Trends in subcutaneous depot medroxyprogesterone acetate (DMPA-SC) use in Burkina Faso, the Democratic Republic of Congo and Uganda

OBJECTIVES: Subcutaneous depot medroxyprogesterone acetate (DMPA-SC) is seen as a valuable innovation in family planning, but little is known about trends in DMPA-SC use or characteristics of users. Using data from Burkina Faso, the Democratic Republic of Congo (DRC) and Uganda, we measured trends i...

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Detalles Bibliográficos
Autores principales: Anglewicz, Philip, Akilimali, Pierre, Guiella, Georges, Kayembe, Patrick, Kibira, Simon P.S., Makumbi, Fredrick, Tsui, Amy, Radloff, Scott
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2019
Materias:
Article
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7286145/
https://www.ncbi.nlm.nih.gov/pubmed/32550528
http://dx.doi.org/10.1016/j.conx.2019.100013
Descripción
Sumario:OBJECTIVES: Subcutaneous depot medroxyprogesterone acetate (DMPA-SC) is seen as a valuable innovation in family planning, but little is known about trends in DMPA-SC use or characteristics of users. Using data from Burkina Faso, the Democratic Republic of Congo (DRC) and Uganda, we measured trends in DMPA-SC and identified characteristics associated with DMPA-SC use. STUDY DESIGN: We used repeated cross-sectional representative data collected between 2016 and 2019. First, we plotted trends in DMPA-SC use for all women and married women. Next, we presented the sociodemographic and family-planning-related characteristics of DMPA-SC users. Finally, we conducted weighted multivariate logistic regression analysis to examine how DMPA-SC users were different from women (1) using all other modern methods combined and (2) not using any modern method. RESULTS: DMPA-SC use increased monotonically in all three countries. Many DMPA-SC users were first-time users of modern contraception (54.5% in Burkina Faso, 34.6% in DRC, 50.7% in Uganda). Never-married women had lower odds than married women of using DMPA-SC (compared to other modern methods) in all three countries [Burkina Faso adjusted odds ratio (AOR) 0.40, 95% confidence interval (95% CI) 0.20–0.80; DRC AOR 0.31 95% CI 0.10–0.93; Uganda AOR 0.24; 95% CI 0.08–0.71]. Level of education was positively associated with DMPA-SC use (compared to no use) (Burkina Faso AOR 1.79; 95% CI 1.03–3.14; Uganda AOR 3.23; 95% CI 1.33–7.84). CONCLUSIONS: DMPA-SC is a rapidly growing method in these settings. Despite the comparable levels of and increases in use for all three countries, the characteristics associated with DMPA-SC use generally differed across countries. IMPLICATIONS: This is the first analysis of patterns of DMPA-SC use with representative data for African countries. Our results confirm that DMPA-SC is increasingly popular, although the profile of users varies across settings.

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