MOKHOTLONG – A user of the newly introduced self-injection depo (Sayana Press) has applauded the innovation, but points to minor practicalities during self-injection. ’Mantšeliseng Mohale, in her early 40s from Ha Rafolatsane in Mokhotlong, has been on Sayana Press for almost a year. She decided to use it because she used to forget to take pills daily which put her at a high risk of falling pregnant. “One thing that makes me love Sayana Press is the fact that I do not experience side effects that people encounter with other family planning methods and again I do not have to visit the health care centre regularly as compared to when I used the other method. With this one I only go there twice a year.
“We travel a long distance to reach the health care centre because the nearer one does not provide family planning services,” she said. “However, I struggle when using the self-injection because it is very hard to press the reservoir when injecting myself, to a point where I have to call my neighbour to help me,” she said. One of the village workers in Ha Rafolatsane, ’Malehloka Lekhotsa, said had she not become a village health worker, she would be one of the people who had a lot of unplanned children because of myths and misconceptions about family planning methods.
“One method was not user friendly to me so with the knowledge I gained after attending several workshops and reading books we were provided with, I was able to make an informed decision of switching from one method to the other. “I am now able to educate my village about family planning and they now have an understanding and I have seen a majority of them opting for Sayana Press providing different reasoning,” she said.
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). When introducing it health care workers demonstrate how to use it twice, then the third time, 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 them two 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. To mark the World Contraception Day in Lesotho this year, which was on September 26, the United Nations Population Fund (UNFPA) Lesotho partnered with local journalists who cover Sexual and Reproductive Health and Rights to undertake a field visit to Mokhotlong where the first cohort of village health workers (VHW) was trained about Sayana Press in September 2019.
The purpose is for the journalists to interview the trained VHW and clients to continue advocacy work for the use of this family planning method. Sexual and Reproductive Health and Rights Coordinator Blandina Motaung, said as UNFPA it is their responsibility to ensure that they leave one behind when it comes to family planning services delivery.
“In Mokhotlong we have some village health workers who are community based distributors trained to distribute and provide family planning services which are less skills intensive, commodities and support to people who are already on family planning,” she said. 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 over 19 000. Sayana Press is pre-filled and ready to inject and simple to use. It is also small and light with a short needle of 2.5cm as compared to regular needles which are 3.8cm long. Mokhotlong district has one of the highest rates of unmet need for family planning in the country, at 25 percent, compared to 18 percent nationally.
It also has the lowest contraceptive prevalence rate (CPR), at 48 percent. This scenario leads to high rates of unplanned pregnancies, school drop-outs, child marriages, teenage pregnancies, unsafe abortions and maternal deaths. World Contraception Day this year focused on the supplies UNFPA delivers to serve women and girls’ sexual and reproductive health needs. This was also done through a campaign – It is a match! This is a campaign that takes educational content about contraception to digital conversations. Facts about contraceptive protection via text messages and online profiles are presented in engaging animations and visual content.