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World’s First Injectable Contraceptives Are Transforming Lives in Uganda

Sheena Ariyapala/DFID

Dina, 40, had heard about family planning. But whenever she thought of coming to a health clinic for advice, she was discouraged by her family and friends. Dina already has nine children, but started using a contraceptive — Sayana Press — for the first time last year.

“People in the community, people in my family, they all discouraged me," Dina said. "They said if I start using contraception I will fall sick.”

But the everyday pressures of feeding, clothing and educating her children — seven of whom were still at home — worried Dina and her husband, James. Making a living as farmers, they realised if Dina continued to get pregnant their income wouldn’t stretch to support more children.

Dina, a mother of nine, started using contraception — Sayana Press — for the first time last year..jpegSheena Ariyapala/DFID

When Dina came to the health centre, Amina, the midwife in charge, explained all the family planning methods that were available, along with their benefits and possible side effects. Dina chose Sayana Press and she was taught how to inject herself.

“My husband is very cooperative," said Dina. "I don’t know how to read so he is the one who helps me remember the dates for my next dose.” 

Dina and James decided to “give family planning a try” as they didn’t want to have more children.

“If I don’t do anything I will continue to have more children, ”James explained. “In the past there used to be a cultural expectation to have a large family, but nowadays it’s not good because things are changing and there are limited resources available.”

1-_8oqo3qDjFtRfduRr-N-dQ.jpegSheena Ariyapala/DFID

Expanding access to contraception and family planning programmes is one of the most cost-effective ways to break the cycle of poverty. It empowers people to plan their futures and reach their fullest potential.

Sayana Press is  a simple all-in-one injectable contraceptive, partly funded by the UK aid budget. It’s small, compact and easy to use, and has gained popularity because anyone can inject themselves once they have been trained. In addition, the women are given a booklet with explanatory images — so even if they’re illiterate they can follow the simple steps that are set out. To administer it, the user just needs to shake it and inject.

During the pilot period of 2015–2016 in Uganda, 130,673 doses were administered by community health workers, of which 29% of those doses went to new users of modern contraception.

Rachel, 19, is a single mother, and works in a salon where she is getting trained as a hairdresser. She got pregnant while she was still in school so had to drop out to have her baby. Rachel lives at home with her mother, who supports her financially while she gets trained.

1-C9FGwgJvAa03bL_2CBVacQ.jpegSheena Ariyapala/DFID

“I like Sayana Press because you can inject yourself and you can do it in secret,” Rachel said. “Only my mother knows that I’m using contraception. If other people find out that I’m using contraception they will start saying that I won’t be able to have more children.”

Preventing unintended pregnancies remains a challenge for many girls and women. To help inform communities about family planning, and break down misconceptions around contraception that stops women from accessing family planning, PATH has trained community health workers in remote villages villages to educate and inform.

The introduction of the injectable contraceptive in Uganda was supported by UK aid as well as the Bill & Melinda Gates Foundation, Children’s Investment Fund Foundation, United Nations Population Fund (UNFPA), and USAID — led by the Ministry of Health and coordinated by PATH.

It’s essential to act now to help the world’s poorest countries grow safer, healthier and more resilient by ensuring that family planning — and future planning — is an option for every woman.

On 11 July the UK will co-host an international summit on family planning in London with the Bill & Melinda Gates Foundation and UNFPA. The summit will bring together partners from around the world and aims to boost global commitments to increase access to family planning services for women and girls in the world’s poorest countries.

Words, photos and interviews: Sheena Ariyapala/DFID