Setbacks in the road to self-injection: a descriptive study of provider and mystery client reports on the DMPA-SC care-seeking experience in Nigeria

This mixed-methods study describes perspectives from health providers and simulated clients on initiation and continuation of DMPA-SC for self-injection in Nigeria. Through mystery (simulated) client interactions, we found that providers were similarly willing to dispense units of DMPA-SC for self-i...

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Main Authors: Madeline Griffith, Sneha Challa, Ayobambo Jegede, Ivan Idiodi, Chioma Okoli, Aminat Tijani, Shakede Dimowo, Awawu Grace Nmadu, Elizabeth Omoluabi, Jenny Liu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Global Women's Health
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fgwh.2025.1552379/full
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author Madeline Griffith
Sneha Challa
Ayobambo Jegede
Ivan Idiodi
Chioma Okoli
Aminat Tijani
Shakede Dimowo
Awawu Grace Nmadu
Elizabeth Omoluabi
Jenny Liu
author_facet Madeline Griffith
Sneha Challa
Ayobambo Jegede
Ivan Idiodi
Chioma Okoli
Aminat Tijani
Shakede Dimowo
Awawu Grace Nmadu
Elizabeth Omoluabi
Jenny Liu
author_sort Madeline Griffith
collection DOAJ
description This mixed-methods study describes perspectives from health providers and simulated clients on initiation and continuation of DMPA-SC for self-injection in Nigeria. Through mystery (simulated) client interactions, we found that providers were similarly willing to dispense units of DMPA-SC for self-injection to different client profiles, which varied in age, marital status, and parity. However, in-depth interviews with providers revealed nuance in their approaches to assessing clients’ eligibility for unsupervised self-injection of DMPA-SC. Factors including client age, marital status, parity, and education influenced who they deemed able to self-inject, which may limit access to DMPA-SC for clients who wish to self-inject the method. Quantitative and qualitative data also indicated that clients faced setbacks in continuing unsupervised self-injection when seeking refills from an unfamiliar provider. Stockouts of DMPA-SC further complicated access; some providers resorted to purchasing DMPA-SC privately and passing the cost onto clients. These findings highlight the need for clearer refill protocols and more consistent supply to ensure equitable access to DMPA-SC for self-injection in Nigeria.
format Article
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institution Kabale University
issn 2673-5059
language English
publishDate 2025-08-01
publisher Frontiers Media S.A.
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series Frontiers in Global Women's Health
spelling doaj-art-978a5bb72b9a41f39e9985956e80c0022025-08-20T04:00:48ZengFrontiers Media S.A.Frontiers in Global Women's Health2673-50592025-08-01610.3389/fgwh.2025.15523791552379Setbacks in the road to self-injection: a descriptive study of provider and mystery client reports on the DMPA-SC care-seeking experience in NigeriaMadeline Griffith0Sneha Challa1Ayobambo Jegede2Ivan Idiodi3Chioma Okoli4Aminat Tijani5Shakede Dimowo6Awawu Grace Nmadu7Elizabeth Omoluabi8Jenny Liu9Institute for Health & Aging, School of Nursing, University of California, San Francisco, CA, United StatesInstitute for Health & Aging, School of Nursing, University of California, San Francisco, CA, United StatesAkenaPlus Health, Abuja, NigeriaAkenaPlus Health, Abuja, NigeriaAkenaPlus Health, Abuja, NigeriaAkenaPlus Health, Abuja, NigeriaAkenaPlus Health, Abuja, NigeriaAkenaPlus Health, Abuja, NigeriaAkenaPlus Health, Abuja, NigeriaInstitute for Health & Aging, School of Nursing, University of California, San Francisco, CA, United StatesThis mixed-methods study describes perspectives from health providers and simulated clients on initiation and continuation of DMPA-SC for self-injection in Nigeria. Through mystery (simulated) client interactions, we found that providers were similarly willing to dispense units of DMPA-SC for self-injection to different client profiles, which varied in age, marital status, and parity. However, in-depth interviews with providers revealed nuance in their approaches to assessing clients’ eligibility for unsupervised self-injection of DMPA-SC. Factors including client age, marital status, parity, and education influenced who they deemed able to self-inject, which may limit access to DMPA-SC for clients who wish to self-inject the method. Quantitative and qualitative data also indicated that clients faced setbacks in continuing unsupervised self-injection when seeking refills from an unfamiliar provider. Stockouts of DMPA-SC further complicated access; some providers resorted to purchasing DMPA-SC privately and passing the cost onto clients. These findings highlight the need for clearer refill protocols and more consistent supply to ensure equitable access to DMPA-SC for self-injection in Nigeria.https://www.frontiersin.org/articles/10.3389/fgwh.2025.1552379/fullself-injectionself-careDMPA-SCimplementation researchmixed-methodsrefills
spellingShingle Madeline Griffith
Sneha Challa
Ayobambo Jegede
Ivan Idiodi
Chioma Okoli
Aminat Tijani
Shakede Dimowo
Awawu Grace Nmadu
Elizabeth Omoluabi
Jenny Liu
Setbacks in the road to self-injection: a descriptive study of provider and mystery client reports on the DMPA-SC care-seeking experience in Nigeria
Frontiers in Global Women's Health
self-injection
self-care
DMPA-SC
implementation research
mixed-methods
refills
title Setbacks in the road to self-injection: a descriptive study of provider and mystery client reports on the DMPA-SC care-seeking experience in Nigeria
title_full Setbacks in the road to self-injection: a descriptive study of provider and mystery client reports on the DMPA-SC care-seeking experience in Nigeria
title_fullStr Setbacks in the road to self-injection: a descriptive study of provider and mystery client reports on the DMPA-SC care-seeking experience in Nigeria
title_full_unstemmed Setbacks in the road to self-injection: a descriptive study of provider and mystery client reports on the DMPA-SC care-seeking experience in Nigeria
title_short Setbacks in the road to self-injection: a descriptive study of provider and mystery client reports on the DMPA-SC care-seeking experience in Nigeria
title_sort setbacks in the road to self injection a descriptive study of provider and mystery client reports on the dmpa sc care seeking experience in nigeria
topic self-injection
self-care
DMPA-SC
implementation research
mixed-methods
refills
url https://www.frontiersin.org/articles/10.3389/fgwh.2025.1552379/full
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