Cost-effectiveness analysis of self-injectable versus health worker-administered injectable contraceptive modalities among women of reproductive age (15-49 years) at Kajjansi Health Center IV Wakiso District
Cost-effectiveness analysis of self-injectable versus health worker-administered injectable contraceptive modalities among women of reproductive age (15-49 years) at Kajjansi Health Center IV Wakiso District
Date
2025
Authors
Nzamunganyiki, Denis
Journal Title
Journal ISSN
Volume Title
Publisher
Makerere University
Abstract
Background:
Globally, injectable contraceptives are valued for their safety and convenience, with self-injection further enhancing accessibility. However, the cost-effectiveness of self-injectables compared to intramuscular methods remains unclear. This study assessed the cost-effectiveness of self-injectable versus health worker-administered DMPA to evaluate its economic and practical benefits.
Objectives:
To assess the incremental costs, effectiveness, and cost-effectiveness of self-injectable versus health worker-administered injectable contraceptive modalities among women aged 15-49 at Kajjansi Health Center IV.
Methods:
The study compared self-injectable and health worker-administered contraceptive modalities over a one-and-a-half-year period using a Decision Tree model from a societal perspective. Costs were estimated by identifying and valuing resources for each modality, while effectiveness was measured in terms of unintended pregnancies averted. Incremental cost-effectiveness ratio (ICER) calculations and sensitivity analyses were conducted to assess robustness under different scenarios and willingness-to-pay (WTP) thresholds.
Results:
The self-injectable contraceptive method had a total cost of $557 and prevented 145 pregnancies, while the health worker-administered method cost $527 and prevented 140 pregnancies. The incremental cost-effectiveness ratio (ICER) of 750 indicates that self-injection provides greater effectiveness for a modest cost increase. Sensitivity analysis confirmed the stability of the results across various scenarios, supporting the cost-effectiveness of the self-injectable method. Conclusions and Recommendations:
Self-injection was a more cost-effective contraceptive modality, preventing more unintended pregnancies at a slightly higher cost compared to health worker-administered injections. These findings provide evidence to support resource allocation decisions and improvements in contraceptive modalities at Kajjansi Health Center IV and similar settings.
Description
A dissertation submitted to Makerere University Graduate School in partial fulfillment of the requirements for the award of the Degree of Master of Health Services Research
Keywords
Injectable contraceptives,
Women,
Reproductive health,
Kajjansi Health Center IV
Citation
Nzamunganyiki, D. (2025). Cost-effectiveness analysis of self-injectable versus health worker-administered injectable contraceptive modalities among women of reproductive age (15-49 years) at Kajjansi Health Center iv Wakiso District. (Unpublished Masters dissertation). Makerere University, Kampala, Uganda.