Sayana? Press: Can it be a 'game changer' for reducing unmet need for family planning?

摘要

1. The product: Sayana? Press (SP) is a 104-mg single dose of medroxyprogesterone acetate (MPA) in 0.65-mL volume, sterilely packaged in the Uniject device. Uniject is a pre-filled, non-reusable blister injection system consisting of a bubble reservoir with an integral, ultra-thin needle, (For a picture of SP, see below and Fig 1 in both accompanying papers by Keith [1,2].) In this issue of Contraception, a group of papers address the acceptability of Sayana? Press (also known as Depo subQ Provera 104? in Uniject) and other research related to this new product. These papers also identify some of the challenges to SP reaching its full-potential as a new contraceptive option in low-resource settings, especially in sub-Saharan Africa and South and Central Asia, where unmet need for family planning is the greatest. SP could be a "game changer," in part, due to its potential for in-home or self-injection. In addition, given the safety and ease of subcutaneous injections with SP, some Ministries of Health may be more likely to enact policy change to permit community health workers (CHWs) and other community-level workers (e.g., drug shop keepers) to provide injectables in countries that currently only permit higher level providers to do so. At a reasonable price, this new product has the potential to expand contraceptive choice and use in underserved communities that otherwise might not have access to injectable contraceptives.