DMPA, a three monthly progestogen-only contraceptive injection, was licenced for use by the Drugs Controller in the nineties. As a result of an intervention plea filed at the time, use of DMPA was restricted to private market.
The manufacturer of the contraceptive, Max Pharma, was given approval on the condition that it would conduct post-marketing studies, as the injection had not been properly researched in India. Even in nineties, womens groups had objected to use of this contraceptive because of the many contraindications and unmanageable side effects already known.
The health ministry announced last week that it was considering introducing injectable contraceptives to increase contraceptive choices for women. Earlier, DMPA was not introduced in the public sector as it was believed that the public sector was not equipped to handle its use in a large-scale manner and also manage its side effects. Recently, health ministry secretary, K Sujatha Rao, said that the public sector now had enough manpower and infrastructure, thanks to the National Rural Health Mission (NRHM), to introduce DMPA.
However, in a memo written to DTAB, womens groups and public health experts pointed out: The health budget has stagnated while the salary and medicine costs have gone up. The only new cadre of health workers that has been created is ill-trained ASHAs (Accredited Social Health Activists), who have no relevance for delivery of injectables. In light of the shortage of obstetricians and gynaecologists, the health system remains incapable of dealing with the safe delivery of a contraceptive requiring intensive medical support and close monitoring for an array of disturbing side effects, said the memo.