Some clients will 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 injection system (Sayana Press).
1. Discuss plan for storage and disposal
Storage. Discuss where the client can store the devices for many months that is 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 device in a container that has a lid and cannot be punctured and can be kept away from children. (Local programs should decide how to help women dispose of used needles.)
2. Explain and show how to self-inject. Show the device and describe its parts. (See picture in instructions, p. 84.) Give the client a copy of the instructions and pictures on the previous 2 pages, a similar instruction sheet, or a booklet of more detailed instructions. Explain the important steps.
Use an injection model to explain and 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. Or you can use fruit or bread.)
3. Ask the client to try it. After you have used the injection model to show self-injection, ask the client to practice injecting the model. Watch her and then discuss what went well and what did not. Answer her questions.
Invite the client to keep trying to inject 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. Then give her injection devices to take home so that she can inject herself in 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.
If she is unable to inject herself, give her the injection. When she returns for her next injection, ask if she wants to try self-injection again. If so, repeat the training.
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 getting more injection devices.
Note: The following instructions can be copied and given to a client.