{"id":61850,"date":"2022-02-08T17:15:00","date_gmt":"2022-02-08T22:15:00","guid":{"rendered":"https:\/\/www.psi.org\/?post_type=disc-post&#038;p=61850"},"modified":"2024-06-05T18:45:49","modified_gmt":"2024-06-05T22:45:49","slug":"overcoming-client-fear-to-self-inject-consumer-insights-light-a-path-toward-dmpa-sc-scale-up","status":"publish","type":"disc-post","link":"https:\/\/www.psi.org\/pt\/disc-post\/overcoming-client-fear-to-self-inject-consumer-insights-light-a-path-toward-dmpa-sc-scale-up\/","title":{"rendered":"OVERCOMING CLIENT FEAR TO SELF-INJECT: CONSUMER INSIGHTS LIGHT A PATH TOWARD DMPA-SC SCALE-UP"},"content":{"rendered":"<p><strong>BY ANDREA CUTHERELL, TEAM LEAD INNOVATION SITES, PSI; ALEXANDRINA NAKANWAGI, PROJECT LEAD, DISC UGANDA, PSI UGANDA; ROSELYN ODEH, DEPUTY TEAM LEAD, DISC NIGERIA, SFH NIGERIA; OLUWATOSIN ADEOYE, SENIOR LEARNING ADVISOR, DISC NIGERIA, SFH NIGERIA<\/strong><\/p>\n\n\n\n<p>Self-care presents an opportunity to strengthen overstretched health systems by offering delivery efficiencies while placing&nbsp;<em>people&nbsp;<\/em>at the center of its design. Countries around the world are recognizing this potential, many of whom are adopting and adapting the&nbsp;<a href=\"https:\/\/www.who.int\/publications\/i\/item\/9789240030909\"><em>World Health Organization\u2019s Consolidated Guideline on Self Care Interventions for Health<\/em><\/a><em>,<\/em>&nbsp;which provides clear&nbsp;recommended self-care approaches worthy of integration in national\/subnational health systems. This shift to integrate self-care more formally within health systems requires a new set of behaviors. Not just for the consumer (or \u2018self-carer\u2019) but for the entire health ecosystem around them, including, perhaps most importantly, the healthcare provider. But critical questions remain:&nbsp;<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>What might behavior change for an ecosystem of healthcare actors look like in practice?\u00a0<\/li>\n\n\n\n<li>What is the role of the healthcare provider in self-care?\u00a0<\/li>\n\n\n\n<li>How might consumer insights light a path toward defining those behavior change efforts?\u00a0<\/li>\n<\/ul>\n\n\n\n<p>The Population Services International-led Delivering Innovation in Self-Care (DISC) program\u2014being implemented in Nigeria and Uganda\u2014aims to answer these questions as they relate to self-injectable contraception, DMPA-SC. And, in doing so, demonstrate that self-care offers health systems a new and critical partner: consumers themselves.&nbsp;&nbsp;<\/p>\n\n\n\n<p>In 2020-2021, DISC conducted extensive programmatic research, including interviews with \u2018early adopters\u2019 of DMPA-SC, prospective users, and the public and private sector providers on whom women rely (distilled in this&nbsp;<a href=\"https:\/\/media.psi.org\/wp-content\/uploads\/2021\/08\/30234417\/DISC-Insights-Synthesis-Report.pdf\">Relat\u00f3rio de S\u00edntese Insight<\/a>). In collaboration with the&nbsp;<a href=\"https:\/\/www.path.org\/articles\/dmpa-sc-collaborative\/\">PATH-led Access Collaborative initiative<\/a>&nbsp;and the Ministries of Health in Nigeria and Uganda, we&nbsp;honed in on the insight that&nbsp;<strong>fear of the needle and\/or pain&nbsp;<\/strong>was a major barrier at the decision stage to self-inject. Yet, most providers aren\u2019t trained to address this fear. This presented a behavior change opportunity worth testing: what if providers were equipped to&nbsp;<em>directly address client fear&nbsp;<\/em>to self-inject? Would more women voluntarily choose to self-inject?&nbsp;<\/p>\n\n\n\n<p>In response, DISC launched the \u2018Moment of Truth\u2019 Innovation in 20 public and private outlets\u2013designated as \u201cInnovation Sites,\u201d \u2013throughout Nigeria and Uganda to test this question and to incubate and test new training approaches. Our work in the innovation sites is focused on optimizing the training curriculum for self-inject providers by&nbsp;<strong>improving providers\u2019 confidence<\/strong>&nbsp;in counseling women to take up self-injectable contraceptives and helping&nbsp;<strong>them to address client fears<\/strong>&nbsp;related to taking up self-inject. Innovation Sites were launched in September 2021 and qualitative and quantitative data were captured over a six-week period. The emerging results are promising. While qualitative findings need to be explored to fully understand the drivers of performance, voluntary uptake conversion rates dramatically increased following exposure to the \u2018Moment of Truth\u2019 Innovation approach. In fact, Innovation Sites in both countries quickly outperformed global benchmarks for self-injection conversion rates in both public and private sectors (see figure).