Publication:

Injectable contraceptive medroxyprogesterone acetate: utilization and experiences among currently married women residing in tea gardens of a block in Darjeeling district, West Bengal, India

Background India has included injectable medroxyprogesterone acetate (MPA) into the Antara Programme to address its high efficacy, though adherence remains a concern. This study assessed the utilization patterns and experiences of currently married women using injectable MPA in tea gardens of Darjeeling district, West Bengal.

Methods A community-based cross-sectional study was conducted from October 2023 to September 2024 in all tea gardens of Naxalbari block. Complete enumeration included 127 currently married women aged 15–49 years who had received at least one MPA dose in the previous year from sub-centres. Participants were eligible for up to four doses annually. Data were collected through face-to-face interviews using a pre-designed, pre-tested schedule after informed consent, and analyzed using descriptive statistics.

Results Most participants were aged 21–25 years (34.6%), with a mean age of 26.7±5.8 years, and 50.3% were primiparous. Injectable MPA was the first contraceptive for 55.9% of women, and 95.3% received information from ASHA workers. All women received the first dose, while 84, 75, and 23 received the second, third, and fourth doses, respectively. Side effects were reported by 100, 64, 60, and 19 women after successive doses. Overall, 81.9% discontinued use mainly due to side effects, predominantly amenorrhea. No pregnancies were reported within the three-month effective period after any dose.

Conclusions Injectable MPA is an effective contraceptive, often used as a first method by young women. ASHA workers facilitate its uptake, but side effects especially amenorrhea is the primary cause for discontinuation.