstrual cycle.

Where is Sayana Press available?

Sayana Press is currently registered in more than 20 countries in Europe, Africa and Asia, and has been introduced in at least nine of those countries so far. It was first registered in the United Kingdom in 2012 and the first use in Sub-Saharan Africa was launched in Burkina Faso in July 2014 through a country-led initiative coordinated by PATH and partners. This was followed by PATH-coordinated introductions in Niger, Uganda and Senegal. More than 310,000 doses of Sayana Press have been administered by health workers in these countries. It has also been introduced in other countries, including Bangladesh and Nigeria.

How much does it cost?

The cost for women varies by country and whether it is being offered through a public, nongovernmental or commercial delivery channel.

In November 2014, Pfizer Inc., the Bill & Melinda Gates Foundation and the Children’s Investment Fund Foundation agreed to a new public-private collaboration through which Sayana Press will be sold for $1 per dose to qualified purchasers such as USAID, UNFPA and country Ministries of Health in 69 of the world’s poorest countries. This agreement aims to increase access to this new option at reduced or no cost, especially for women with an unmet need for contraception.

How do self-injectable contraceptives prevent unintended pregnancies and educate women on sexual health?

Access to modern contraception options like Sayana Press can help prevent unwanted or unintended pregnancies. In turn, this can help reduce maternal deaths by delaying motherhood, spacing births and avoiding unsafely performed abortions.

In many countries like Uganda, clinic- and community-based health workers are trained to provide education and counseling on reproductive health along with a range of contraceptive options, enabling women and girls to make informed choices about what family planning approach is right for them.

Family planning options vary by country and areas within countries. In Uganda, some of the most common options offered include injectable contraception, oral contraceptive pills, male and female condoms, implants, IUDs, sterilization and natural or traditional family planning methods.

In Uganda, the most commonly used family planning option is injectable contraception, like Depo-Provera or a similar Ugandan product called Injectaplan. Sayana Press is a newer injectable contraceptive, offered in select districts of Uganda starting in 2014.

Life and death on a remote Icelandic island. Read Latterly’s ebook ‘The Lost Brother: The Tale of the Grímsey Triplets,’ available now at Amazon.com.

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