Trial reportPloS one2022
Testing a counseling message for increasing uptake of self-injectable contraception in southern Malawi: A mixed-methods, clustered randomized controlled study.
Trial report in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 18 citations in OpenAlex.
- Feasibility and acceptability of DMPA-SC self-injection in Addis Ababa, Ethiopia: a mixed-methods study.Reproductive health · 2025Article
- The case for investing in provider-administered subcutaneous DMPA: a costing study.BMJ global health · 2025Article
- Validation of a measure of contraceptive self-injection self-efficacy in Uganda.BMC women's health · 2025Article
- DMPA-SC self-injection experiences of clients and providers in Uganda: the role of community health workers in reproductive self-care service delivery.BMC women's health · 2025Article
- Knowledge, confidence and social support: Kenyan women's priority needs for contraceptive self-injection learning through a social cognitive theory lens.BMC women's health · 2025Article
- Development of a community-based peer-support intervention to improve contraceptive agency and diffuse self-injectable contraception in Uganda: Application of the human-centered design approach.BMC women's health · 2025Article
- Improving Contraception Outreach through Human-Centered Design: A Pilot Study of the Ndingathe ("I Can") Intervention in Rural Malawi.PloS one · 2025Article
- Women's Perspectives on the Unique Benefits and Challenges of Self-Injectable Contraception: A Four-Country In-Depth Interview Study in Sub-Saharan Africa.Studies in family planning · 2024Article
- Key informant views on potential acceptability and feasibility of long-acting antiretroviral treatment for HIV in Kenya.BMC infectious diseases · 2024Article
- Health care provider and client experiences of counselling on depot medroxyprogesterone acetate subcutaneous (DMPA-SC) for self-injection in Malawi.PLOS global public health · 2023Article
- "Men can take part": examining men's role in supporting self-injectable contraception in southern Malawi, a qualitative exploration.Reproductive health · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveWhile self-injection of subcutaneous depot medroxyprogesterone acetate (DMPA-SC) has well-documented benefits, uptake may be improved by addressing client concerns such as fear of self-injury and low self-efficacy. However, current training materials for family planning providers do not address these concerns. We used an iterative process with family planning providers and clients, male community leaders and partners, and stakeholders in Malawi to develop a counseling message addressing user-centered concerns about self-injection. We report on our testing of the effectiveness of this evidence-based message for increasing self-injection uptake in the context of full method choice.
methodsWe randomized 60 public facilities across two districts in southern Malawi to orient their providers to the message (treatment) or not (control). After strengthening data quality, we extracted routine service delivery data from the facilities six months before and after introducing the message. We compared pre- and post-orientation trends for the treatment and control groups using generalized linear mixed models. We conducted eight focus group discussions with a sample of providers oriented to the message.
resultsThe message was feasible to implement and highly acceptable to providers. During June 2020-June 2021, 16,593 new clients used injectables in Mangochi district (52% DMPA-SC; 15% self-injected). In Thyolo district, 7,761 new clients used injectables during July 2020-July 2021 (29% DMPA-SC; 14% self-injected). We observed high variability in number of clients and self-injection uptake across facilities and over time, indicating inconsistent offering of self-injection. In both districts, we found significant increases in self-injection in treatment facilities after message introduction. However, this increase was not sustained, especially when DMPA-SC was unavailable or about to expire.
conclusionBased on the study findings, we recommend the evidence-based message be used in programs offering DMPA-SC self-injection services. However, effective use of the message is contingent upon a consistent supply of DMPA-SC.
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