&nbsp;&nbsp;<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter\"><a href=\"https:\/\/media.psi.org\/wp-content\/uploads\/2022\/02\/30233453\/DISC-moment-of-truth-figure-1.png\"><img fetchpriority=\"high\" decoding=\"async\" width=\"1024\" height=\"576\" src=\"https:\/\/media.psi.org\/wp-content\/uploads\/2022\/02\/30233453\/DISC-moment-of-truth-figure-1-1024x576.png\" alt=\"\" class=\"wp-image-54040\" srcset=\"https:\/\/media.psi.org\/wp-content\/uploads\/2022\/02\/30233453\/DISC-moment-of-truth-figure-1-1024x576.png 1024w, https:\/\/media.psi.org\/wp-content\/uploads\/2022\/02\/30233453\/DISC-moment-of-truth-figure-1-300x169.png 300w, https:\/\/media.psi.org\/wp-content\/uploads\/2022\/02\/30233453\/DISC-moment-of-truth-figure-1-768x432.png 768w, https:\/\/media.psi.org\/wp-content\/uploads\/2022\/02\/30233453\/DISC-moment-of-truth-figure-1-31x17.png 31w, https:\/\/media.psi.org\/wp-content\/uploads\/2022\/02\/30233453\/DISC-moment-of-truth-figure-1.png 1133w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/a><\/figure>\n\n\n\n<p>DISC is currently in the process of analyzing the results to optimize provider training and associated activities. We\u2019re also working with partners to identify pathways to scale up in Nigeria and Uganda\u2014either through other partners or by incorporating the training into national curricula.&nbsp;&nbsp;<\/p>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p>This small-scale innovation illustrates the potential for consumer insights to better inform behavior change of a health ecosystem and, in doing so, support the evolution of health systems to be more responsive and resilient.&nbsp;<\/p>\n<\/blockquote>\n\n\n\n<p>During its ongoing update of the National Family Planning Curriculum, the Uganda Ministry of Health is incorporating a module on addressing client fear. In Nigeria, the Ministry of Health is excited about this approach and sees it as something that may inform policy change. If the results are as promising as they appear to be during our initial stages of analysis, this relatively simple adjustment to provider curriculum could help encourage providers to offer self-injection. It could also increase the potential for\u202fwomen to\u202fexperience\u202fher own\u202fpower\u202fand\u202fagency\u202fover her sexual and reproductive health care needs,\u202fa\u202funique advantage of\u202fthis self-care method. Equally important, this small-scale innovation illustrates the potential for consumer insights to better inform behavior change of a health ecosystem and, in doing so, support the evolution of health systems to be more responsive and resilient, with consumers at their core.&nbsp;<\/p>","protected":false},"featured_media":44371,"template":"","disc-resource-type":[],"disc-language":[2488],"disc-country":[2490,2491],"disc-page-type":[2494],"class_list":["post-61850","disc-post","type-disc-post","status-publish","has-post-thumbnail","hentry","disc-language-english","disc-country-nigeria","disc-country-uganda","disc-page-type-stories-updates"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.psi.org\/pt\/wp-json\/wp\/v2\/disc-post\/61850","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.psi.org\/pt\/wp-json\/wp\/v2\/disc-post"}],"about":[{"href":"https:\/\/www.psi.org\/pt\/wp-json\/wp\/v2\/types\/disc-post"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.psi.org\/pt\/wp-json\/wp\/v2\/media\/44371"}],"wp:attachment":[{"href":"https:\/\/www.psi.org\/pt\/wp-json\/wp\/v2\/media?parent=61850"}],"wp:term":[{"taxonomy":"disc-resource-type","embeddable":true,"href":"https:\/\/www.psi.org\/pt\/wp-json\/wp\/v2\/disc-resource-type?post=61850"},{"taxonomy":"disc-language","embeddable":true,"href":"https:\/\/www.psi.org\/pt\/wp-json\/wp\/v2\/disc-language?post=61850"},{"taxonomy":"disc-country","embeddable":true,"href":"https:\/\/www.psi.org\/pt\/wp-json\/wp\/v2\/disc-country?post=61850"},{"taxonomy":"disc-page-type","embeddable":true,"href":"https:\/\/www.psi.org\/pt\/wp-json\/wp\/v2\/disc-page-type?post=61850"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}