Self-Injection Can Be an Option

Women can learn to inject themselves with the subcutaneous formulation of DMPA (DMPA-SC). Some women like self-injection better than injections by health workers. Self-injection may save women time and money. WHO recommends making self-administration of injectable contraception available as an additional approach to deliver injectable contraception to individuals of reproductive age.

Teaching Clients to Self-Inject

For clients who want to give themselves the injections, you can teach them how to do this. The following steps apply to self-injection with DMPA-SC in the Uniject device (marketed as Sayana Press).

1. Discuss the plan for storage and disposal.

Storage. Discuss where the client can safely store the devices for many months. They should be kept out of the reach of children and animals and in moderate temperatures (not in direct sunlight or in a refrigerator).

Disposal. Discuss how the client can dispose of the devices in a container that has a lid and cannot be punctured and which can be kept away from children. (Local programs should decide how to help women dispose of used needles.)

2. Explain and show the client how to self-inject. Show the client the device and describe its parts. (See pictures in the instructions, on the next pages.) Give her a copy of the instructions and pictures provided below, a similar instruction sheet, or a booklet of more detailed instructions. Explain the important steps. Use a sample injection device and an injection model (instead of a human limb) to show the client how to do each step while helping the client follow along on the instruction sheet. (If an injection model is not available, you can use a condom filled with salt or sugar. Alternatively, you can use fruit or bread.)

Try injection on model

3. Ask the client to try it. After you have demonstrated the steps of self-injection, ask the client to practice on the injection model with a Uniject device. Watch her and then discuss what went well and what did not. Answer her questions, and invite the client to keep practicing on the model until she can do all the steps correctly and feels ready to inject herself.

4. Ask the woman to inject herself while you are watching. When she has successfully done this, give her injection devices to take home so that she can inject herself every 3 months into the future. Make sure that she understands when her future injection dates are, and how to calculate those dates by noting the same day of the month every 3 months.

5. Tell the client where to get more injection devices. Invite her to contact you if she has any questions or problems with self-injection or with getting more injection devices.