Dosabe Mbantegheis, 38 years old is a community counselor working with MSF health promoter staff to encourage the effective use of contraception and counseling for family planning in rural communities in Masisi territory.
Family planning

DRC: Bringing family planning closer to home

Self-injectable options can overcome barriers to contraception

In many parts of the Democratic Republic of Congo (DRC), recurrent conflict and displacement of people can make it difficult for women to regularly access health centres. As a result, many girls and women miss out on consistent access to contraception that would allow them to space out their births and avoid unwanted pregnancies. 

Since 2019, Doctors Without Borders (MSF) has been offering women a long-acting contraceptive called Sayana Press in four projects in the DRC. This injectable contraceptive lasts three months and is highly effective (99 per cent) against pregnancy when used correctly. 

In front of the general referral hospital in the Nizi area, mothers go out to get some fresh air, do the laundry and cook.
In front of the general referral hospital in the Nizi area, mothers go out to get some fresh air, do the laundry and cook.
MSF/Solen Mourlon

Women can receive their first injection in a health centre, where a healthcare provider or community health worker teaches them how to do the next injection themselves and provides up to four doses to take home – enough to last for one year.

This self-care approach means that women can manage their own contraceptive needs without having to regularly visit the health centre, or take daily pills. Doctors Without Borders (MSF) Nurse in Drodro, Naomi Kugonza, says Sayana Press can be lifesaving because it means that women are less likely to have unsafe abortions. 

“We also use it to reduce the rates of maternal mortality caused by unwanted pregnancies and clandestine abortions caused by sexual violence or pregnancies too close together.” 
 

A patient holds the drugs she has just been given to proceed with a termination of pregnancy at Kusisa hospital, North Kivu.
A patient holds the drugs she has just been given to proceed with a termination of pregnancy at Kusisa hospital, North Kivu.
Davide Scalenghe

Unsafe abortion is one of the top five causes of maternal mortality globally.  

“This is a woman-centred method; they can self-inject the medication and do the follow-up alone,” she adds.

The drug can also be stored at room temperature and is easy to transport, which is helpful in this area where women and girls are often forced on the move.

The Sayana Press is similar in formulation to the injectable contraceptive Depo-Provera but contains a lower dose and is administered just under the skin using a single-use syringe with a short needle.


Doctors Without Borders (MSF) is currently offering the contraceptive in Mambasa, Nizi, Drodro and Angumu in DRC.
 

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