New Reinjection Job Aids Available for Providers of DMPA and NET-EN

Family Health International (FHI) and IntraHealth International are pleased to announce the release of several new job aids for the reinjection of injectable contraceptives<http://www.fhi.org/en/RH/Pubs/servdelivery/reinjection_job_aids.htm>. These tools are designed to help clinicians and community health workers improve their services to women who return for reinjections of depot medroxyprogesterone acetate (DMPA) and norethisterone enantate (NET-EN).

Why is a Provider Tool Needed to Improve Continuation Rates?
Research conducted by FHI in South Africa<http://www.guttmacher.org/pubs/journals/3306607.html> revealed that over half of women returned late for their reinjections of DMPA and NET-EN, and providers turned away a substantial portion of these women-even those who arrived within the approved grace period. A follow-up study demonstrated that the introduction of reinjection job aids for providers led to much higher reinjection rates among clients in the intervention clinics compared to the control sites.

New Reinjection Job Aids for Clinicians and Community Health Workers
The DMPA job aid reflects 2008 guidance from the World Health Organization (WHO) regarding how late a woman can be for reinjection without there being a risk of pregnancy-widely referred to as the extended grace period<http://www.fhi.org/en/RH/Pubs/Briefs/HC/DMPA_reinjection_window.htm>. Both the DMPA and NET-EN job aids describe the strategies that clinicians can use to rule out pregnancy among women who return outside of the recommended grace periods, so that those who are not pregnant can receive same-day reinjections. Simplified versions designed for use by community health workers (CHWs) are also available; the CHW versions provide only one strategy-a pregnancy checklist-for ruling out pregnancy. The job aids are available on FHI's website in English, French, and Spanish:

*       English DMPA for clinicians<http://www.fhi.org/NR/rdonlyres/emtmdnhdnf6kce7pziqcx5gd62tsr7tpbcsdtharbplxouhv63mgel7vthlctwueyyd4ilxs435hjn/DMPAreinjectionclinicians1.pdf> (PDF, 294 KB)
*       English NET-EN for clinicians<http://www.fhi.org/NR/rdonlyres/eldemegzegljbxlcga6wzlylgwiz6emwh5n4x6e62yneler4ubdqburtj7e5bbh5p5dgznlxcpuygm/NETENreinjectionclinicians.pdf> (PDF, 289 KB)
*       Spanish DMPA for clinicians<http://www.fhi.org/NR/rdonlyres/egtgwmwssxovma6djjt3aey5xdtsn5otuuorf5shl7eqb3l5updz4cob2nmio3zv42zs7zdelkhf5m/DMPAreinjectioncliniciansSpa.pdf> (PDF, 296 KB)
*       Spanish NET-EN for clinicians<http://www.fhi.org/NR/rdonlyres/edynkivo2n5j7rj3o25pqd2akfqz4jdkmdrzz3pxtf2c5k4pglo3gosiyl2do4hi3enkh7fn76ijcm/NETENreinjectioncliniciansSpa.pdf> (PDF, 290 KB)
*       French DMPA for clinicians<http://www.fhi.org/NR/rdonlyres/e3t3s7p5a4oeail4ifo43t4yqbmoyng2ut72oirf56xyrqhevzdchgy6f7q4sxhdxzojctsnzqqagl/DMPAreinjectioncliniciansFre1.pdf> (PDF, 374 KB)
*       French NET-EN for clinicians<http://www.fhi.org/NR/rdonlyres/eitase6nte3nsj5byze4wo44nvnqldotskh7adcl2zfphnvjsgkej2ekhqzeawj6ipmy4cpuhlkjbn/NETENreinjectioncliniciansFre1.pdf> (PDF, 372 KB)

*       English DMPA for CHWs<http://www.fhi.org/NR/rdonlyres/eteurljiytw34l6pjywplssnzwkgcxghyjrzviueiik2ahxh2estgpww3iqyd7d2yz6n3o6q4amrrb/DMPAreinjectionCHWs.pdf> (PDF, 289 KB)
*       English NET-EN for CHWs<http://www.fhi.org/NR/rdonlyres/elx2e7ugru7szqmp2z6onygdf57fs3iokaropvubgr6r6l4x5jwqsmcatt75bmc7uw32yxxmpikbom/NETENreinjectionCHWs.pdf> (PDF, 284 KB)
*       Spanish DMPA for CHWs<http://www.fhi.org/NR/rdonlyres/ekynuelsrwc7bj4h4rvvno7wfqw2ike6u766sn7zayx3esgx7l3mlptmrlizbkbrgdfhywo5mwxpre/DMPAreinjectionCHWsSpa.pdf> (PDF, 291 KB)
*       Spanish NET-EN for CHWs<http://www.fhi.org/NR/rdonlyres/e4mnmnnd3h4pe4dwcut744rupk7clqh2jkn3qxlr7bo6shcoyf2uydzj53mg6pp3tq6se4bwrkrcid/NETENreinjectionCHWsSpa.pdf> (PDF, 287 KB)

The French CHW versions will be available within the next few months. Printed copies of the English versions for clinicians (DMPA and NET-EN) are available at no cost to organizations and libraries working in developing countries. Please email your request to [log in to unmask]<mailto:[log in to unmask]>. CHW versions are only available online.

Family Planning Screening Checklists
The reinjection job aids are meant to be companion pieces to the Checklist for Screening Clients Who Want to Initiate DMPA (or NET-EN)<http://www.fhi.org/en/RH/Pubs/servdelivery/checklists/dmpachecklists/index.htm>, a simple provider tool designed to help screen clients who have made an informed decision to initiate use of DMPA or NET-EN. FHI recently released updated versions of all of the Family Planning Screening Checklists<http://www.fhi.org/en/RH/Pubs/servdelivery/checklists/index.htm> and the accompanying Training and Reference Guides for Family Planning Screening Checklists<http://www.fhi.org/en/RH/Pubs/servdelivery/checklists/Guides.htm>.

David Hock
Family Health International
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