Service Delivery Considerations for Introducing New Injectable Contraceptives Lasting 4 and 6 Months in Nigeria and Uganda: A Qualitative Study.

IF 2.5 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Rebecca L Callahan, Holly M Burke, Anna Lawton, Funmilola M OlaOlorun, Fredrick Mubiru, Helen Anyasi, Christina M Wong, Dieudonné Bidashimwa, Marissa Velarde, Lucy W Ruderman
{"title":"Service Delivery Considerations for Introducing New Injectable Contraceptives Lasting 4 and 6 Months in Nigeria and Uganda: A Qualitative Study.","authors":"Rebecca L Callahan, Holly M Burke, Anna Lawton, Funmilola M OlaOlorun, Fredrick Mubiru, Helen Anyasi, Christina M Wong, Dieudonné Bidashimwa, Marissa Velarde, Lucy W Ruderman","doi":"10.9745/GHSP-D-23-00214","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>New family planning (FP) product introduction requires understanding the target market and support from stakeholders from across the health sector. We aimed to understand the perspectives of FP providers and other stakeholders on the potential introduction of new subcutaneous (SC) depot medroxyprogesterone acetate (DMPA) injectable contraceptives lasting 4 and 6 months in Nigeria and Uganda.</p><p><strong>Methods: </strong>Between July 2021 and February 2022, we conducted 48 in-depth interviews (IDIs) and 11 focus group discussions (FGDs) with FP providers and other stakeholders involved with service delivery, program management, and policymaking in Lagos and Abuja in Nigeria and Kampala and Luwero in Uganda. IDIs and FGDs explored respondents' reactions to and preferences for the new injectables lasting 4 and 6 months.</p><p><strong>Results: </strong>Most respondents liked the idea of longer-acting DMPA-SC products, noting the potential for reduced facility visits for clients and workloads for providers, cost savings for users and the health system, and potential for improved commodity logistics. Some nonproviders raised concerns about confusion among providers and clients with the availability of multiple injectable products; however, providers did not share this concern. The greatest interest among all groups was for the 6-month injectable, even without the option for self-injection. Several respondents reported that self-injection is not widespread in either context, and some noted that contact with a provider would be important for products with longer durations. Respondents' acceptability of the new injectables assumed that side effects would be no worse than the existing 3-month product.</p><p><strong>Conclusions: </strong>Family planning stakeholders in Nigeria and Uganda are supportive of expanding the method mix with new injectables, which they see as having the potential to meet the needs of more users. Concerted engagement of health providers, policymakers, and the community will be necessary for successful introduction once these new contraceptive products are available.</p>","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":null,"pages":null},"PeriodicalIF":2.5000,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10749649/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Global Health: Science and Practice","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.9745/GHSP-D-23-00214","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0

Abstract

Background: New family planning (FP) product introduction requires understanding the target market and support from stakeholders from across the health sector. We aimed to understand the perspectives of FP providers and other stakeholders on the potential introduction of new subcutaneous (SC) depot medroxyprogesterone acetate (DMPA) injectable contraceptives lasting 4 and 6 months in Nigeria and Uganda.

Methods: Between July 2021 and February 2022, we conducted 48 in-depth interviews (IDIs) and 11 focus group discussions (FGDs) with FP providers and other stakeholders involved with service delivery, program management, and policymaking in Lagos and Abuja in Nigeria and Kampala and Luwero in Uganda. IDIs and FGDs explored respondents' reactions to and preferences for the new injectables lasting 4 and 6 months.

Results: Most respondents liked the idea of longer-acting DMPA-SC products, noting the potential for reduced facility visits for clients and workloads for providers, cost savings for users and the health system, and potential for improved commodity logistics. Some nonproviders raised concerns about confusion among providers and clients with the availability of multiple injectable products; however, providers did not share this concern. The greatest interest among all groups was for the 6-month injectable, even without the option for self-injection. Several respondents reported that self-injection is not widespread in either context, and some noted that contact with a provider would be important for products with longer durations. Respondents' acceptability of the new injectables assumed that side effects would be no worse than the existing 3-month product.

