Evidence map›Paper›PMID 40916043›Full record

ArticleBMC women's health2025

Injectable contraceptive continuation and user experiences in Punjab, Pakistan: a non-randomized prospective cohort study protocol.

Hannah Tappis, Kanwal Qayyum, Emily Bryce, Aisha Fatima, Megan Christofield, Huma Haider, Afshan Ameen, Syed Muhammad Akbar Gardezi, Fazal Rafay, Fauzia Assad

Registry-linked trialAbstract readClinical Trial Protocol
In one paragraph

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. It is linked to trial NCT05774626 (Continuation of Subcutaneous and Intramuscular Injectable Contraception), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT05774626 completednot on this map

Continuation of Subcutaneous and Intramuscular Injectable Contraception: a Non-randomized Prospective Cohort Study in Punjab, Pakistan

TypeobservationalSponsorJhpiegoRan2024 to 2025Enrolled1,009ConditionsContraceptive UsageArmsContraceptive usage
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Hannah TappisJhpiego, Baltimore, Maryland, USA. Hannah.Tappis@jhpiego.org.ORCID 0000-0002-4289-5418
Kanwal QayyumJhpiego, Islamabad, Pakistan.
Emily BryceJhpiego, Baltimore, Maryland, USA.
Aisha FatimaJhpiego, Islamabad, Pakistan.
Megan ChristofieldJhpiego, Baltimore, Maryland, USA.
Huma HaiderJhpiego, Islamabad, Pakistan.
Afshan AmeenJhpiego, Islamabad, Pakistan.
Syed Muhammad Akbar GardeziJhpiego, Islamabad, Pakistan.
Fazal RafayJhpiego, Islamabad, Pakistan.
Fauzia AssadJhpiego, Islamabad, Pakistan.

Funding

Gates Foundation INV-005538
6 · The paper itself

Abstract

backgroundEvidence from multiple pilots and post-introduction scale-up initiatives have demonstrated that self-administered subcutaneous depot-medroxyprogesterone acetate (DMPA-SC) has potential to improve contraceptive continuation rates and expand contraceptive access to populations with limited utilization of facility-based health services. Only a few of these studies have been conducted in South Asian countries, and none where most contraceptive use is of non-hormonal methods that require limited to no contact with the health system, leaving policymakers in countries like Pakistan with limited context-specific evidence to guide decisions on whether, how, and for whom to introduce DMPA-SC.

methodsA prospective cohort study will be conducted in 41 health facilities and surrounding communities in Punjab, Pakistan. The primary objective of the study is to compare the 12-month contraceptive continuation rate for women who receive DMPA-SC with that for women who receive intramuscular depot-medroxyprogesterone acetate (DMPA-IM). The secondary objectives are to compare characteristics and experiences of participants who opt for DMPA-SC with those of women who opt for DMPA-IM, which must be administered by a health worker. Additionally, a sub-study is planned to assess how well women opting for self-injection of DMPA-SC adhere to standards for commodity storage, injection timing, injection technique and waste disposal. DISCUSSION: This research offers an opportunity to contribute to global efforts to reduce inequities in access to contraceptive method choices, while generating actionable evidence to inform health sector decision-making in Pakistan. Although study sites are limited to health facilities where a woman's first self-injection of DMPA-SC is supervised by a nurse, midwife, medical officer, Lady Health Visitor, Family Welfare Worker or Family Welfare Councilor, the research protocol and findings will provide a foundation for future studies testing alternative service provision and self-injection support models.

trial registrationRegistered on clinicaltrials.gov as an observational study (NCT05774626).

Indexed as

Contraception BehaviorContraceptive Agents, FemaleMedroxyprogesterone AcetateAdultFemaleHumansInjections, IntramuscularInjections, SubcutaneousObservational Studies as TopicPakistanProspective StudiesYoung AdultContraceptive Agents, FemaleMedroxyprogesterone AcetateContraceptiveDMPA-IMDMPA-SCFamily planningInjectable contraceptivePakistanSelf-careSelf-injection

Identifiers

PMID40916043
PMCPMC12416068

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.