Experiences & Perspectives on Injectable Contraceptive on Its Users in Tamil Nadu- A Qualitative Report
DOI:
https://doi.org/10.55489/njcm.151120244609Keywords:
Depot Medroxy Progesterone Acetate (DMPA), Injectable contraception, Contraceptive method, Perspectives towards DMPA, Reproductive age womenAbstract
Background: Injectable contraception, Depot Medroxy-Progesterone Acetate (DMPA), is a popular birth control option due to its safety, effectiveness, and discretion. It offers three months protection with minimal impact on the daily lives, reducing the need for frequent visits to healthcare facilities. Understanding women’s experiences with DMPA is crucial for improving the quality of contraceptive services and their reproductive health outcomes. This study aimed to elucidate the experiences and perspectives of women using injectable contraceptive - Depot Medroxy-Progesterone Acetate.
Methodology: The study employed a Phenomenological approach, with in-depth, semi-structured interviews among ten women, aged 21-40 years, who received DMPA at a Family Planning Clinic in Tamil Nadu, India. Participants who had used DMPA for at least three months to one year were selected using convenience sampling. Data were analysed and identified themes through the Colaizzi method.
Results: Thematic analysis revealed eight key themes: reasons for choosing DMPA, decision-making process, concerns and discontinuation, information sources, management strategies, willingness to recommend, reluctance to recommend, and suggestions for improving DMPA utilization.
Conclusions: This study highlights the need for enhancements in injectable contraceptive services, providing insights to inform future family planning policies and strategies.
References
Family planning in health services. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser. 1971;476:1-65. PMID: 5004039.
Family Planning. National Health Mission [Internet]. Available at: https://nhm.gov.in/index1. php?lang=1&level=2&sublinkid=821&lid=222.
Phukan RS. Family planning in India: Its history, programmes, importance and impact [Internet]. My India. 2015. Available at: https://www.mapsofindia.com/my-india/society/family-planning-in-india-its-history-programmes-importance-and-impact. Accessed 2024 Aug 16.
National Health Mission Tamil Nadu: Department of Health & Family Welfare Govt. of Tamil Nadu, India. 2022. Available from: https://nhm.tn.gov.in/en Accessed on 2024 Aug 16.
National Population Policy [Internet]. www.pib.gov.in. Available from: https://www.pib.gov.in/pressreleasepage.aspx?prid=1601839. Accessed 2024 Aug 16.
Department of Health & Family Welfare Ministry of Health & Family Welfare Government of India. Annual Report 2023-24. New Delhi: Department of Health & Family Welfare Ministry of Health & Family Welfare Government of India; 2024: 72-79.
Update on NFHS-5 & Rural Health Statistics. Available from https://pib.gov.in/Pressreleaseshare.aspx?PRID=1843842#:~:text=Overall%20Contraceptive%20Prevalence%20Rate%20(CPR,from13%20percent%20to%209%20percent. Accessed on 2024 Aug 16.
National Family Health Survey (NFHS-5), 2019-21: India: Volume 1. International Institute for Population Sciences (IIPS) and ICF: Mumbai; 2021.
Why Method Mix Matters? Evidence on contraceptive method mix in developing countries: South and South-East Asia [Internet]. Available at: https://www.populationfoundation.in/wp-content/uploads/2020/04/Fileattached-1513326457-Infographic.pdf. Accessed 2024 Aug 16.
Advantages and disadvantages of DMPA injectable contraceptives [Internet]. Tech Featured. 2018. Available at: https://techfeatured.com/12284/advantages-and-disadvantages-of-dmpa-injectable-contraceptives. Accessed 2024 Aug 16.
DMPA contraceptive injection: Use and coverage [Internet]. KFF. 2020 [cited 2024 Apr 18]. Available at: https://www.kff.org/womens-health-policy/fact-sheet/dmpa-contraceptive. Accessed 2024 Aug 16.
Contraceptive injection. DMPA: Progestogen hormone [Internet]. Patient.info. Available at: https://patient.info/sexual-health/long-acting-reversible-contraceptives-larc/contraceptive-injection. Accessed 2024 Aug 16.
Park K. Textbook of Preventive and Social Medicine. 27th ed. Jabalpur: Bhanot Publishers; 2023.
Implementation research on DMPA-SC self-injection [Internet]. WHO. Available at: https://www.who.int/publications/m/item/implementation-research-on-dmpa-sc-self-injection. Accessed 2024 Aug 16.
White K, Potter JE, Hopkins K, et al. The association between injectable contraception and invasive cervical cancer risk in women aged 15–44 years. Cancer Causes Control. 2020;31(5):471-9.
