Self-inject contraceptive gains popularity



BOTHA-BOTHE – Up to 19 000 women in the Lesotho are now using the new family planning method called Sayana press. Subcutaneous Depo Medroxyprogesterone acetate DMPA (Sayana press) is a new self-injectable family planning method that is administered under the skin and said to be highly effective for preventing pregnancy.

Sayana press is delivered every three months but, like any other family planning method, it does not protect against HIV or other sexually transmitted infections (STIs). On first use health care workers demonstrate how to use it, then clients inject themselves in the presence of the health care workers and if they are satisfied with the way a client uses it, they give a few of them to use at home in due time.

Clients have to mark in their health booklets for health care workers to monitor the process on the next visit. The advantage here is that there is no need to visit the facility regularly as the clients use Sayana press from the comfort of their homes. One of the recipients of Sayana press, ’Mareabetsoe Lebaka, 26, of ’Moteng Kolone, praised the convenience of a self-injection method of contraception as it saves her travelling costs to the health centre and from missing her family planning routines.

Lebaka, who was initially using the three months depo medroxyprogesterone injection as her preferred method of family planning, got pregnant with her second baby because she had missed her appointment to get her dose at the ’Muela Health Care centre due to lack of transport fare.

She currently has two children. “I used a three-month depo which I used to get at ’Muela Health Centre because I did not have money to go to the clinic and then I missed my appointment, which led to an unplanned pregnancy. That is how I got my second born; my first born is four years old and my second born is a year old.

“I am so happy that we have been introduced to this self-injection method because it has saved me from further unplanned pregnancies, and freeing me of costs,” she said. ’Mareabetsoe said her visits to the clinic have decreased and she has no reason to miss her routine while she now has an opportunity to get a self-injection to use from the convenience of her home.

This, she said, at an event to celebrate World Contraceptive Day at a ’Moteng outreach prepared by the United Nations Population Fund (UNFPA) and the Lesotho Planned Parenthood Association (LPPA) where villagers were taught about family planning services and the introduction of Sayana press. Rethabile Semelane, 27, from Motahare ’Moteng, said she also had the same struggles of having to travel from her home to ’Muela Health Centre because the nearest clinic does not offer family planning services.

“I am currently using a three-month depo and would like to use the Sayana press, that is why I came today to learn about it fully. I think this new self-injection (Sayana press) saves time and transport costs. If my wife were to use it she would have time to take care of our children and do household chores. She is already using family planning but the problem comes when her time is due and we do not have transport money for her to visit the clinic since the clinic is too far for her to travel on foot,” said Josiasa Matabane.

LPPA Clinical Manager, Retšelisitsoe Makabateng, said they frequent the ’Moteng outreach and their target is at least 15 women a day should take Sayana press. However, their challenge was that a lot of women were scared of self-injecting but after the demonstration a lot of them are now opting for it.

“Sayana press is an innovative product that can reduce unintended pregnancy for adolescents and young people who have barriers of accessing family planning services due to cultural beliefs and long-distance travel. “It is a suitable product to contribute towards ending unmet need for family planning as it is suitable for distribution through retail pharmacies and communities where people live in, hence it is accessible. “It can help prevent maternal death and unsafe abortions, said UNFPA Reproductive Health Commodities security/supplies coordinator,” Tšeliso Masilo.

According to UNFPA Lesotho, Sayana press was included in family planning guidelines in 2017, approved for inclusion in national essential medicines in 2018, and the first batch was procured in 2019 then piloted in the two districts of Mokhotlong and Quthing. In 2019, 400 village health workers and 35 health care workers were trained and by the end of 2020, 4 368 women were on Sayana press. The number has currently increased to 19 000. Sayana press is pre-filled and ready to inject while it is simple to use; it is also small and light with a short needle of 2.5cm as compared to ordinary needles of 3.8cm.

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