Service Delivery

Mary Phiri, a community health worker (CHW), administers Depo Provera to her client, Josephine Tembo, outside Mary’s home in Mandombe Village, Luangwa District, Zambia. © 2012 Leigh Wynne/FHI 360, Courtesy of PhotoshareEnsuring high-quality services is vital to any family planning program that provides injectable contraceptives. A client considering starting a new contraceptive method needs to be informed of the most appropriate contraceptive options and then carefully screened to ensure she is medically eligible to use her chosen method. Injectable contraceptives are safe and suitable for nearly all women, including women who have or have not had children; married and unmarried women; and women of any age, including adolescents and women over 40 years old.
If a woman chooses injectables, her health care provider needs to counsel her about potential side effects and provide strategies to help her continue using the method effectively. For example, providers must be able to carefully explain the grace period before and after a woman’s scheduled reinjection date during which she can receive a reinjection and remain protected from unintended pregnancy. Counseling women about possible bleeding changes and other side effects of injectables is an important part of providing the method. Bleeding changes are among the most common method-related reasons for women discontinuing hormonal contraceptive methods. In addition to determining medical eligibility and counseling clients on injectables, service providers must also know how to give injections safely and how to properly store and manage injectables.
The Service Delivery section of the Injectables Toolkit houses counseling tools, job aids, and reference materials to help service providers perform the following tasks well:
  • Counsel clients on a range of contraceptive options.
  • Screen clients to determine whether they are medically eligible to use injectable contraceptives.
  • Counter myths and misinformation about injectables with effective and accurate counseling messages.
  • Instruct clients on the importance of returning on time for reinjections and on what to do if they miss their scheduled reinjection appointment.
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