Protecting Global Gains: Seizing opportunities in Madagascar to expand access to contraceptives

March 11, 2021

March is Women’s History Month and the Protecting Global Gains campaign is featuring a pioneering effort underway in Madagascar that helps women take control of their sexual and reproductive health during the COVID-19 pandemic–self-injectable contraceptives.

Seizing opportunities in Madagascar to expand access to contraceptives describes how the Ministry of Health in Madagascar, PATH, and John Snow, Inc. introduced virtual trainings and protocols to teach healthcare providers to both administer DMPA-SC (subcutaneous depot medroxyprogesterone acetate) and to counsel women on how to self-inject. DMPA-SC self-injection is a contraceptive option well suited to lockdowns as it reduces the need for clinic visits and allows women autonomy in their reproductive health.

With a remote 10-step self-injection training tool and virtual supervision of trainees by the Ministry of Health, district management teams were able to reach 100 percent of family planning providers who in turn supported women interested in self-injecting. This was even higher than pre-COVID times when in-person supervision reached only about half the providers still in need of training. The availability of more family planning providers to train in self-injection encouraged more women to take up modern contraceptives: up to 24 percent of the women who have adopted self-injection were new to family planning. The program’s success highlights the importance of client-centered and community-responsive services in health systems that are able to swiftly adapt to changing circumstances.

Follow Protecting Global Gains on social media at @hivpxresearch, @theglobalfight, @Amref_Worldwide, and #ProtectingGlobalGains, and consider amplifying these stories on your own social media. Advocates can encourage their national leaders to renew their commitments to improve access to contraceptive information, services, and supplies, and to advocate for self-care approaches including contraceptive self-injection. Visit to learn more about how to take action.