NextBillion - An Initiative of the William Davidson Institute at the University of Michigan

Thursday, October 13, 2016

Before the birth of her first child last year, Warom Molly had never used hormonal birth control. But at her daughter Bethel’s postnatal checkup in Gulu, Uganda, Warom knew exactly which method she wanted: Sayana Press, a three-month, progestin-only contraceptive shot that is self-injectable.

Following this hospital visit, Warom would receive some training on self-injection, and then get to take home a dose to administer to herself. This “do-it-yourself” option represents a radical and potentially life-saving level of control for women in places like Gulu, where contraception can be difficult to obtain. Many Ugandan women have to travel miles away from their villages, usually by foot, and wait hours in long lines to get medical care, including contraception, whether that’s Depo-Provera, the birth control shot that has to be administered in a clinic, or the far less popular option in Uganda, the pill.

But thanks to its novel injection system developed by the global health nonprofit PATH, Sayana Press, which is manufactured by Pfizer and costs just $1 per dose, is very easy (and safe) for health workers — and women themselves — to administer.

Sayana Press also helps to solve another vexing problem for the women of Uganda: the opposition of controlling partners, who may be against birth control altogether. A discreet shot injected every three months is far easier to hide. “Some of [the husbands] are very bitter,” explains Rosemary Lamwaka, one of the nurses in Gulu teaching women how to self-inject Sayana Press. “They don’t want their wives to use family planning. They heard some local myths that family planning makes women barren. [Women] want Sayana Press [so they can] keep their secret very well, and they end up injecting when the man is not around.”