Champions unite for contraceptive self-care

Earlier this year, the Injectables Access Collaborative (AC) organized two regional workshops, bringing together more than 35 self-care champions from Benin, the Democratic Republic of the Congo, Ghana, Kenya, Madagascar, Malawi, Mozambique, Nigeria, Togo, Uganda, and Zambia.

The workshops, held in Cotonou, Benin for French-speaking countries and Nairobi, Kenya for English and Portuguese-speaking countries, provided opportunities to share experiences, explore recent evidence and resources, and develop advocacy strategies.

The attendees represent the project’s Self-Injection Ambassadors initiative, a network of local, regional, and global leaders who are united by a critical mission: to increase women’s and girls’ family planning access to a broad range of family planning options, including contraceptive self-injection.

Strong bonds were established among the ambassadors, who include ministry of health officials, pharmacists, civil society leaders, and university lecturers, and these cross-country connections have continued through conversations on WhatsApp and virtual learning exchanges hosted by the AC.

After the convenings, three Self-Injection Ambassadors shared their experiences advocating for self-injection, workshop takeaways, and their thoughts on the road ahead.

Ambassadors’ advocacy for expanded access to contraception is often motivated by their personal convictions.

Dr. Anne-Marie Tumba Benabiabu, Director of the National Reproductive Health Program at the DRC Ministry of Health, joined the initiative when it launched in 2020. Dr. Benabiabu participates to support women and influence her country’s health policies.

She remarks, “I got involved in the advocacy for self-injection because I am first and foremost a woman and a committed activist. Empowering women is key to reducing poverty; we are going to make children by choice, and not by chance, and I support women as they make the decisions that are right for them. Then you can move the country forward!”

Expanding access to self-injection throughout Nigeria’s health system—including those living in isolated and remote areas—is what motivates Dr. Kayode Afolabi, Executive Director of Reproductive Health and Child Survival Consulting.

“Self-injection gives a lot of autonomy to women and increases access to family planning” he explains.

“In our country, we are most concerned about women and young girls living in rural areas where they may not have access to a basic health care facility, including primary health care. So, my conviction about the advocacy for self-injection is to enhance access to voluntary family planning for women and young ladies who desire it.”

Women and girls in rural areas must often travel long distances to the nearest health facility, where they might find the clinic closed or face long wait times. Providing women with the capacity to self-inject contraception at their convenience enables them to use their preferred family planning method despite limited access to health facilities and providers.

New ambassador Ms. Nelly Munyasia, Executive Director of the Reproductive Health Network Kenya, sees her engagement with the initiative as a way to increase her technical expertise and continue learning about the latest evidence.

She explains, “I’m supporting women to be able to manage their family planning needs. As a health care provider, I appreciate the challenges women continue to face in Kenya and in the Global South as a whole. I am using my voice to ensure that women understand that self-injection is available, and they can do it from the comfort of their home.”

At the conclusion of the workshops, ambassadors were eager to return home and implement strategies to improve contraceptive access. They expressed interest in working with local AC leadership and collaborating with each other to leverage successful advocacy approaches.

In Kenya, Ms. Munyasia plans to advocate for ongoing support of self-injection clients to ensure they remain confident. She is also exploring ways to broaden access through nontraditional providers like medicine vendors. She credits the Self-Injection Ambassadors initiative and the AC for equipping her with advocacy tools.

Drawing from what he learned about Ghana’s approach during the workshop, Dr. Afolabi is focusing on expanding health insurance coverage for family planning services in Nigeria. His goal is to ensure that both national and state health insurance programs include self-injection, while continuing to collaborate with ambassadors from Ghana and Uganda, with whom he shares common challenges.

To improve coordination in the DRC, Dr. Benabiabu will share insights from the workshop with local family planning stakeholders, particularly to address supply chain issues. She appreciates the ongoing support from the AC in raising awareness, improving policies, and strengthening health provider training, and emphasizes the close, collaborative partnership with the AC.

In the months following the workshop, ambassadors have made progress toward their national goals. Ambassadors in the DRC are planning a digital advocacy campaign around self-injection, timed to coincide with 2024 World Contraception Day on September 26. In Nigeria, Ambassadors’ efforts led to a recent update to the self-injection dispensing protocols, which will give women and girls more reproductive autonomy by allowing qualified self-injectors to take home additional DMPA-SC devices. Meanwhile, in Kenya, self-injection is starting to roll out as the national self-care guidelines are put into practice.

DMPA-SC: Subcutaneous depot medroxyprogesterone acetate.