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Job aids for the reinjection of injectable contraceptives

2009 — FHI 360 and IntraHealth International field tested and co-branded several job aids designed to help health care providers better serve women who return for reinjections of the contraceptives depot-medroxyprogesterone acetate (DMPA) and norethisterone enantate (NET-EN). Research that FHI 360 conducted in South Africa, with support from the U.S. Agency for International Development, revealed that approximately half of injectable users were late for their reinjections, and a substantial portion of those who arrived within the approved grace period were denied a reinjection. A follow-on study in South Africa conducted by FHI 360 demonstrated that clinics where job aids for providers were introduced experienced much higher reinjection rates among clients than did control sites. The easy-to-use job aids were modified for a global audience after being field tested in Senegal.

The DMPA job aid reflects 2008 guidance from the World Health Organization regarding how many weeks late a woman can be for reinjection without risk of pregnancy — widely referred to as the extended grace period. The job aids describe the strategies that providers can use to rule out pregnancy for women who return outside of the recommended grace periods, so that those who are not pregnant can receive same-day reinjections. The job aids are available in English, French and Spanish. For versions of the job aids for clinicians, please see:

Simplified versions designed for use by community health workers (CHWs) who provide DMPA and NET-EN are also available. The CHW versions provide only one strategy — a pregnancy checklist — for ruling out pregnancy. The job aids for CHWs are available in English, French and Spanish. For versions of the job aids for CHWs, please see:

For job aids adapted to the policies and guidelines of specific countries, please see:

The reinjection job aids are meant to be companion pieces to the Checklist for Screening Clients Who Want to Initiate DMPA (or NET-EN), a simple provider tool designed to help screen clients who have made an informed decision to initiate DMPA or NET-EN.