Assessment of Facilitators and Barriers to Practicing Self-Care Approaches in Fragile Settings using subcutaneous DMPA – South Sudan

The Momentum Integrated Health Resilience (MIHR) Project, managed by IMA World Health is United States Agency for International Development (USAID) funded project implemented in South Sudan. The project aimed to generate evidence-based knowledge on the facilitators and barriers affecting access, uptake, and continued use of depot medroxyprogesterone acetate for subcutaneous injection (DMPA-SC) in fragile contexts. The study evaluated multiple facets, including factors influencing contraceptive method choices, the demographic profile of users, the quality of care provided, adherence to safe injection practices, effectiveness of re-injection reminders, and the impact of self-injection on individual and couple resilience.

Employing a cross-sectional, mixed-methods design, the study targeted multiple demographics including women of reproductive age (15-49 years) who have been using DMPA since October 2021, their male partners, Boma Health Workers (BHWs), and facility-based health workers from both private and public MIHR-supported facilities. Data collection involved qualitative methods, including in-depth interviews with DMPA users, focus group discussions (FGDs) with BHWs, and triad interviews for facility-based health workers. Additionally, de-identified contraceptive data extracted from health facility registers to provide insights into demographic patterns and previous contraceptive use among DMPA-SC and DMPA-IM users.