ArticleBMC women's health2025
Quality of counseling for self-administering injectable contraception: field evidence from mystery client interactions in Lagos, Nigeria.
Article in BMC women's health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 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
4 citing papers in PubMed.
- Understanding clients' and providers' perspectives on the implementation of subcutaneous depot medroxyprogesterone acetate (DMPA-SC) for self-injection programming in Nigeria.BMJ global health · 2026Article
- Introduction to the special supplement, unlocking the potential of self-injectable contraception: evidence from coordinated investments.BMC women's health · 2025Article
- How do pro-social tendencies and provider biases affect service delivery? Evidence from the rollout of self-injection of DMPA-SC in Nigeria.BMC women's health · 2025Article
- 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 · 2025Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
backgroundSelf-injection (SI) of subcutaneous depot medroxyprogesterone acetate (DMPA-SC) is a self-care intervention (drugs, diagnostics, or devices that can be provided mostly outside the health system) implemented across Nigeria. Per national guidelines, first-time DMPA-SC users can obtain units for SI after two in-person training visits. Success of self-care interventions, the option for SI included, depends on local policies and individual providers to create an enabling environment. Thus, we aimed to 1) assess providers' fidelity to Ministry of Health protocols; 2) assess the extent of bias in fidelity; and 3) to asses client-centeredness.
methodsEight mystery client actors portrayed an older, married woman or a younger, unmarried woman without DMPA-SC experience. They sought contraception, including DMPA-SC for SI, at 30 public and 30 private facilities. A total of 120 interactions were planned (two per facility-one by each profile). Immediately following their interactions, actors completed a debrief survey about their experiences. Using responses from these debrief surveys, we described key actor-reported outcomes (providers' fidelity to Ministry of Health protocols for SI dispensing, SI training, and supporting contraceptive decision-making). We also examined objective and subjective client-centeredness outcomes. We assessed bias in fidelity and client-centeredness through bivariate tests for differences by actor profile (younger/unmarried vs older/married) and facility type (health facility vs pharmacy/PPMV).
resultsFidelity to dispensing guidelines (i.e., refusing DMPA-SC units for SI) differed by facility type (χ
conclusionsWillingness to dispense DMPA-SC for SI differed by facility type but not by client profile. However, younger, unmarried profile actors experienced more scrutiny from providers. These findings indicate a need for clarifying service provision protocols to ensure an enabling environment for women's access to and use of self-injectable contraception.
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