Edelman AB, Cherala G, Blue SW, et al. Depot medroxyproges-terone acetate contraceptive use and cancer risk in women: A meta-analysis. Contraception. 2021;104(4):417-24. Doi: https://doi.org/10.1016/j.contraception.2021.05.001
Kaunitz AM, Grimes DA. Depot medroxyprogesterone acetate: A highly effective contraceptive option with benefits beyond birth control. Obstet Gynecol. 2019;133(2):351-9. Doi: https://doi.org/10.1097/AOG.0000000000003050
Ministry of Health and Family Welfare Government of India [Internet]. 2015. Available at: https://dhsprogram.com/pubs/pdf/FR339/FR339.pdf. Accessed 2024 Aug 16.
National Family Health Survey [Internet]. rchiips.org. Available at: https://rchiips.org/nfhs/nfhs4.shtml. Accessed 2024 Aug 16.
Forero R, Nahidi S, De Costa J, Mohsin M, Fitzgerald G, Gibson N, et al. Application of four-dimension criteria to assess rigour of qualitative research in emergency medicine. BMC Health Serv Res. 2018;18(1):1-11. Doi: https://doi.org/10.1186/s12913-018-2915-2
Burke HM, Packer C, Buluzi M, Healy E, Ngwira B. Client and provider experiences with self-administration of subcutaneous depot medroxyprogesterone acetate (DMPA-SC) in Malawi. Contraception. 2018;98(5):405-10. Doi: https://doi.org/10.1016/j.contraception.2018.02.011
Basu G, Bairagya A, Mondal R, Roy S. Prevalence and reasons behind use of injectable contraceptive among the women of reproductive age group: A cross-sectional survey in rural areas of Nadia District, West Bengal. J Family Med Prim Care. 2021;10(7):2566-71. Doi: https://doi.org/10.4103/jfmpc.jfmpc_2465_20
Shah S, Asghar A, Rafiq S. A study on injectable DMPA (Depomedroxy Progesterone Acetate) and effect of its use as a short term contraception in immediate postpartum women. Int. J. of Health Sci. [Internet]. 2023 May 2;7(S1):296-304. Doi: https://doi.org/10.53730/ijhs.v7nS1.14195
MacLachlan E, Atuyambe LM, Millogo T, Guiella G, Yaro S, Kasasa S, et al. Continuation of subcutaneous or intramuscular injectable contraception when administered by facility-based and community health workers: findings from a prospective cohort study in Burkina Faso and Uganda. Contraception. 2018;98(5):423-9. Doi: https://doi.org/10.1016/j.contraception.2018.08.007
Liu J, Shen J, Diamond-Smith N. Predictors of DMPA-SC continuation among urban Nigerian women: The influence of counseling quality and side effects. Contraception. 2018;98(5):430-7. Doi: https://doi.org/10.1016/j.contraception.2018.04.015
Osinowo K, Ekholuenetale M, Ojomo O, Hassan A, Ladipo OA. Patterns of triggers, ideation and motivational factors of contraceptive utilization among women and gate-keepers in Nigeria: A scoping study on the resilient and accelerated scale-up of DMPA-SC in Nigeria (RASUDIN). Contracept Reprod Med. 2020;5(1):38. Doi: https://doi.org/10.1186/s40834-020-00141-6
Rai L, Prabakar P, Nair S. Injectable depot medroxyprogesterone: A safe and effective contraception for an Indian setting. Health Popul Perspect Issues. 2007;30(1):12-23.
Kotecha PV, Patel SV, Baxi RK, Kapadia S, Mehta K. Women's and providers' experiences with injectable contraceptives (Depo-Provera): A view from Vadodara, India. Indian J Clin Pract. 2020;31(2):152-6.
Bertrand JT, Bidashimwa D, Makani PB, Hernandez JH, Akilimali P, Binanga A. An observational study to test the acceptability and feasibility of using medical and nursing students to instruct clients in DMPA-SC self-injection at the community level in Kinshasa. Contraception. 2018;98(5):411-7. Doi: https://doi.org/10.1016/j.contraception.2018.08.002
Burke HM, Mueller MP, Perry B, Packer C, Bufumbo L, Mbengue D, et al. Observational study of the acceptability of Sayana® Press among intramuscular DMPA users in Uganda and Senegal. Contraception. 2014;89(5):361-7. Doi: https://doi.org/10.1016/j.contraception.2014.01.022
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Rajalakshmi Rajaraman, Sasi Vaithilingan, Rajeswari C, Selvavinayagam Thirumalaichiry Sivaprakasan , Somasundaram Anavarathan
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
The authors retain the copyright of their article, with first publication rights granted to Medsci Publications.