Game changer: Here is an injectable contraceptive for self-use

Depo-Medroxyprogesterone Acetate (DMPA-SC), it is injected subcutaneously (just under the skin), including into the buttocks, anterior thigh, abdomen or back of the upper arm.

Photo credit: Photo I Pool

What you need to know:

  • Depo-Medroxyprogesterone Acetate is injected under the skin, including into the buttocks, anterior thigh, abdomen or back of the upper arm.
  • It is 99 per cent effective at preventing unintended pregnancies when administered correctly and on time every three months.

In response to the growing demand for accessible and convenient contraceptive options, a range of self-injectable contraceptives has been introduced into the country.

Known as subcutaneous Depo-Medroxyprogesterone Acetate (DMPA-SC), it is injected subcutaneously (just under the skin), including into the buttocks, anterior thigh, abdomen or back of the upper arm.

According to a fact-sheet provided by the Reproductive Health Network Kenya (RHNK), DMPA-SC only requires minimal training to be used properly. Its ease and simplicity of use allows community health workers, pharmacists, and even women to inject it themselves.

“It is reversible and combines the contraceptive drug and needle into a single device that is small, light, and easy to use. It is also 99 per cent effective at preventing unintended pregnancies when administered correctly and on time every three months,” reads the document.

All this has made it attractive to one of its first users. Francisca Auma, 24, only uses contraceptives if they are short-term and non-invasive. She tells Nation.Africa that she, for instance, wouldn't use the non-hormonal IUD option because it is painful to insert.

“I am also in a long-distance relationship. It’s not like an actual commitment but rather a 'when I see you' kind of thing, so I wanted to have safe sex without committing to a long-term contraceptive method,” she says.

When the nurse at her local clinic presented her with an array of options, Francisca says she avoided one that would leave physical indicators that she was on contraceptives.

She did that because she did not want anyone, besides her partner, to know that she was taking measures to avoid pregnancy.

Francisca's insights shed light on the challenges faced by many women in accessing suitable birth control methods that align with their preferences and lifestyle.

For Naomi Moraa, 19, she did not want to repeat the mistake she made when she got pregnant at 16. She chose to get the injectable contraceptive before marriage.

“I was not prepared to be a teen mother. I had to drop out of school to take care of my child. My parents did not have enough money to keep me in school and take care of my child and me. This is the reason I would like to wait for at least five years before getting pregnant again,” Naomi says.

Short-term contraceptive

Naomi adds that the nurse at her local clinic had also informed her of a hormonal contraceptive that could last three years, but she preferred the injectable one because it was short-term (three months) and she could self-administer it in the future.

“My body has also quickly adapted to the contraceptive. I was afraid I would have irregular periods or nausea, but that has not been the case.”

Leila Abdulkeir, a youth leader based in Kilifi, told Nation.Africa that several cultural obstacles hinder access to contraceptives.

“Many women on the Coast have to ask for permission from their husbands before they can get contraceptives. Sometimes they even have to sneak into the clinics to get their contraceptives without telling their husbands,” she stated.

Addressing the financial aspect, Leila discussed how the high cost of healthcare services poses a significant barrier, forcing many women to prioritise basic needs over contraceptives.

The barriers lead to unmet contraceptive needs of many women. According to the 2022 Kenya Demographic and Health Survey, the national unmet need for family planning stands at 14 per cent, a notable decline from the 35 per cent recorded in 1993.

The Kenya National Bureau of Statistics also revealed that 14 per cent of married women aged 15–49 in Kenya face an unmet need for family planning, which restricts their ability to prevent unintended pregnancies and plan their families.

Notably, there are significant variations among regions, with certain hard-to-reach counties, including Marsabit, Tana River and West Pokot, reporting higher unmet needs for family planning and reaching rates as high as 38 per cent.

Awareness campaign

This is why last Friday, RHNK joined hands with the Ministry of Health’s Division of Reproductive and Maternal Health and the Clinton Health Access Initiative to launch a campaign to raise awareness of the injectable contraceptive.

The campaign is dubbed Chaguo Mkononi, a Swahili phrase that translates into "the choice is in your hands.” The endeavour is grounded in the principles of reproductive health autonomy.

At the launch in a Nairobi hotel, Nelly Munyasia, the executive director of RHNK said the campaign is focused on promoting autonomy and choice in family planning, with an emphasis on empowering women to self-administer contraceptives in the comfort of their own homes.

Regarding the introduction of self-injectable contraceptives in Kenya, Ms Munyasia clarified that the method has been available for about three years.

However, she acknowledged challenges in its uptake, particularly in regions where traditional gender dynamics hinder women's agency in healthcare decisions.

Despite these challenges, the campaign aims to bridge the gap by promoting the government's self-care guidelines and encouraging women to take charge of their reproductive health.

Furthermore, Ms Munyasia outlined the campaign's implementation strategy, which involves collaboration with the Ministry of Health and partners across the counties.

“The three-year campaign aims to achieve widespread adoption of self-injectable contraceptives across Kenya," she added.

"The goal is to cascade the campaign's messaging and initiatives through grassroots networks, leveraging community health promoters to disseminate information and generate demand for self-injectable contraceptives.”

At the launch, RHNK also expanded its toll-free hotline, Nena na Binti Call Centre, which translates into “Talk to a girl.”

The digital intervention is supposed to serve as a dedicated resource hub, offering unrestricted access to life-saving sexual and reproductive health and rights information.

Through the call centre, women and girls will access information on family planning, referrals for contraception services, as well as legal and psychosocial support.

As the campaign unfolds, RHNK hopes to reach five million women, especially in arid and semi-arid regions with high unmet needs of family planning.