Injectable Contraception Cohort Study in Punjab, Pakistan
- Conditions
- Contraceptive Usage
- Interventions
- Behavioral: Contraceptive usage
- Registration Number
- NCT05774626
- Lead Sponsor
- Jhpiego
- Brief Summary
The aim of this study is to assess the value proposition of expanding contraceptive options available to women in Punjab, Pakistan to include subcutaneous depot medroxyprogesterone acetate (DMPA-SC).
Specific objectives are:
1. To compare 12-month continuation rates for DMPA-SC and intramuscular DMPA (DMPA-IM) among married women 18- 49 years of age in two districts of Punjab, Pakistan
2. To understand how characteristics and experiences of DMPA-SC and DMPA-IM users differ.
3. To assess how well women opting for self-injection of DMPA-SC adhere to standards for commodity storage, injection timing, injection technique, and waste disposal
- Detailed Description
Depot medroxyprogesterone acetate (DMPA) is a highly-effective, injectable contraceptive method that requires injections every 11 to 17 weeks. It is available in both intramuscular (IM) and subcutaneous (SC) formulations, which are therapeutically equivalent and have similar safety profiles. DMPA-IM has been included in the method mix for most countries for many years. DMPA-SC is a newer formulation being added to the method mix in select settings. Studies demonstrate that self-administration of subcutaneous DMPA (DMPA-SC) outside clinical settings is safe, effective, feasible, acceptable, and can improve continuation, and a recommendation in favor of self-injected DMPA-SC is included in WHO guidelines on self-care interventions for health and well-being.
The Bill and Melinda Gates Foundation is funding implementation research in multiple countries to understand how self-injection of DMPA-SC can best be introduced to specific markets to expand the contraceptive options available to women and girls, health system characteristics, the demand for self-injection when DMPA-SC is offered alongside a range of other methods, and women's and girl's ability to start and continue use. Jhpiego has received funding to conduct one of these 'market tests' in Punjab, Pakistan.
The aim of this study is to assess the value proposition of expanding contraceptive options available to women in Punjab, Pakistan to include subcutaneous depot medroxyprogesterone acetate (DMPA-SC).
Specific objectives are:
1. To compare 12-month continuation rates for DMPA-SC and intramuscular DMPA (DMPA-IM) among married women 18- 49 years of age in two districts of Punjab, Pakistan
2. To understand how characteristics and experiences of DMPA-SC and DMPA-IM users differ.
3. To assess how well women opting for self-injection of DMPA-SC adhere to standards for commodity storage, injection timing, injection technique, and waste disposal
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- Female
- Target Recruitment
- 1000
- Married women aged 18-49 years
- Decide to use injectable contraception and meet WHO medical eligibility criteria for injectable use
- Want to avoid pregnancy for at least 12 months
- Live within study districts
- Are willing to be contacted by study team members via telephone and/or in-person
- Women under age 18 and above 49
- Unmarried women
- Hope to become pregnant within next 12 months
- Do not reside within study districts
- Are not willing to be contacted by study team members via telephone or in-person
- Lack cognitive capacity to give informed consent or complete interviews
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description DMPA-IM Contraceptive usage All married women of reproductive age who receive family planning counseling at a participating health facility and who choose to receive injectable contraception will be given an option of either DMPA-IM (current health worker administered standard of care) or DMPA-SC (new administration method, with option for self-injection after completing training). DMPA-SC Contraceptive usage All married women of reproductive age who receive family planning counseling at a participating health facility and who choose to receive injectable contraception will be given an option of either DMPA-IM (current health worker administered standard of care) or DMPA-SC (new administration method, with option for self-injection after completing training). Those opting for DMPA-SC will receive training on self-injection procedures and an opportunity to practice injection procedures on a model (e.g. condom filled with salt) to demonstrate confidence and proficiency to inject herself under the supervision of a healthcare provider. Clients will then be shown how to use a calendar to determine when their next injection is due, and provided a calendar/reminder card, job aids that illustrate self-injection steps (including safe disposal of needles), and 3 doses of DMPA-SC to take home for future use.
- Primary Outcome Measures
Name Time Method DMPA continuation rate up to 12 months Participant use of DMPA measured at 3, 6 and 9 months following enrollment (providing coverage for 3 months with each dose)
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (41)
BHU Herdo Sehari
🇵🇰Kasur, Punjab, Pakistan
BHU Fatehpur
🇵🇰Kasur, Punjab, Pakistan
BHU Sheikh Bhago
🇵🇰Kasur, Punjab, Pakistan
BHU Serhali
🇵🇰Kasur, Punjab, Pakistan
Fatima Maternity Home
🇵🇰Kasur, Punjab, Pakistan
FWC Chunian-1
🇵🇰Kasur, Punjab, Pakistan
FWC Rosa Tibba
🇵🇰Kasur, Punjab, Pakistan
FWC Sheikh Umad Kohna
🇵🇰Kasur, Punjab, Pakistan
FWC Talwandi
🇵🇰Kasur, Punjab, Pakistan
Hajra Maternity Home
🇵🇰Kasur, Punjab, Pakistan
RHC Ellabad
🇵🇰Kasur, Punjab, Pakistan
RHC Gandasingh
🇵🇰Kasur, Punjab, Pakistan
Ali Maternity Home
🇵🇰Khanewal, Punjab, Pakistan
RHC Khuddian
🇵🇰Kasur, Punjab, Pakistan
RHC Mustafabad
🇵🇰Kasur, Punjab, Pakistan
Bhu 171/10-R
🇵🇰Khanewal, Punjab, Pakistan
FHC DHQ Khanewal
🇵🇰Khanewal, Punjab, Pakistan
BHU Chack 131/15 L
🇵🇰Khanewal, Punjab, Pakistan
FWC Makhdoom Pur
🇵🇰Khanewal, Punjab, Pakistan
RHC Makhdom pur
🇵🇰Khanewal, Punjab, Pakistan
FWC Model Center
🇵🇰Khanewal, Punjab, Pakistan
Tehseen Surgical Clinic
🇵🇰Khanewal, Punjab, Pakistan
Zainab Maternity Home
🇵🇰Khanewal, Punjab, Pakistan
FWC Qaiser Garh
🇵🇰Kasur, Punjab, Pakistan
FWC Kasur 5
🇵🇰Kasur, Punjab, Pakistan
BHU Rao Khan Wala
🇵🇰Kasur, Punjab, Pakistan
FHC Kasur
🇵🇰Kasur, Punjab, Pakistan
Bhu 76/10-R
🇵🇰Khanewal, Pubjab, Pakistan
Bhu 44/15-L
🇵🇰Khanewal, Punjab, Pakistan
Rafique Maternity Home
🇵🇰Kasur, Punjab, Pakistan
FWC Kacha Khuh
🇵🇰Khanewal, Punjab, Pakistan
RHC Changamanga
🇵🇰Kasur, Punjab, Pakistan
BHU Pakhoki
🇵🇰Kasur, Punjab, Pakistan
FWC Kotha Kalan
🇵🇰Kasur, Punjab, Pakistan
Bhu 30/10-R
🇵🇰Khanewal, Punjab, Pakistan
Bhu 79/10-R
🇵🇰Khanewal, Punjab, Pakistan
Bhu 92/10-R
🇵🇰Khanewal, Punjab, Pakistan
Bhu 92/15-L
🇵🇰Khanewal, Punjab, Pakistan
RHC Kacha Khuh
🇵🇰Khanewal, Punjab, Pakistan
RHC Tulamba
🇵🇰Khanewal, Punjab, Pakistan
FHC THQ Mian Cahnu
🇵🇰Khanewal, Punjab, Pakistan