Self-injectable medicine could revolutionise contraceptive access and use

Self-injectable medicine. [iStockphoto] In Kenya, access to family planning and contraception remains critical, with many women facing barriers to accessing quality reproductive health services. These include geographical barriers, particularly in rural and remote areas, posing significant challenges for women seeking services due to distance to the nearest health facility and financial constraints. In particular, such challenges deter women from accessing family planning and contraception methods of their choice due to costs or transportation to healthcare facilities. Young women and girls further face unique barriers due to societal norms, stigma, and legal restrictions. These intersecting factors create complex barriers to family planning and contraception access, emphasising the need for tailored strategies to address the diverse needs and challenges faced by individuals seeking to exercise their reproductive rights. Despite efforts to improve family planning access, Kenya continues to grapple with high rates of unmet need for family planning and contraception, particularly among marginalised populations. According to the Kenya Demographic Health Survey 2022, the modern contraceptive prevalence rate among married women aged 15-49 years was 63 per cent, while the unmet need for family planning stood at 14 per cent, which limits women's ability to prevent unintended pregnancies and plan their families. The introduction of subcutaneous depot medroxyprogesterone acetate (DMPA-SC), a self-injectable contraception, offers a promising solution to revolutionise contraceptive access and use that reduces access-related barriers for women, enhance women's autonomy and increase contraceptive continuation rates. DMPA-SC is easy-to-use and is highly effective and reversible and provides three months of protection against pregnancy with a single injection. Further, evidence shows that women can self-administer DMPA-SC safely and effectively, and that it offers discreet administration, making it particularly suitable for women who face challenges accessing regular healthcare services. The 2022 Kenya Demographic Health Survey findings highlighted that contraceptive use among married and sexually active unmarried women in Kenya preferred injectables as a contraceptive method. Among currently married women, injectables ranked as the most commonly used method, with a usage rate of 20 per cent, and among sexually active unmarried women, injectables usage rate was 16 per cent. These findings show the significant preference for injectables among women of reproductive age in Kenya. Reproductive Health Network Kenya in partnership with the Ministry of Health, Division or Reproductive and Maternal Health is last week launched a campaign dubbed 'Chaguo Mkononi' that aims at reshaping access to family planning and contraception in Kenya. Grounded on the principles of reproductive health autonomy and women empowerment, the campaign seeks to dismantle barriers to family planning and contraception access, and provide comprehensive information and services to women through self-care. By promoting the use of DMPA-SC, alongside other contraception options, and emphasising the importance of informed decision-making, the campaign looks to empower women to take control of their reproductive health and make choices that align with their goals and aspirations, as well as enhance achievements made towards attainment of Family Planning 2030 commitments made by the Ministry of Health and National Council for Population and Development in 2021. The campaign will focus on increasing awareness and understanding of available contraception options, placing emphasis on self-injectable contraception, while addressing barriers and ensuring that women can easily access the information and resources. It will also address reduction of stigma associated with self-care in contraception, creating an environment where women feel empowered to make choices regarding their reproductive health without fear or judgment. Through these interventions, the campaign will ultimately contribute to a decrease in unintended pregnancies and unsafe abortions, improving women's overall reproductive health and positive socio-economic and individual outcomes.

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