Country of Operation
SummaryThe DiMPA is a network of private OB/GYNs and general practitioners trained to provide quality family planning services with a focus on the depot-medroxyprogesterone acetate (DMPA) 3-month injectable in 45 cities of Uttar Pradesh, Uttarakhand and Jharkhand.
The goals of the network are: to create awareness about DMPA as a safe and effective method of contraception; to increase access to and use of DMPA through the private health sector by establishing a network; and to promote correct use and compliance through sustained high quality of service.
Key program components
From 2006-2009, the Abt Associates-led Private Sector Partnerships-One (PSP-One) project has been scaling-up the DiMPA Network, a successful branded network of Obstetrics and Gynecology and general practitioners in northern India trained to provide quality family planning services with a focus on providing the Depot Medroxyprogesterone Acetate (DMPA) 3-month injectable contraceptive. The scale-up has taken place over four phases, throughout which PSP-One has developed partnerships with the private and commercial sectors and implemented low-cost and scalable interventions to increase network members' knowledge and skills related to family planning. The network started with three pilot cities and 105 providers in Uttar Pradesh (UP) where use of injectables was almost nonexistent. By the fourth and final phase of the project the network had grown to a total of 45 cities and 1,400 providers in UP, Uttrakhand, and Jharkhand. The program components include: * Training providers with an evidence based approach * Voluntary provider enrollment in the DiMPA network to increase access to DMPA at an affordable price point * Employing accessible and multiple communication channels to create awareness about DMPA * Monitoring and evaluating the program for increased use and knowledge and sustained quality of care Additionally, creation of the network has facilitated improvements in attitudes towards injectable contraceptive, which represents a major step forward in efforts to increase the contraceptive prevalence rate. In November 2008, the program launched a toll free helpline to address concerns about the use of DMPA and increase awareness about it amongst potential users. The DiMPA Helpline had received more than 330,000 calls as of June 2010. Today, there are separate lines for women and men with trained tele-counselors providing method-specific counseling and answers to queries related to DMPA, and where appropriate, referring clients to the nearest DiMPA clinic.
The necessity of promoting DMPA through a private sector network was readily apparent early in the project. Despite the wide acceptance and proven safety of the product worldwide, and even the backing of India’s own regulating agency, the government of India did not (and still does not) include DMPA in the national family planning basket of goods, limiting its availability to the private sector. Additionally, activist groups in India firmly believed that injectables were detrimental to women's health. As a result, a broad base of support was needed within the medical community to combat these negative voices. Organizing providers into the network provided this base and enabled the program to obtain the support of the Federation of Obstetric and Gynecological Society of India (FOGSI), who issued a consensus statement approving DMPA as a safe and effective method and encouraged its 18,000 members to promote the product within the WHO guidelines.