REVOLUTIONIZING CONTRACEPTION: PERCEPTION AND INFLUENCE OF SELF- ADMINISTERED DEPOT MEDROXYPROGESTERONE ACETATE ON CONTRACEPTION PREVALENCE

Abstract

Background: The self-administered subcutaneous depot medroxyprogesterone acetate (DMPA-SC) has emerged as an innovative approach to improve contraceptive access and reproductive autonomy among women. Understanding women's perceptions and factors influencing its uptake is essential for expanding contraceptive coverage. Objectives: To determine the perception and influence of self-administered DMPA-SC on contraceptive prevalence among married women of reproductive age. Study Design & Setting: This descriptive cross-sectional study was conducted from January to June 2026 at five Reproductive Health Services (RHS-A) centers of the Population Welfare Department in District Hyderabad, Sindh, Pakistan. Methodology: A total of 361 married women aged 18–49 years were enrolled using non-probability consecutive sampling. Data were collected using a structured pre-tested questionnaire. Variables included demographic characteristics, contraceptive use, perceptions toward self-administered DMPA-SC, healthcare access, support systems, and behavioral factors. Data were analyzed using IBM SPSS version 25.0. Associations were assessed using Pearson’s Chi-square test, with p<0.05 considered statistically significant. Results: Overall contraceptive prevalence was 78.1%, while the prevalence of self-administered DMPA-SC use was 39.6%. Positive perceptions were observed with mean scores of 3.21±1.32 for confidence, 3.31±1.31 for safety, 3.33±1.28 for effectiveness, 3.19±1.33 for satisfaction, and 3.58±1.10 for ease of use. Regular contraceptive use and high adherence were reported by 55.7% and 50.1% of women, respectively. DMPA SC use was significantly associated with perception domains, healthcare access, health literacy, support systems, availability, policy support, training, and behavioral factors (all p<0.001). Conclusion: Self-administered DMPA-SC was associated with positive perceptions and substantial utilization. Healthcare access, support systems, availability, and training significantly influenced its uptake.