Currently, women in rural areas in developing countries must travel to urban health centers or hospitals to receive certain birth control options that require insertion by skilled healthcare providers. The time and cost of travel presents a barrier to many women in rural location seeking long-term birth control options.

Ethiopia has a lack of trained healthcare providers—2.5 physicians per 100,000 people—limiting the delivery of effective long-term contraception including subcutaneous contraceptive implants.

We co-designed, with Ethiopian healthcare providers and researchers, an assistive task-shifting device for accurate contraceptive implant administration.

SubQ Device

The assistive device, SubQ Assist, acts like a template, guiding healthcare providers during implant insertion, eliminating the possibility of unsafe administration and effectively shifting the task of administration to community health workers (CHWs).

Based in Evidence
In benchtop and cadaver testing, the accuracy of SubQ Assist (2.4 x 0.6 mm) was greater than the current contraceptive implant administration method (2.9  0.5 mm) with the target depth being 1.7  0.5 mm. In pre-clinical usability testing, 131 Ethiopian healthcare providers, including 53 CHWs, were recorded using the assistive device and were interviewed about their experience with the assistive device. Through the recordings and interviews, we identified that interest exists in SubQ Assist because it shifts the task of contraceptive implant administration and received feedback to inform design changes.

Expected Impact
In Ethiopia, over 30,000 CHWs service over 50% of the population, nearly 50 million people.  In enabling CHWs to administer implants, we will provide contraceptive implants to 1.5 million women in Ethiopia. This increase in contraceptive implant use will prevent unintended pregnancies, abortions, miscarriages, and maternal and infant deaths. CHWs will track contraceptive implant use in patient medical records, which are already in use in Ethiopia.
Future Work
Currently, we are looking for partnering organizations to help develop and execute a small scale clinical trial in Ethiopia to demonstrate safety and efficacy. Additionally, we are seeking funding to support this trial and manufacturing and distribution partners.