Ouagadougou – "My husband was against contraceptive," recalls Aïssa*. She recently gave birth to triplets.  She has four older children, the youngest barely two years old. "Since the triplets, the financial burden has grown so much that it's been easier to persuade him," she adds.

Aïssa is one of the new family planning converts in Burkina Faso, where the use of modern contraception methods has doubled over the last decade. By 2020, almost 32% of women of child-bearing age were using modern contraceptive methods to avoid unwanted pregnancies, or to delay pregnancy, compared with 15% the previous decade.

"This new contraceptive reduces time spent in health facilities and ensures continuity of care. » – Edith Bassoma, head of the maternity ward at the Nagrin medical centre, south of Ougadougou.

To reinforce this progress, the country, with the support of World Health Organization (WHO) and other partners, launched a pilot programme in 2018 to promote use of a new contraceptive called depot medroxyprogesterone acetate subcutaneously (DMPASc) that women can self-inject at home.

Initially implemented in four health districts, the programme was subsequently extended to 54 others, representing more than 75% of all health districts in Burkina Faso.

When Aïssa visited the health centre in Sig-Nonghin health district’s sector 22, in the country’s capital, she was offered various options. But she was particularly interested in the new self-injectable one.

"I was afraid to use this method because I thought I wouldn't be able to have any more children. I changed my view after one of my neighbours who had used it had her second child. » – Angèle Dabire, DMPA user 

"This new contraceptive reduces time spent in health facilities, and ensures continuity of care," explains Edith Bassoma, head of the maternity department at Nagrin Medical Centre, south of Ougadougou, where she teaches women how to inject the contraceptive.

"Most women prefer injectable contraceptives. The fact that they learn how to inject themselves is an advantage. Our centre is always very busy, so this avoids the risk of them not returning due to the large numbers of patients,” says Bassoma. Promotional materials contain both text and explanatory images for those who cannot read. The educational talks also help dispel anxiety. "At first, I was afraid to use this method because I thought I wouldn't be able to have any more children," says Angèle Dabire, who is at the clinic for a new dose. "I changed my view after one of my neighbours, who had been using the contraceptive for over a year, had her second child.”

To support implementation of the programme, national documentation and guidelines were drawn up, and health centre staff trained to raise awareness and introduce women to the injection technique. 

"Training health professionals in this new method, stepping up awareness campaigns, and setting up a supply mechanism for all health facilities have enabled us to attract new users," explains Dr Mathieu Bougma, Head of the Family Planning Department at the Ministry of Health and Public Hygiene’s Family Health Directorate.

In addition, WHO is sharing its expertise in a tripartite research project with the Ministry of Health and the Health Science Research Institute. "The aim of the research being carried out in the Garango Health District is to highlight the strengths of the pilot phase, which will make it easier to scale up this innovative contraceptive method throughout the country," explains Dr Clotaire Hien, Sexual Reproductive Health and Rights Programme Officer at Burkina Faso’s WHO Country Office.

Four years after the start of the pilot phase, Burkina Faso is home to almost 1.5 million subcutaneous DMPA users, or more than one quarter of all women of child-bearing age.