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Using data from facility exit interviews with clients seeking family planning services in public health facilities in Uganda and Nigeria, we develop a visual information cascade to identify potential missed opportunities for the provision of subcutaneous depot medroxyprogesterone acetate (DMPA-SC) self-injection services. More than a third of respondents in Uganda (31.2%) and Nigeria (40.5%) reported not receiving any information about the self-injection contraceptive from a provider during family planning service provision. This was despite a stated desire to learn about the method that the client expressed during the exit interview after the facility visit. The cascade also highlights missed opportunities to provide adopters who self-injected with additional doses to take home, which is one of the method's core attributes as a self-managed contraceptive method. Using subcutaneous depot medroxyprogesterone acetate self-injection method as a case study, we demonstrate the utility of constructing a description of contraceptive counseling and service cascade for identifying potential gaps in quality and person-centeredness of service delivery, aiming to enhance the overall family planning experience for clients in these regions.
Ontiri et al. (Sun,) studied this question.