ProgestinOnly Injectable Contraceptives DMPA and NETEN Session IV

Progestin-Only Injectable Contraceptives: DMPA and NET-EN Session IV: Practicing Provision of Progestin-Only Injectables Session IV, Slide 1

Overview The injection can be given in: X the upper arm the hip or buttock Session IV, Slide 2

How to Give the Injection: Steps 1 -2 1. Wash your hands well with soap and water. 2. Dry your hands with a clean towel or let them air dry. Session IV, Slide 3

How to Give the Injection: Steps 3 -5 3. If the skin around the injection site is dirty, clean the site with a cotton ball soaked in clean water. 4. Double-check the bottle for content, dose, and expiration date. 5. Roll the bottle gently between the palms of your hands. Session IV, Slide 4

How to Give the Injection: Steps 6– 9 6. Hold the bottle of DMPA or NET-EN and remove the plastic cap. 8. Insert the needle into the rubber cover and empty the entire contents into the syringe. 7. Open the sterile package containing the syringe and the needle (if necessary attach needle to syringe). 9. Hold the syringe upright and tap on the barrel to move the air into the tip. Expel the air from the syringe gently. Session IV, Slide 5

How to Give the Injection: Step 10 10. Locate the exact site to insert the needle. injection site edge of hip bone (pelvis) knobby part of arm the hip injection site knobby top part of long bone in leg crease at arm pit pelvic bone injection site X the upper arm upper outer quadrant sciatic nerve the buttock Session IV, Slide 6

How to Give the Injection: Step 11 11. Insert needle straight into the muscle. Syringe must enter the skin straight―not at an angle Hold the syringe like a dart. Use a dartlike motion to insert the needle. DMPA or NET-EN must be injected into the muscle Session IV, Slide 7

How to Give the Injection: Steps 12 -13 12. Inject DMPA or NET-EN, emptying all of the contents of the syringe, then pull the needle out of the muscle. 13. Gently press the injection site with a clean cotton ball or cloth. Instruct the client not to rub or massage the site. Session IV, Slide 8

How to Give the Injection: Steps 14 -15 14. Place the used syringe in 15. Wash hands again with a puncture-proof container. soap and water. Use great care to avoid a needle-stick injury to yourself or others. Session IV, Slide 9

Practice Safe Handling of Needles Do not re-cap the needle. Do not touch the needle. Do not leave the needle inside the vial. Do not dispose of used needles in anything other than a sharps container. Do not overfill the sharps container. Destroy full sharps container by burning or burying. Session IV, Slide 10

Caring for a Needle-Stick Injury • Wash injured area with soap and water as soon as possible. • Do not apply anything to the site. • Contact your supervisor. • Seek counseling and care at a health facility. Source: CDC, 2001. Session IV, Slide 11

Finding the Injection Site knobby part of arm injection site crease at arm pit Upper arm Session IV, Slide 12

Practice Finding the Injection Site injection site edge of hip bone (pelvis) injection site X sciatic nerve upper outer quadrant Hip knobby top part of long bone in leg Buttock Session IV, Slide 13

Using the DMPA Reinjection Job Aid Describe how the job aid helps you decide whether these women can receive their next injection. 1. Had initial injection on 15 Jan. Has returned for reinjection on 15 Mar. Mentions light bleeding and spotting but no other health problems. Wishes to continue DMPA. 2. Had her previous injection on 04 Feb. Has returned for reinjection on 01 Jun. Mentions minor complaints about feeling moody and bloated but no other health problems. Wishes to continue DMPA. 3. Had previous injection on 13 Jan. Has returned for reinjection on 03 Jun because her husband who has been gone the past month is due home. She would like to continue using DMPA. She has developed no other health problems since her previous injection. Session IV, Slide 14

Using the NET-EN Reinjection Job Aid Describe how the job aid helps you decide whether these women can receive their next injection. 1. Had initial injection on 15 Jan. Has returned for reinjection on 19 Feb. Mentions light bleeding and spotting but no other health problems. Wishes to continue NET-EN. 2. Had her previous injection on 04 Feb. Has returned for reinjection on 13 Apr. Mentions minor complaints about feeling moody and bloated but no other health problems. Wishes to continue NET-EN. 3. Had previous injection on 13 Jan. Has returned for reinjection on 16 Apr because her husband who has been gone the past month is due home. She would like to continue using NET-EN. She has developed no other health problems since her previous injection. Session IV, Slide 15