Preference for Sayana® Press versus intramuscular Depo-Provera among HIV-positive women in Rakai, Uganda: a randomized crossover trial

Operational assessments of Sayana® Press provision in Senegal and Uganda

“…This operational assessment leveraged acceptability studies conducted by FHI 360 in Senegal and Uganda [3,4] and Johns Hopkins Bloomberg School of Public Health with the Rakai Health Sciences Project in Uganda [5] by targeting the same clinics and community-based distribution programs that participated in those studies 3 and asking a sample of providers to reflect on their experience managing and administering SP. We conducted 58 semistructured interviews with both clinic providers who managed SP logistics in the clinic setting and CHWs who managed SP in the community.…”

“…4 The clinics participating in the JHU/RHSP study do not have affiliated CHWs, only clinic-based providers. 5 In Senegal, where participating CHWs were injection naive (i.e., not experienced with DMPA IM injections), they were not asked to compare their SP experience against past experience with DMPA IM. Rather, we asked them to evaluate how easy or difficult it was to offer SP and how the storage, supply, transportation, etc., of SP compare to their experience managing family planning methods more generally.…”

“…Respondents who expected SP to be either less or more challenging were asked to elaborate. 5 This pattern of inquiry was repeated for each topic, including storage, waste management, transportation and the injection-delivery process. 6 Not all questions were relevant for every provider, so the denominator varies slightly by question series.…”

“…2 While other studies establish the acceptability of SP [3][4][5], this study examines SP provision from a service delivery standpoint, assessing the extent to which the Uniject system with a subcutaneous needle simplifies the logistics of managing and administering injectable contraception, thereby easing concerns about task shifting to CHWs. Uniject has been studied in the context of vaccine programs (tetanus toxoid) and safe motherhood and child survival programs (oxytocin and hepatitis B), but this is only the second study to examine the Uniject delivery system in the context of a family planning program [6][7][8].…”

How to transform the practice of engineering to meet global health needs

“…BD invested $25 million to establish a dedicated manufacturing line for empty Uniject packages in Singapore and $10 million to launch the product on the global market; today, vaccine manufacturers buy empty Uniject containers and prefill them for global distribution (11). Since 2000, millions of doses of hepatitis B and tetanus vaccines have been delivered with Uniject, and efforts are under way to use Uniject to expand access to injectable contraceptives in lowresource settings (12). Through a partnership with Biodel, Uniject is now being developed for emergency delivery of liquid glucagon to treat severe hypoglycemia, where a simple, portable solution is of particular importance for first responders or parents of children with diabetes.…”