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Abstract
Background Self-injectable contraceptives, namely subcutaneous depot medroxyprogesterone acetate 104 mg micronised formulation delivered via uniject system, reduce the need to travel to a facility for contraceptive access, but the initial, in-person, training may be a barrier to starting this method. This article reports on a small, exploratory pilot in Kenya to test the feasibility and acceptability of digital self-injection training.
Methods Participants (n=11) who were currently using injectable contraceptives, intramuscular depot medroxyprogesterone acetate 150 mg injected by a healthcare worker, received digital self-injection training from a trained clinician via a WhatsApp video call. Participants administered a simulated self-injection on a model and an actual self-injection (under supervision) on themselves. The participants’ self-injection proficiency, a measure of the feasibility of remote training, was documented using a checklist, and participants were administered a questionnaire about their training experience. The training was observed, and content analysis was used to understand the functionality of training.
Results All participants were proficient when performing the self-injection on themselves after receiving the remote training and reported that the training was acceptable. A barrier to training via a video call was lack of access to quality digital devices. Eight training ‘lessons learnt’ emerged from the training observations.
Conclusions Training participants to administer self-injectable contraceptives via WhatsApp video call was feasible and acceptable. Training lessons learnt offer pragmatic adaptations for communicating about a practical skill via a digital channel. Further research is needed to ascertain the efficacy of digital training for self-injection and feasibility and acceptability for wider groups.
- Contraceptive Devices, Female
- family planning services
- Health Services Accessibility
- Health Services Research
- hormonal contraception
- long-acting reversible contraception
Data availability statement
Data are available upon reasonable request.
Statistics from Altmetric.com
- Contraceptive Devices, Female
- family planning services
- Health Services Accessibility
- Health Services Research
- hormonal contraception
- long-acting reversible contraception
Data availability statement
Data are available upon reasonable request.
Footnotes
Contributors RM led on study protocol design and training of the study team. She collaborated on questionnaire and observation data collection and led on data analysis and report writing. RK collaborated on study protocol design and led on carrying out self-injection training with participants. She collaborated on questionnaire data collection and reviewed the final report. FK led on participant recruitment in the health centre and managed in situ research activities. She reviewed the final report. PB led on concept generation and supervised on study protocol design, data collection, data analysis and report writing. She provided extensive review of the final report. PB is the guarantor.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests PB: The relationships and activities that could have influenced the work are her role as clinical director of SH:24, a not-for-profit community interest company that provides online sexual health services.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.
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