title: Self-administration of injectable contraceptives: a systematic review.
abstract: BACKGROUND
  The contraceptive injectable is a safe and effective method that is used worldwide. With the variety of injectable delivery systems, there is potential for administration by the woman herself. Self-administration of the contraceptive injectable is the subject of this systematic review.
  
  
  OBJECTIVE
  To assess how effective and safe the contraceptive injectable method is when women themselves perform/administer it, compared with when the usual healthcare providers administer it.
  
  
  METHODS
  We searched PubMed, Popline, Cochrane, CINAHL, and Embase for articles with subject headings or text words related to 'self-administration' and 'contraception'.
  
  
  METHODS
  Studies that compared the administration of the contraceptive injectable by the woman herself versus administration by the healthcare provider were included. Outcomes of interest were continuation rates, safety, and the women's overall satisfaction with the contraceptive provider and method.
  
  
  METHODS
  We undertook data extraction, descriptive analysis, and assessment of risk of bias.
  
  
  RESULTS
  Three studies met the inclusion criteria. The best available evidence shows that there may be little or no difference in continuation rates when women self-administer contraceptive injections (326 per 1000 women; 95% CI 192-554 per 1000 women) compared with administration by healthcare providers (304 per 1000 women). Safety was not estimable as no serious adverse events were reported in any of the studies. With regards to overall satisfaction towards the provider and the method, the effect of the intervention was uncertain.
  
  
  CONCLUSIONS
  Findings suggest that with appropriate information and training the provision of contraceptive injectables for the woman to self-administer at home can be an option in some contexts.
  
  
  CONCLUSIONS
  This review assessed the continuation rates and safety of self-administration of the contraceptive injection.
authors.affiliation: Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
authors.forename: C R
authors.initials: CR
authors.lastname: Kim
authors.affiliation: Knowledge Centre for the Health Services, Norwegian Institute of Public Health, Oslo, Norway.
authors.forename: M S
authors.initials: MS
authors.lastname: Fønhus
authors.affiliation: Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
authors.forename: B
authors.initials: B
authors.lastname: Ganatra
mesh_terms: D000328:Adult; D003267:Contraception / Q000379:methods*; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007267:Injections / Q000379:methods*; D012646:Self Administration / Q000379:methods*; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female
keywords: Contraception; injectable; self-administration