Background/Objectives
Self-injection (SI) of DMPA-SC presents a unique value proposition for the use of the product (Osinowo, et al., 2020). Unfortunately, this practice is still low in Nigeria. As important stakeholders at the state level, family planning (FP) managers are key in reducing the bottlenecks to uptake of FP services. This study aims to identify the barriers limiting the SI uptake among women of reproductive age (WRA) in Nigeria using the perspective of FP managers. Results from this study can provide a foundation for health systems strengthening at different levels and support expansion of access to SI among WRA.
Materials/Methods
This is a cross-sectional descriptive study, conducted among FP coordinators from all 37 states of the country. A data collection tool was developed to elicit qualitative responses on the barriers to the uptake of SI. Thematic analysis of the responses was carried out to identify core barriers to SI uptake.
Results
A total of 34 out of 37 respondents from all geo-political zones of Nigeria, completed the data collection tool. Stock-out of DMPA-SC was a major barrier identified by almost all respondents (97.1%), while over one-third (38%) of the respondents identified inadequate provider training (37.8%) and funding for family planning supportive supervision (40.5%) respectively, as the other supply-side barriers to the uptake of SI. Identifiable demand-side barriers include lack of awareness on SI (10.8%), myths and misconceptions about the method (10.8%) and fear of needles (2.7%) . Only one respondent identified staff attrition as a barrier to SI uptake.
Conclusion
The result from this study shows that the poor uptake of SI in Nigeria is affected by both supply- and demand-side barriers. It is essential that government and stakeholders at all levels address these service delivery bottlenecks to expand access to SI in Nigeria.
