This piece was originally featured on the DISC microsite blog.
By Abigail Winskell, DISC Deputy Director.
It might seem obvious that the development of sexual and reproductive health options, including self-injectable contraceptives, should be centered around women’s needs and wants. You might assume that a woman would be provided with many options and that she’d be supported in making informed decisions about her own sexual and reproductive health every step of the way.
Unfortunately, too frequently that is not the case. Instead, these critical and even lifesaving products or services are often developed without thinking about how, and by whom, they will be used.
The result is that today, even when women feel comfortable demanding what sexual and reproductive health services and products they want and need, barriers remain. When it comes to contraceptive self-injection in particular, the journey is riddled by challenges at almost every turn—from awareness of contraceptive self-injection’s value and alignment with her goals for her life, to decision-making about what works best for her through to beginning self-injection and continuing its use.
Many women aren’t even made aware that contraception is relevant and valuable for their lives. And even if they are informed about contraceptive options, few women are familiar with contraceptive self-injection. In fact, seeking information about sexual and reproductive health services remains clouded in stigma and fear, and women tend to get information from a few, trusted sources—mostly other women or healthcare workers.
And even when women do make the decision to self-inject (a decision that is often driven by a health care worker’s suggestion rather than a woman’s enquiry), other challenges arise. Women often face unfounded fears about side effects, inconsistent pricing, and poor quality of available products.
That’s why, at DISC, we’ve examined existing evidence, assessed the market and carried out consumer and provider research to take a deep dive into women’s current—and ideal—self-injection journey. Our goal is to demonstrate that contraceptive self-injection is a viable cornerstone of sexual and reproductive health care, and that by supporting women to exercise their voice, choice and agency over their health, women can use their power to help improve sexual and reproductive health outcomes.
If we’re successful, a woman’s journey toward self-injection is transformed and becomes easier. She is supported every step of the way: from the moment she first learns about self-injection to the moment when she becomes a proactive advocate for self-injection, because she had such a positive experience herself. Along the way, she feels informed about all her options and is reassured any concerns or fears. She is confident enough to give self-injection a try and has the support she needs to continue doing so, in the comfort and privacy of her own home.
Achieving this vision is not easy, but it is certainly feasible. Already, we’re working in Nigeria and Uganda to create an environment that supports women throughout their entire self-injection journey, and we’re gaining valuable insights along the way.
Ultimately, our aim is to help advance understanding of how health systems can best support women to succeed in self-managed care—including and beyond contraceptive self-injection—and to ensure that this entire process always puts the woman at its center.