If DMPA is included in the govt's family planning programme, it would be the sixth modern contraceptive method to be given free of cost.

Govt okay with injectable contraceptive for women How much is too muchImage for representation
news Wednesday, September 16, 2015 - 20:22

The Health Ministry has in principle approved the introduction of injectable contraceptives for women in the government's family planning programmes. 

"We have given in-principle approval. But the cost for inclusion in the national programme has to be worked out," a TOI report quotes an official as saying.

This comes weeks after Drug Technical Advisor Board (DTAB), the topmost drug technical advisory body of the Union Health Ministry, recommended the introduction of an injectable contraceptive called DMPA in order to widen the choice of contraceptives available to women. 

What is DMPA?

Deoxy/Depot* medroxy progesterone acetate or DMPA is an injectable contraceptive that prevents pregnancy for three months. It is administered on the arms or buttocks. It constitutes of a female hormone that helps prevents the egg from being released from the ovary. 

"DMPA is one of the best methods of contraception, especially in a set-up where it becomes difficult to track whether patients are taking pills as prescribed," says Dr Jaishri, who is a senior consultant, Gynecology, with Apollo Hospitals and Motherhood in Chennai. 

Reiterating that the drug is effective for three months, she said that it is good for short term use. "If used for years at stretch, it could affect bone density. However, DMPA is absolutely fine for short-term use," she says. 

“The biggest advantage of injectable contraceptives,” Aarti Dhar wrote in The Wire,  “is privacy and is particularly helpful to those women who cannot negotiate contraceptive use with men and are not empowered enough to adopt spacing methods.”

There is scientific evidence which states that DMPA helps in protecting against risk of pregnancy, cancer of the lining of uterus, uterine fibroids and anemia, she added.

Though DMPA has been allowed for use in the private health sector since 1994, efforts to include it under government programmes have faced significant opposition from some NGOs and women's rights groups, due to the reported side-effects of the drug including menstrual irregularities, de-mineralization of bones and that that it takes around 5-6 months to regain fertility after the shots are discontinued. 

In the 1990’s, there were two cases against DMPA in the Supreme Court. In 1995, the DTAB after examining the issue had told the apex court, “DMPA should not be allowed to mass use in the National Family Planning Program and its use should be restricted to women who would be aware of all the implications of use,” the Deccan Herald reported. 

However, the health ministry later reviewed the utility of injectable contraceptives and on July 24 a national meeting on the issue held that such contraceptives are suitable for introduction in the government programme.

In her report, Dhar also mentioned that there is evidence from Africa which showed that the use of injectable contraceptives was directly proportional to an increase in the risk of contracting HIV since couples tended to not use other contraception methods like condoms  to prevent infection.
According to guidelines provided by the Family Planning Association of India, which has been advocating the use of injectable contraceptives and was part of the expert group set up the health ministry to look into the issue, a condom should be used during every act of intercourse to protect against STIs/HIVs. 

"The government would not include any method which is not safe or is ineffective," said Dr Manisha Bhise, Assistant Director Access, FPA India. 

“About 12 million women used injectables in 1995. Between 1995 and 2005 the number of women worldwide using injectable contraceptives more than doubled. In 2005 over 32 million were using injectables and recent data show the global uptake of injectables at 42 million.”- Family Planning Association of India.

If the deoxy medroxy progesterone acetate (DMPA) is included in the public health system under the National Family Planning Programme, it would be the sixth modern contraceptive method to be given free of cost.

At present, there are five birth control options which are available free of cost in the family planning programmes of India including female sterilisation, male sterilisation, IUD, condoms and pills. 

(While some reports state that DMPA stands for Depot medroxy progesterone acetate, there are a few that use Deoxy. Doctors state that DMPA stands for Depot medroxy progesterone acetate.)