Expanding Services for Injectables: How family planning programs and providers can meet clients' needs for injectable contraceptives
More and more women are using injectable contraceptives today, and very likely even more will use this method in the future as it becomes increasingly available. Women choose injectables because they are effective, long-lasting, and private. For family planning programs, meeting increasing demand while maintaining good quality will be the key to success with injectables. Between 1995 and 2005 the number of women worldwide using injectable contraceptives more than doubled. About 12 million married women used injectables in 1995. In 2005 over 32 million were using injectables. Injectables are the fourth most popular method worldwide, after female sterilization, the intrauterine device (IUD), and oral contraceptives. In sub-Saharan Africa, injectables are the most popular method, chosen by 38% of women using modern methods. By 2015 worldwide use is projected to reach nearly 40 million--more than triple the 1995 level. Greater access largely explains this rapid growth in use. Approval of the progestin-only injectable DMPA (depot medroxyprogesterone acetate) in the United States in 1992 removed a constraint to access and a source of controversy in many countries over providing a drug that was not approved for contraception in the United States. Also, approval in the United States enabled the U.S. Agency for International Development (USAID) to supply DMPA to developing countries. As of 2006 DMPA was registered in 179 countries, an increase from 106 countries in 1995. Several countries, including Ghana, Vietnam, and Zambia are introducing or scaling up DMPA services as part of a package of reproductive or primary health care services.