From January 30 to February 2, 2017, 150 researchers, health professionals, advocates, and donors from 191 countries met in Dakar, Senegal for three days to strategize how best to strategize advocacy and policy approaches for introducing and increasing access to subcutaneous depo provera via Uniject, also known as DMPA-SC or Sayana® Press2. The Advance Family Planning (AFP) initiative3 co-organized the meeting in collaboration with PATH and IntraHealth, along with a global steering group of international nongovernmental organizations (INGOs) and in-country partners. Each of the African and Asian countries represented left the meeting with evidence-based objectives specific to policy changes needed to increase access to DMPA-SC. They also developed a preliminary plan for engaging decision-makers, donors, and other stakeholders. Subsequent to the meeting, participants ensured that advocacy action plans were discussed, refined, and implemented to increase access to this method in their countries. See the AFP website for meeting presentations.
Reflecting the aim of the meeting, then Senegal Minister of Health, Awa Coll-Seck, highlighted her country’s efforts to expand access to DMPA-SC within a broader method mix. Although the participants came from very diverse countries, all saw DMPA-SC’s potential to overcome barriers to contraceptive access and relieve the health system through alternative channels of provision, including self-injection. Donors4 stood ready to support country-led efforts. Initial support for the meeting was matched two to one by cost-sharing from other organizations and donors. One hundred and twenty-four of the 150 participants funded (in full or in part) their own travel costs.
A session featuring World Health Organization (WHO) and experts in HIV acquisition and hormonal contraception helped countries anticipate guidance5 issued in March and provided WHO with greater insight into potential implications for introduction and scale-up of DMPA-SC. Within a week following the meeting, Kenya and Nigeria convened policymakers and others in their countries to chart a course for increasing access to DMPA-SC. Other countries created taskforces and used connections made to organize policymaker visits to learn first-hand about the realities of increased access and self-injection. Two participants published pieces related to the meeting6. Participant evaluations confirmed the meeting’s utility and importance. A survey of participants in September 2017 found that nearly all had applied the evidence shared at the meeting to improve access to DMPA-SC following the meeting