Conclusions: Family planning stakeholders in Nigeria and Uganda are supportive of expanding the method mix with new injectables, which they see as having the potential to meet the needs of more users. Concerted engagement of health providers, policymakers, and the community will be necessary for successful introduction once these new contraceptive products are available.

在尼日利亚和乌干达引入持续 4 个月和 6 个月的新型注射避孕药时的服务提供考虑因素:定性研究。
背景:引进新的计划生育(FP)产品需要了解目标市场,并得到卫生部门相关人员的支持。我们旨在了解计划生育服务提供者和其他利益相关者对尼日利亚和乌干达可能引入的新型皮下注射(SC)醋酸甲羟孕酮(DMPA)注射避孕药物(4 个月和 6 个月)的看法:2021 年 7 月至 2022 年 2 月期间,我们在尼日利亚的拉各斯和阿布贾以及乌干达的坎帕拉和卢韦罗与 FP 提供者和其他参与服务提供、项目管理和政策制定的利益相关者进行了 48 次深入访谈(IDI)和 11 次焦点小组讨论(FGD)。IDI 和 FGD 探讨了受访者对 4 个月和 6 个月新型注射剂的反应和偏好:大多数受访者都喜欢长效 DMPA-SC 产品,并指出这有可能减少患者到医疗机构就诊的次数和医疗服务提供者的工作量,为用户和卫生系统节约成本,并有可能改善商品物流。一些非医疗服务提供者担心提供多种注射产品会使医疗服务提供者和客户产生混淆;但是,医疗服务提供者并不认同这种担忧。所有群体对 6 个月注射剂的兴趣最大,即使没有自我注射的选择。一些受访者称,自我注射在这两种情况下都不普遍,一些受访者指出,对于使用期限较长的产品,与提供者联系非常重要。受访者对新注射剂的接受程度假定副作用不会比现有的 3 个月产品更严重:结论:尼日利亚和乌干达的计划生育利益相关者支持使用新型注射剂来扩大方法组合,他们认为新型注射剂有可能满足更多使用者的需求。一旦这些新的避孕产品上市,医疗服务提供者、政策制定者和社区的共同参与将是成功引进的必要条件。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Global Health: Science and Practice
Global Health: Science and Practice Medicine-Health Policy
CiteScore
3.50
自引率
7.50%
发文量
178
审稿时长
22 weeks
期刊介绍: Global Health: Science and Practice (GHSP) is a no-fee, open-access, peer-reviewed, online journal aimed to improve health practice, especially in low- and middle-income countries. Our goal is to reach those who design, implement, manage, evaluate, and otherwise support health programs. We are especially interested in advancing knowledge on practical program implementation issues, with information on what programs entail and how they are implemented. GHSP is currently indexed in PubMed, PubMed Central, POPLINE, EBSCO, SCOPUS,. the Web of Science Emerging Sources Citation Index, and the USAID Development Experience Clearinghouse (DEC). TOPICS: Issued four times a year, GHSP will include articles on all global health topics, covering diverse programming models and a wide range of cross-cutting issues that impact and support health systems. Examples include but are not limited to: Health: Addiction and harm reduction, Child Health, Communicable and Emerging Diseases, Disaster Preparedness and Response, Environmental Health, Family Planning/Reproductive Health, HIV/AIDS, Malaria, Maternal Health, Neglected Tropical Diseases, Non-Communicable Diseases/Injuries, Nutrition, Tuberculosis, Water and Sanitation. Cross-Cutting Issues: Epidemiology, Gender, Health Communication/Healthy Behavior, Health Policy and Advocacy, Health Systems, Human Resources/Training, Knowledge Management, Logistics and Supply Chain Management, Management and Governance, mHealth/eHealth/digital health, Monitoring and Evaluation, Scale Up, Youth.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信