Implementing self‐injection (SI) of subcutaneous depot‐medroxyprogesterone acetate (DMPA‐SC) is a key self‐care strategy for sexual and reproductive health, but SI uptake remains low, and assertions about the potential of SI to increase women's control over contraceptive use lack evidence. We sought to qualitatively explore how women with diverse contraceptive experiences—including those with and without experience using SI—view the benefits and challenges of SI as compared to other methods. We conducted 241 in‐depth interviews with women across four sub‐Saharan African countries and found alignment between the perceived and experienced benefits of SI across our diverse sample. Through the benefits of privacy, easier access, and self‐management, we found SI can promote greater control over the contraceptive experience by facilitating a woman's ability to act on her preferences and control who is involved in or aware of her contraceptive use. Interviews revealed SI's potential is, however, constrained by inherent limitations in the method; for example, it is often not private or accessible enough and many fear injecting themselves. SI has the most potential when implemented with programmatic solutions that mitigate challenges women experience or anticipate and allow more women to benefit from the privacy, easier access, and self‐management that SI offers.

中文翻译：

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女性对自注射避孕法独特益处和挑战的看法：撒哈拉以南非洲四国深度访谈研究


实施皮下长效醋酸甲羟孕酮 （DMPA-SC） 的自我注射 （SI） 是性和生殖健康的关键自我保健策略，但 SI 的采用率仍然很低，并且关于 SI 有可能增加女性对避孕药具使用的控制的断言缺乏证据。我们试图定性地探讨具有不同避孕经验的女性（包括有和没有使用 SI 经验的女性）如何看待 SI 与其他方法相比的好处和挑战。我们对四个撒哈拉以南非洲国家的女性进行了 241 次深入访谈，发现在我们不同的样本中，感知到和体验到 SI 的好处之间存在一致性。通过隐私、更轻松的访问和自我管理的好处，我们发现 SI 可以通过促进女性根据自己的偏好采取行动并控制参与或了解其避孕药具使用的人的能力，促进对避孕体验的更大控制。然而，访谈显示 SI 的潜力受到该方法固有局限性的限制;例如，它通常不够私密或不够容易获得，许多人害怕注射自己。当通过程序化解决方案实施时，SI 具有最大的潜力，这些解决方案可以减轻女性经历或预期的挑战，并让更多女性从 SI 提供的隐私、更轻松的访问和自我管理中受益。