From crisis to control: How self-injectable contraceptive is empowering women
The subcutaneous Depo-Medroxyprogesterone Acetate (DMPA-SC), a self-injectable family planning commodity.
What you need to know:
- The contraceptive is designed for ease of use, allowing it to be self-administered by the user or by trained healthcare providers like community health workers or pharmacists.
From a health crisis that landed Maureen Ongaro in the hospital to regaining control of her body and life, her journey with contraception has been anything but ordinary.
For years, she struggled with the devastating side effects of the three-month Depo-Provera injection, which led to heavy and extended bleeding accompanied by dizziness and a lack of appetite. It ended in hospitalisation and a shocking drop in her blood levels.
But everything changed when Maureen discovered a game-changing solution: the self-injectable contraceptive called DMPA-SC (Depot Medroxyprogesterone Acetate Subcutaneous). The contraceptive offers a convenient and potentially more accessible option for women.
It is designed for ease of use, allowing it to be self-administered by the user or by trained healthcare providers like community health workers or pharmacists. It is used after every three months, injected on the belly, below the navel.
“One day while visiting the hospital, I found healthcare workers training women about this self-injectable contraceptive. I became interested and after trying it out, my body adapted remarkably well. My periods returned to normal, my appetite improved, and my blood pressure stabilised,” explains Maureen.
“Beyond the health benefits, this method offered me invaluable discretion and control over my family size. Unlike pills, which could be discovered by my husband and potentially lead to conflict, the self-injectable contraceptive allows me to manage my reproductive health privately. My husband remains unaware of my current contraceptive use, which helps maintain harmony in our home,” she adds.
She explains that she receives the contraceptive for free at her nearest county government hospital.
“Initially, I received the injections at the hospital. But after some time, I was taught how to administer the injection myself at home. I regularly visit the hospital for blood pressure checks. For disposal, I safely discard the used container and syringe in a pit latrine,” she says.
She notes that she has shared her positive experience with friends, many of whom are considering switching from their current family planning methods.
“I've been using this self-injectable for over a year now, and I plan to continue using it unless any issues arise, in which case I'll consult my doctor for guidance. This method has truly transformed my health and given me peace of mind.”
“DMPA-SC comes prefilled, simplifying administration and reducing logistical complexities. You simply remove the device, activate it, and administer.”
As part of Injectable Access Collaborative project, DMPA-SC was provided by inSupply Health. Launched in 2017, the project is ending after achieving significant milestones in increasing the uptake of DMPA-SC self-injections in Kenya.
Dr Johnson Anyona, manager for Supply Chain InSupply Health, explains that at the beginning of the project, the uptake of the contraceptive was less than one per cent in Kenya. Currently, 20 per cent of injectable contraceptive users choose self-injection.
“As at 2023, the average consumption of DMPA-SC in the public sector was around 25,000 units per month. Today, we're nearing 70,000 units. This is in our five project counties, including Nairobi, Kakamega, Trans Nzoia, Isiolo and Nakuru. We have also trained over 500 healthcare workers to administer the method and support self-injecting clients, and trained more than 400 community health promoters to expanding access, particularly in remote areas,” he adds.
Five counties
Between July 2024 and May 2025, 48,216 clients received DMPA-SC in the public sector across five counties. Of these, 16 per cent (7,682) used self-injection. Kakamega had the highest number of total clients (20,420) and the highest self-injection uptake at 25 per cent. Nairobi had the second-highest total clients (14,303) but a lower self-injection rate (six per cent). Trans Nzoia showed notable uptake with 19 per cent of clients self-injecting.
Nakuru and Isiolo recorded lower self-injection uptake at seven per cent and four per cent, respectively. Overall, while self-injection adoption is progressing (from less than one per cent in 2022 to 16 per cent in 2025, it varies significantly by county, indicating opportunities for targeted demand generation and training to increase self-injection rates. The data is from sentinel sites and not all the public facilities in these counties
Despite progress, significant challenges remain, particularly in Nairobi. The county faces a low "skills and knowledge deficit" (indicating good understanding and abilities), but struggles with erratic commodity supply, inconsistent Health Management Information System (HMIS) data, and a lack of consistent client tracker systems for return dates. Furthermore, Nairobi has unclear directions for used needle and syringe disposal and inadequate partner support due to knowledge gaps.
Nakuru County experiences its own set of issues, including inadequate DMPA-SC supply, insufficient knowledge among Community Health Promoters, a limited number of health facilities trained on the injectable, and the failure to capture self-injectable data in routine family planning tools.
Dr Anyona identified policy and public awareness as major hurdles to uptake. The absence of a clear policy permitting self-injection and guidelines for providers and clients created initial challenges.
He noted” “Given the product's novelty, public awareness was low, thus requiring public awareness campaigns and training of service providers. The final, persistent challenge remains supply chain bottlenecks. Even with excellent initiatives, if the product isn't available, services cannot be offered.”
“Recent authorisation for private pharmacies to offer injectable contraceptives offers new avenues for access, providing convenience, discretion, and privacy, and addressing long queues often seen in public facilities. The project's next phase aims to address remaining barriers, including women's fear of self-injecting and critical considerations for home waste disposal.”
Regarding safe disposal, Dr Anyona advised: "We've developed resources and informational materials to guide clients on proper storage and disposal at home. Clients are instructed to keep used devices in a puncture-proof container, like an old Valon jar, to prevent needle stick injuries. Once full, these containers can be taken to the nearest pharmacy or health center for proper disposal as sharps cannot be thrown in general waste.”
DMPA-SC is free in the public sector, supported by donor and government funding. In the private sector, the contraceptive costs between Sh500 to Sh1,000, varying by provider.
