Are injectable contraceptives the answer to East Africa's family planning problem?
Are injectable contraceptives the answer to East Africa's family planning problem?
Advantages and disadvantages of DPMA contraception use and administration in East Africa.
In East Africa, new proposals have been issued for meeting family planning needs, allowing community health workers rather than doctors or nurses to administer contraceptives, including a contraception shot. In Uganda and Kenya, in spite of severe shortages in nursing staff, many nurses find themselves unemployed or employed in unrelated professions.
In Kenya, the government reported 8,000 nurses without work, while the health sector reported 44,000 nursing positions vacant. Even so, the Kenyan government rejected this proposal because it does not want community-based workers to do jobs that formerly were performed only by nurses. In an effort to facilitate nurses returning to work, the government has implemented an Economic Stimulus Program, which will recruit and staff nurses throughout Kenya. In addition, although community health workers currently distribute condoms and birth control pills, allowing non-professionals to administer injectable contraceptives could put patients at serious health risk.
In contrast, in Uganda, a pilot program has shown success with community health workers administering the injections, following training and with supervision by a professional. Uganda's Director of Health Services, Dr Kenya-Mugisha Nathan, is supportive of the proposal.
Since the mid-2000s, trial programs have been launched throughout East Africa to expand community-based distribution (CBD) of injectable contraceptives, primarily in the form of depo provera (DPMA). A shot of DPMA will prevent pregnancy for 3 months; for continued efficacy, patients must receive subsequent shots, every 3 months. There are clear and documented advantages and disadvantages associated with DPMA, both generally, and specifically pertaining to East Africa.
Advantages of injectable contraception:
Birth control pills are hard to keep a secret.
Many men refuse to use condoms, so injectable contraception allows women to be responsible for their own protection.
Rural women have limited access to sterilization and implanted contraceptives, so injectable contraceptives may be their only option.
Injections only need to be given once every 3 months.
Disadvantages of injectable contraception:
Injections do not provide protection against HIV or STIs.
DPMA is relatively costly compared to other methods of birth control.
Common side effects include heavy or irregular bleeding, amenorrhea, headaches, and weight gain.
Studies have shown delayed return of fertility associated with DPMA.
DPMA has been proven to put women at risk for bone mineral density (BMD) loss, especially for women who have not yet given birth, women with low levels of calcium, and smokers.
Are injectable contraceptives the answer to East Africa's family planning problem?
Advantages and disadvantages of DPMA contraception use and administration in East Africa.
GlobalSister.org
February 26, 2010
In East Africa, new proposals have been issued for meeting family planning needs, allowing community health workers rather than doctors or nurses to administer contraceptives, including a contraception shot. In Uganda and Kenya, in spite of severe shortages in nursing staff, many nurses find themselves unemployed or employed in unrelated professions.
In Kenya, the government reported 8,000 nurses without work, while the health sector reported 44,000 nursing positions vacant. Even so, the Kenyan government rejected this proposal because it does not want community-based workers to do jobs that formerly were performed only by nurses. In an effort to facilitate nurses returning to work, the government has implemented an Economic Stimulus Program, which will recruit and staff nurses throughout Kenya. In addition, although community health workers currently distribute condoms and birth control pills, allowing non-professionals to administer injectable contraceptives could put patients at serious health risk.
In contrast, in Uganda, a pilot program has shown success with community health workers administering the injections, following training and with supervision by a professional. Uganda's Director of Health Services, Dr Kenya-Mugisha Nathan, is supportive of the proposal.
Since the mid-2000s, trial programs have been launched throughout East Africa to expand community-based distribution (CBD) of injectable contraceptives, primarily in the form of depo provera (DPMA). A shot of DPMA will prevent pregnancy for 3 months; for continued efficacy, patients must receive subsequent shots, every 3 months. There are clear and documented advantages and disadvantages associated with DPMA, both generally, and specifically pertaining to East Africa.
Advantages of injectable contraception:
Disadvantages of injectable contraception:
For more information, please go to GlobalSister.org.
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