This DMPA-SC Advocacy Pack brief details the strong body of evidence and experience with self-injection of DMPA-SC, including how the practice can reduce access-related barriers, improve contraceptive continuation, and enhance women’s autonomy.

Developed by the PSI Delivering Innovation in Self-Care (DISC) project, this training package is intended to guide ministries of health, family planning/reproductive health projects, and any implementing organization that is interested in integrating an empathy-based approach to improve health providers’ quality of care.

The training content addresses risks of preventable client “drop-off” during the initiation stage of women’s self-injection journey by using empathetic counseling to instill client confidence and address common concerns such as fear of the needle. In addition to supporting providers’ service delivery, the training modules can support improved health system functioning by putting the client’s experience front and center and by bringing more structure and guidance to the supportive supervision process, enabling providers to build their competencies after the training sessions.

For more information on integrating this training curriculum in your family planning program, please contact the PSI DISC project at disc.info@psi.org.

An in-depth look at DMPA-SC and self-injection introduction in Zambia

The DMPA-SC Access Collaborative (AC) hosted this virtual discussion on February 16, 2023 to explore the challenges of introducing new contraceptive methods in the context of informed choice programming. This webinar focused on findings from a recent study conducted in Zambia which aimed to determine:

• The barriers to clients’ ability to exercise autonomy in their choice of family planning methods and modes of administration.
• The extent to which provider perceptions and method bias affect access to self-injection as a new contraceptive option.

This research was conducted as part of the AC’s broader learning agenda and focused on the potential risks to informed choice that could arise as new products or service innovations are integrated in family planning programs. While a new intervention is intended to expand contraceptive access and options, its introduction may inadvertently convey to providers that it is inherently better than existing products or practices. In the case of DMPA-SC, providers may promote self-injection over provider administration. Alternatively, providers may feel hesitant about a new method and withhold information. In either case, the client’s right to receive accurate information about a variety of methods and to make an informed choice about her reproductive health care is compromised. To explore these questions, the AC conducted a literature review and study interviewing both clients and providers to understand how DMPA-SC and self-injection are being offered in Zambia’s Copperbelt Province.

The global family planning handbook provides high-quality, up-to-date guidance for health care professionals working in low- and middle-income countries. “Chapter 4: Progestin-Only Injectables” includes information and guidance for DMPA-SC administration and self-injection.

The Training Resource Package (TRP) for Family Planning’s Progestin-Only Injectable module includes sessions V and VI which are focused on DMPA-SC and self-injection, as well as a number of related handouts and resources. Developed in partnership with the Access Collaborative, these materials are intended for training health care providers who offer progestin-only injectable contraception (“injectables”) in the public or private sector.

The TRP website features training information and materials for a wide range of family planning methods. This includes curriculum components and tools for trainers to design, implement, and evaluate family planning and reproductive health training.

Supportive supervision plays a critical role to ensure high-performing health workers have the appropriate knowledge, skills, and motivation in order to deliver quality family planning (FP) services and informed choice counseling. This package includes three supportive supervision tools that can be used by regional or district health teams when conducting supervision visits at health facilities that offer FP services:

1. Supportive supervision checklist to assess provision of family planning counseling
2. Observation checklist to assess health workers counseling clients on DMPA-SC self-injection
3. Remote supervision of family planning providers (includes family planning and self-injection)

Tools #1 and #2 can be used together or separately, depending on whether or not the supervision visits include follow-up with providers recently trained to counsel clients on DMPA-SC self-injection.

Tool #3 is intended for use in situations where in-person supervision is not possible; the supervision exercise can be conducted through phone or video. This tool includes guidance and instructions for supervisors who plan to conduct supervision remotely.

The tools are intended to serve as guides and can be adapted for specific settings as needed. For more information, contact FPoptions@path.org.

This instruction sheet is intended for health care providers who are learning to administer DMPA-SC.

This brief lists key references and resources from the evidence base on DMPA-SC. Pair this with the Evidence at-a-glance brief if your target decision-maker would like to have access to the data in that handout.

These short training videos are intended for both self-injection clients and health workers learning to administer the contraceptive DMPA-SC. The 5-minute self-injection video provides instructions for women who have made the decision to self-inject DMPA-SC in the context of informed choice counseling. The 7-minute training video is for health workers who are administering DMPA-SC injections to women. Both are available in English, French, Portuguese, and Spanish at the links below.

If you are interested in customizing these videos for your family planning program, we can make the voiceover scripts and video files available. For more information, please email FPoptions@path.org.

This 32-page publication outlines the GATHER model of family planning counseling, which has been successfully used for nearly two decades and is based on the elements described including tips, illustrations, techniques, technical information, and charts.