Uganda Study: Self-Injection Boosts Women's Health Choices

Women in rural Uganda are experiencing a powerful shift in reproductive confidence thanks to a contraceptive method they can control themselves.

A 12-month study tracking nearly 1,900 women found that those who chose to self-inject their birth control reported significantly stronger decision-making power over their family planning within six months. The research, published in January 2025 by scientists from UC San Francisco and Makerere University, focused on DMPA-SC, a three-month contraceptive shot women can give themselves at home.

The study followed 1,828 women aged 15 to 45 across five districts in Eastern and Northern Uganda. Of these participants, 216 chose self-injection while others selected implants, IUDs, or clinic-administered shots.

Researchers measured changes in what they call "contraceptive agency," the ability to make informed choices about preventing pregnancy and act on those decisions confidently. Women who self-injected saw their agency scores rise by 0.10 points on a three-point scale compared to women using other methods.

That number might sound small, but it represents real change. Women who administered their own injections reported better understanding of their reproductive rights and increased confidence in making contraceptive choices without external pressure.

The empowerment effect was strongest in the first six months. By the one-year mark, differences between the groups had faded, likely due to practical challenges like contraceptive shortages, limited privacy at home, and lack of partner support.

The Ripple Effect

Uganda introduced self-injection in 2017 as part of national efforts to expand family planning access. Since then, the country has distributed the method through Village Health Teams, bringing reproductive healthcare directly into communities.

The World Health Organization recognizes self-injection as an important tool for strengthening reproductive autonomy. The method doesn't replace other contraceptive options but gives women another choice that fits their lives.

The researchers emphasize that the benefits depend on consistent access and supportive environments. When women have reliable supplies and the freedom to make their own health decisions, self-injection can be genuinely empowering.

The study received ethical approval from multiple institutions and funding from the Gates Foundation. It was conducted between 2022 and 2024 in the districts of Iganga, Mayuge, Kole, Lira, and Oyam.

The findings suggest a simple truth: giving women more control over how they receive healthcare can strengthen their voice in other life decisions too.