Innovations for Choice and Autonomy (ICAN)

Study Overview

Across much of sub-Saharan Africa, injectable contraceptives are the most common contraceptive methods of choice. With the introduction of subcutaneous depot medroxyprogesterone acetate (DMPA-SC), which includes a prefilled syringe system, it is now possible for women to administer an injectable contraceptive by themselves. The option to self-inject is a promising self-care option with the potential to help women manage their fertility in line with their preferences.

Innovations for Choice and Autonomy (ICAN) is a project rooted on the idea that women’s autonomy and decision-making should be a key priority in all sexual and reproductive health (SRH) efforts. Led by a consortium of researchers in Kenya, Malawi, Nigeria, Uganda, and the United States, ICAN is funded by the Bill and Melinda Gates Foundation’s (BMGF) (2019-2024) to deeply understand how SI can be implemented to support informed contraceptive choice and use from the perspective of women in study countries. Kenya, Malawi, Nigeria, and Uganda represent varied contexts in which implementation of DMPA-SC for self-injection (SI) is at different stages. Through a variety of research methods, scalable approaches tailored to meet and measure women’s needs are being identified, developed, and evaluated by our ICAN team.

Study Aims & Objectives

ICAN has five key objectives:

Research
  • Improved understanding of who may be the most likely to benefit from the introduction of SI. 
  • Improved understanding of effective approaches for introducing and supporting the use of SI (in the context of a full basket of contraceptive options) in a way that helps women overcome barriers and optimize facilitators to contraceptive decision-making and use. 
  • Improved understanding of the role SI can play in promoting empowered contraceptive decision-making and autonomy.
Capacity
  • Improved mixed methods research capacities and quality among research partners in Kenya, Malawi, Nigeria, Uganda, and United States.
  • Improved understanding and coordination of how to best scale up SI among Foundations (BMGF & CIFF), their grantees, and broader family planning/self-care community.

To answer the research objectives, ICAN has three overarching aims: