Subcutaneous DMPA: New Terms and Tools for Advocates to Increase Access to Injectable Contraception
It’s an interesting time to be a family planning advocate. In many FP2020 countries, we’re making real strides in increasing access to contraception—due in part to the emergence of new methods, from novel female condoms, to implants, to injectables. Maintaining and advancing funding commitments and supportive policies will be even more important as we work to continue hard-won progress.
New family planning products give advocates something to be excited about. It’s easy and inspiring to rally around a single new method that can expand choices within a broad method mix, especially if the new method has unique features or benefits designed to better meet women’s needs. And it’s essential to create enabling environments that support introduction and scale-up of a new contraceptive at the national and subnational levels.
But product-specific advocacy comes with responsibilities. For example, family planning advocates should promote access to a wide range of high-quality contraceptives (rather than elevate a single product) and ensure that women are able to choose their preferred method without discrimination or coercion. One often-overlooked responsibility is our naming of these products, and how terminology can help or hinder efforts to increase choice.
What’s in a (contraceptive) name?
One new contraceptive that has generated global enthusiasm goes by the brand name Sayana® Press1. It’s an innovative injectable that combines the contraceptive drug DMPA and needle into the Uniject™ injection system2. Sayana Press is simple and easy to use, with a short needle that is injected into the fat under the skin (a subcutaneous injection) rather than into the muscle (an intramuscular injection). With training and support, community health workers can administer the contraceptive, and women can even self-inject. Sayana Press is the subcutaneous DMPA product that is available today in an increasing number of FP2020 countries.
While many people know and refer to the product as Sayana Press, this name applies to one specific product alone—the branded product manufactured by Pfizer Inc. When talking about the regulatory status or procurement orders for this specific product, using the term “Sayana Press” makes good sense. And family planning providers working with their clients will likely find it easy and practical to use the brand name as well.
Family planning advocates and experts, however, can play a key role by helping to familiarize the global health community with a term that’s not tied to any one brand. As more subcutaneous DMPA injectables become available in the future, including generics, using nonproprietary terms can help decision makers consider a variety of such injectables (branded or generic) to add into their contraceptive method mix, rather than simply default to the brand name they recognize.
After many stakeholder consultations and brainstorming sessions, PATH decided to try out “subcutaneous DMPA”—or DMPA-SC for short—as the preferred general term to describe DMPA products that are injected into subcutaneous fat. While the name may take some getting used to (including how to pronounce and spell it!), it accurately describes Sayana Press and any future generic products, and lays the groundwork for expanded choice. (It’s also worth remembering, especially for those of us who have been working on this new product for a while, that the name Sayana Press probably felt unfamiliar and even odd the first time we heard it, too.)
Rolling out “subcutaneous DMPA” with new advocacy tools
PATH has been working with a wide range of partners to ensure advocates, implementers, and decision makers have the evidence, information, and tools to increase access to subcutaneous DMPA as part of a wide range of contraceptive options. Developed by PATH in collaboration with international and national family planning organizations, our recently launched Advocacy Pack for Subcutaneous DMPA (available in English and French) offers evidence-based, customizable tools for advocates to inform their own strategy development as well as helpful handouts to educate and influence decision makers. The launch represents the first time the name “subcutaneous DMPA” is deliberately being used.
Early feedback suggests that these resources will make a real difference. According to one advocate in Kenya, “The Advocacy Pack has come at a great time. Policy makers can clearly understand the evidence and what needs to be done. We will use these materials to educate key decision-makers and to assist in developing a road map for scale-up of subcutaneous DMPA.”
A new era of family planning advocacy
With a fresh name and new tools, PATH hope that advocates and partners around the world will integrate subcutaneous DMPA into their ongoing family planning goals to increase access and choice. We’d love to hear what you’re doing. Send us your feedback (including your experience using the term “subcutaneous DMPA”) to email@example.com. Together, we can put a variety of contraceptive options within reach of women around the world!