By Chioma Obinna
When the Federal Government early in the year approved Sayana Press injectable contraceptive for self-injection by users, many women particularly, unmarried women heaved a sigh of relief that it would bring about improved access to modern contraceptives in Nigeria. But months after, most family planning centres run by the government are yet to have the product for onward services.
This is coming on the heels of the signing of Memorandum of Understanding, MoU by the Federal Government and the United Nations Population Fund, UNFPA, for the procurement of contraceptive in the country for the next four years.
Investigations by Good Health Weekly showed that six months after the Federal government formally approved the commodity, it is yet to be found in the public health facilities.
Some of the medical workers who spoke to good health weekly under the condition of anonymity said although it has been approved, it is yet to get to the facilities. According to them, it has not been included in the government’s approved contraceptives in the various centres.
The commodity, Sayana Press is a three-month progestin-only injectable contraceptive that combines the drug and needle in a Uniject™ injection system. It is small, light, easy-to-use, and requires minimal training, making it ideal for rural settings and community-based distribution efforts and, increasingly, for women to administer themselves.
Introduced in 2014, Sayana Press, the product has been hailed as a “game-changer,” due to its ease of use and ability to be administered by non health professionals and users.
Today, the introduction of the product in Burkina Faso, Niger, Senegal, and Uganda has helped these countries move towards scale- up contraceptive use. Within the period of pilot – July 2014-June 2016 over 120,000 new users were administered.
Today, in countries like Uganda, Sayana Press has proved to be a ‘game changer’ as it has empowered community women in taking charge of their reproductive health.
In 2014, DKT Nigeria became the first programme to commercially introduce Sayana Press through social marketing in Africa, with funding from the Bill & Melinda Gates Foundation and the Children’s Investment Fund Foundation as well as Pfizer. Although, findings show it has been distributed in some states in Nigeria but the product is only available in private hospitals, clinics, maternity homes, pharmacies among others. Health watchers are of the view, that following progress made by these countries, Nigeria may be able to acheive its target of 36 percent Contraceptive Rate, CPR, by 2018 as projected if it begins the implemenmtation.
However, efforts to reach the Federal Ministry of Health through the Head of Reproductive Health Division, Federal Ministry of Health, Dr Kayode Afolabi proved abortive as he declined comments saying that “As a civil servant, I am not permitted to talk to the press without ministerial approval.”
Confirming the situation in a chat with Good Health Weekly, Lagos State Team Leader, Nigerian Urban Reproductive Health Initiative, NURHI, Dr. Omasanjuwa Edun, who admitted there was no active promotion of the use of Sayana press in Nigeria currently said the product is still within the private sector.
Edun identified process of procurement as one of the factors delaying availability of the products in public health facilities, adding that until these processes are completed, procurement may not be possible.
“We are still struggling of getting the normal commodities and distribution, so until they come up with a good strategy on how to add Sayana press to the existing contraceptive commodities that we have but we are not there yet,” he explained.
Edun who endorsed the effectiveness of the product, said right now the UNFPA is working with DKT to push Sayana press into 10 States in Nigeria, “so when they do that, the outcome of the initial pilot will now form how they want to do a nationwide distribution to all the states.
“But definitely, it is very convenient and it is something that I would recommend because part of the challenges that we face today is that women are exposed to the public when they go to the facilities where people can tag them as ‘family planning seekers.’ But with Sayana press, they can just buy it with a prescription over- the- counter or they walk into a facility and just buy it and walk out. They don’t have to stay there; they can go home and do it themselves unlike other contraceptives. If it is available it will be a welcome development.”
Also in an interview with Good Health Weekly, Head of Cross River Sub Office and Programme Coordinator, UNFPA Nigeria Country Office, Mr. Kenneth Ehouzou noted that Sayana Press can increase access to a safe, effective, and popular family planning option. He said as an self-injectable contraception, the product offers the potential to improve contraceptive access for women worldwide
On availability in Nigeria, he said that the programme started as a pilot programme in 2015 in two States and later scale to 10 States, adding that evidence is being built to showcase the advantages for community distribution as against others which require more skilled health care workers that are not readily available in the communities. He further noted that the Federal Ministry of Health is developing a strategy to scale up for community distribution.