Lived experiences of self-injectable contraceptive use among women in rural Malawi

Mandayachepa Nyando, Emily Himes, Martha Kamanga, Alfred Maluwa, Address Malata, Innocencia Mtalimanja, Tamanda Jumbe, Beth Phillips, Janelli Vallin, Lauren Suchman, Kelsey Holt

Abstract

Drawing on women’s lived experiences using self-injectable (SI) contraception, this study explores the method’s integration into rural Malawi and the impact on women’s lives. We conducted in-depth interviews with 18 SI users from Ntchisi and Mulanje districts. A two-phase analysis—first thematic, then narrative—identified benefits, challenges, and motivations for use. Our findings illustrate that many women transitioned from provider-administered injectables to SI, seeing value in its convenience and cost savings when health facilities were distant. Having multiple units at home offered protection against common stockouts. Women reported increased autonomy, greater privacy, and more partner cooperation than with provider-dependent methods. Many were motivated to promote SI through social networks. Challenges included inconsistent supply, varying reliability of Health Surveillance Assistants (HSAs), and early difficulties with self-administration. Findings highlight the need to invest in HSAs, ensure consistent supply, and leverage social support to optimize implementation of this innovative contraceptive method

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