Sayana Press Pilot Introduction Project
Access to modern contraception can save lives. About one in three maternal deaths could be avoided by delaying motherhood, spacing births, preventing unintended pregnancies, and avoiding unsafely performed abortions.
Healthier mothers mean healthier children and improved child survival. Families can better care for and educate those children, and communities benefit when women can participate in broader economic and community activities.
Injectable contraceptives are among the world’s most popular methods for preventing pregnancy, offering women safe and effective protection, convenience, and privacy. Until now, however, they have not been widely available outside clinic settings. Sayana® Press, a lower-dose formulation and presentation of Depo-Provera®, offers the potential to improve contraceptive access for women worldwide.
Sayana Press is a three-month, progestin-only injectable contraceptive product packaged in the Uniject™ injection system, a small prefilled autodisable device. It contains 104 mg per 0.65 mL dose of depot medroxyprogesterone acetate (DMPA) and is administered via subcutaneous injection.
Sayana Press is small, light, easy to use, and requires minimal training, making it especially suitable for community-based distribution—and potentially for women to administer themselves through self-injection.*
Commitment to increasing access
In July 2012, the London Summit on Family Planning launched a new coordinated effort to ensure that voluntary family planning services reach an additional 120 million women and girls in the world’s poorest countries by 2020. An estimated 222 million women and girls worldwide want to prevent unintended pregnancy but are not using modern contraception.
More than 150 leaders from donor and developing countries, international agencies, civil society, foundations, and the private sector pledged their support to improving access to family planning information, services, and supplies.
As part of this event, a group of public and private partners announced plans to work with national programs to offer Sayana Press to women in sub-Saharan Africa and South Asia between 2013 and 2016. The original Sayana Press pilot introduction partnership included the Bill & Melinda Gates Foundation, the US Agency for International Development (USAID), the UK Department for International Development (DFID), the United Nations Population Fund (UNFPA), Pfizer Inc., and PATH. In 2014, the Children’s Investment Fund Foundation (CIFF) also joined the partnership.
Pilot introduction overview
As a result of the Summit on Family Planning commitment, PATH and partners are supporting country-led pilot introduction of Sayana Press in Bangladesh, Burkina Faso, Niger, Senegal, and Uganda. Country introduction activities are beginning in 2014 and will continue through 2016. Sayana Press is being introduced through normal delivery channels in the public, nongovernmental, and commercial sectors. Donors involved in the Summit on Family Planning have procured the introduction units of Sayana Press.
These pilot introduction activities build on small-scale Sayana Press acceptability studies and operational assessments completed in Ethiopia, Senegal, and Uganda in 2012 and 2013. The studies generated information concerning the acceptability of Sayana Press among clients and health care providers as well as qualitative data on the perceptions and policy implications of potential home and self-injection of Sayana Press.
The pilot introduction partners share the goal of including Sayana Press in family planning programs to help address the unmet need for contraception. Sayana Press is expected to increase contraceptive access and reach new users.
Introduction countries and delivery channels
Ministries of health in the four African nations introducing Sayana Press are leading the pilot introductions. PATH is working closely with the ministries and other key partners including UNFPA, USAID, nongovernmental organization service delivery partners, and social marketing groups on Sayana Press pilot introduction.
With the pilot introduction of Sayana Press, injectable contraceptives will for the first time be a routine part of community-based health care in Burkina Faso, Niger, and Senegal, giving women convenient access in their own villages. In Uganda, the Sayana Press pilot introduction activities are building on the Ministry of Health’s commitment to expand community-based delivery of injectable contraceptives and are making specific efforts to increase family planning access for younger women. In Bangladesh, USAID is planning to support introduction of the product through social marketing.
After the pilot introduction phase, PATH will work with partners to help ensure that women continue to have access to a range of contraceptive products.
Evidence for decision-making
Looking beyond the current introductions, PATH plans to work closely with ministries of health in Senegal and Uganda to build the evidence base on issues such as the operational feasibility and cost-effectiveness of Sayana Press self-injection among women. PATH and partners anticipate that evidence generated through all project activities will enable stakeholders to make informed decisions on whether and how to include Sayana Press in family planning programs in the future—including the feasibility and impact of delivery through self-injection.
Sayana Press has been approved by regulatory authorities in the European Union and several countries around the world.† Country-level regulatory approvals are in place in all five pilot introduction countries.
Sayana Press project key fact sheets:
- Sayana Press Pilot Introduction Project Summary
- Sayana Press Clinical Brief
- Frequently Asked Questions About Sayana Press
†Sayana Press was approved in the European Union via procedure number UK/H/0960/002UK/H/0960/002. The UK was the Reference Member State. A Public Assessment Report is available at the Heads of Medicines Agency website and the Medicines and Healthcare Products Regulatory Agency web page.