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a) The training should include:
- counseling of potential acceptors (including the fact that some removals may be difficult and may require more than one removal procedure),
- counseling that removal should be entirely voluntary and at the option of the client,
- infection prevention measures, and
- techniques for inserting and removing implants (with an emphasis on removal training).
Those programs that focus on removal training and correct insertion training should experience less difficulty in performing removals. Training programs require practical, hands-on experience in insertion and removal techniques, and use of models for practice before working with clients is advisable.
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a) Training in counseling is just as important as technical training for providers who supply NORPLANT® Implants. Counseling training should help providers to effectively communicate the advantages and disadvantages of the method, possible side effects, the length of protection provided, the procedures for insertion and removal, reasons to return to the clinic, and information on follow-up care.
Insertion and removal of NORPLANT® Implants are minor surgical procedures. Therefore, all centers inserting and removing NORPLANT® Implants need to follow basic infection prevention measures. Insertion and removal are relatively easy to learn, but formal training is needed to minimize the potential for difficult removals that may result from poor insertion techniques. An emphasis on removal training allows providers to understand the relationship between good insertion placement and ease of implant removal. Providers who have mastered insertion and removal skills on models before working with clients achieve competency in a shorter time.
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b) Doctors, nurses, midwives, paramedics, and other health workers can perform insertion (including immediate postpartum and postabortion insertion) and removal procedures provided they are appropriately trained.
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b) Any specially trained doctor, nurse, midwife, or other health worker can perf orm NORPLANT® Implants insertions and removals.
- Statement on NORPLANT® subdermal contraceptive implant system. IPPF Medical Bulletin 1995;29(5).
- McIntosh N, Blouse A, Schaefer L, editors. NORPLANT® Implants Guidelines for Family Planning Service Providers, second edition. Baltimore: JHPIEGO Corporation, 1995.
- NORPLANT® Levonorgestrel Implants: a summary of scientific data. New York: The Population Council, 1990.
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