Trends in subcutaneous depot medroxyprogesterone acetate (DMPA-SC) use in Burkina Faso, the Democratic Republic of Congo and Uganda

Philip Anglewicz; Pierre Akilimali; Georges Guiella; Patrick Kayembe; Simon P S Kibira; Fredrick Makumbi; Amy Tsui; Scott Radloff

doi:10.1016/j.conx.2019.100013

Trends in subcutaneous depot medroxyprogesterone acetate (DMPA-SC) use in Burkina Faso, the Democratic Republic of Congo and Uganda

Contracept X. 2019 Nov 9:1:100013. doi: 10.1016/j.conx.2019.100013. eCollection 2019.

Authors

Philip Anglewicz¹, Pierre Akilimali², Georges Guiella³, Patrick Kayembe², Simon P S Kibira⁴, Fredrick Makumbi⁵, Amy Tsui¹, Scott Radloff¹

Affiliations

¹ Johns Hopkins Bloomberg School of Public Health, Department of Population, Family and Reproductive Health, 615 N. Wolfe Street E4533, Baltimore, MD 21205, USA.
² School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.
³ Institut Supérieur des Sciences de la Population, University of Ouagadougou, Ouagadougou, Burkina Faso.
⁴ Department of Community Health and Behavioral Sciences, Makerere University School of Public Health, Kampala, Uganda.
⁵ Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda.

Abstract

Objectives: Subcutaneous depot medroxyprogesterone acetate (DMPA-SC) is seen as a valuable innovation in family planning, but little is known about trends in DMPA-SC use or characteristics of users. Using data from Burkina Faso, the Democratic Republic of Congo (DRC) and Uganda, we measured trends in DMPA-SC and identified characteristics associated with DMPA-SC use.

Study design: We used repeated cross-sectional representative data collected between 2016 and 2019. First, we plotted trends in DMPA-SC use for all women and married women. Next, we presented the sociodemographic and family-planning-related characteristics of DMPA-SC users. Finally, we conducted weighted multivariate logistic regression analysis to examine how DMPA-SC users were different from women (1) using all other modern methods combined and (2) not using any modern method.

Results: DMPA-SC use increased monotonically in all three countries. Many DMPA-SC users were first-time users of modern contraception (54.5% in Burkina Faso, 34.6% in DRC, 50.7% in Uganda). Never-married women had lower odds than married women of using DMPA-SC (compared to other modern methods) in all three countries [Burkina Faso adjusted odds ratio (AOR) 0.40, 95% confidence interval (95% CI) 0.20-0.80; DRC AOR 0.31 95% CI 0.10-0.93; Uganda AOR 0.24; 95% CI 0.08-0.71]. Level of education was positively associated with DMPA-SC use (compared to no use) (Burkina Faso AOR 1.79; 95% CI 1.03-3.14; Uganda AOR 3.23; 95% CI 1.33-7.84).

Conclusions: DMPA-SC is a rapidly growing method in these settings. Despite the comparable levels of and increases in use for all three countries, the characteristics associated with DMPA-SC use generally differed across countries.

Implications: This is the first analysis of patterns of DMPA-SC use with representative data for African countries. Our results confirm that DMPA-SC is increasingly popular, although the profile of users varies across settings.

Keywords: Burkina Faso; Contraceptive use; DMPA-SC; Democratic Republic of Congo; Family planning; Sayana® Press; Uganda.