CHAI Study

Piloting innovative provision channels and waste management strategies to expand DMPA-SC self-injection in the DRC

(Piloting injectable contraceptive provision in drugstores)

Role: Prime Recipient

Donor: Clinton Health Access Initiative (CHAI) / Access Collaborative

 

This project will capitalize on the evidence, experience, local talent, and current infrastructure for family planning in DRC that has been built over the past ten years, and position existing actors to carry priority initiatives forward at the close of 2023.

OBJECTIVES

  • Obtain support for pilot approach from key program and policy stakeholders in DRC
  • Assess the feasibility and acceptability to train drugstore operators in the provision of DMPA-SC to women living in Kinshasa’s communities.
  • Disseminate evidence that will support changes in existing policies and leverage neighborhood drugstores as a source of contraceptives.

This pilot is part of the continuous efforts to expand access to modern contraceptives, and particularly the new injectables DMPA-SC (Sayana Press), by leveraging local drugstores operating in Kinshasa, DRC. Despite not being formally sanctioned as formal “pharmacies”, neighborhood drugstores remain one of the preferred sources of contraceptive and FP counseling for women living in Kinshasa’s communities. To date, they are not authorized to provide injectable contraceptives (either for sale or administration to clients).

The main objective of this project is to establish evidence supporting the feasibility and acceptability of using drugstores as a safe, reliable, and effective delivery channel for DMPA-SC clients (injection recipients and self-injectors). This evidence will contribute to advocacy efforts led in DRC by Pathfinder to promote the integration of DMPA-SC administration and support for (self-)injection in pharmacies and drug shops, and ultimately expand access and facilitate continued use of DMPA-SC.

Under the project, a cohort of 50 drugstore operators (DSO) from four Health Zones in Kinshasa Province will be trained in the administration of DMPA-SC, counseling on side-effects and re-injection doses resupply and waste management, and self-injection (SI) initiation and supervision

This project will leverage a mixed-methods evaluation design, including a cohort study and a mystery client component, to test whether DSO can safely, reliably, and adequately support DMPA-SC injection and self-injection clients and will later evaluate the appropriateness of DSO counseling and their attitudes towards self-injectors.

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