STANDARD

OPERATING PROCEDURE
FOR PACKAGING OF STERILE INJECTING KITS
CHAMPION-IDU
PSI THAILAND

This document is meant to provide clear and simple instructions to drop-in center
staff in the preparation of safe injecting kits under the CHAMPION-IDU project. The
guidelines herein should be followed at all project sites.

This document contains the following sections:
! Objectives
! Commodities
! Equipment
! Eligibility
! Steps
! M&E
! Payment

OBJECTIVES
The new packing arrangements have been developed by PSI for several reasons that
are explicated below:

! Meaningful participation: The meaningful participation of members of the
project client group is considered best practice by many international
agencies and peer-led groups across the world. PSI therefore is keen on
following such recommendations to increase meaningful participation of
people who inject drugs by developing mechanisms through which people
who inject drugs can contribute to the success of the CHAMPION-IDU project.
By encouraging clients to undertake packing activities at drop-in center level,
PSI and its partners will be creating opportunities for empowerment of the
client group.
! Education: Beyond meaningful participation and empowerment, the packing
process will provide additional opportunities to give information, education
and training to clients. In particular, all packing activities will be preceded by
a short training on hand washing and sterilization. This will directly
contribute to IDUs understanding of what sterile injecting equipment is, why
such equipment is needed, why it is so important in terms of health
promotion and how that is linked to HIV prevention. Clients involved in the
packing should be able to explain the what defines sterile.
! Supporting PWID: By providing a stipend to clients of the CHAMPION-IDU
project, PSI will encourage clients to gain a bit of work experience thereby
contributing to the overarching project objective of improving the quality of
life of people who use drugs.
! Promotion: Finally, conducting the packing process at DIC level should
contribute to the promotion of the CHAMPION-IDU project. With this
opportunity, new IDUs can be reached and stimulated to join activities
beyond the packing at the DIC or later through outreach.

COMMODITIES

The CHAMPION-IDU safe injecting kit should always contain the following items:
! 5x needles
! 5x syringes
! 5x vials of sterile water
! 5x cotton balls
! 5x filters
! 5x alcohol swabs

In addition, at the discretion of the DIC manager, additional items can be included in
the kit:
! condoms
! spoons
! tourniquets

All items should be packed into the designated CHAMPION-IDU plastic bag
depending on the size of the needle/syringe used:
! Orange bag: #27 needle, 1ml syringe, detachable
! Black bag: #27 needle, 1ml syringe, non-detachable
! Blue bag: #25 needle, 1ml syringe
! Green bag: #25 needle, 3ml syringe

Note that bags with the small filters should be punched in the lip to easily identify
bags with different filter types.

EQUIPMENT

In order to ensure that items in the kit remain sterile, the following equipment has
been provided to you. The equipment below is absolutely necessary to properly
pack all items into the bags.

Mask (box, 50 pcs)

Latex gloves (box, 100 pcs) Tweezers (unit,

stainless steel)

Tweezers holder Medicine counting table
(unit, stainless steel)
(unit, stainless steel)

Flip chart paper

Small plastic bags

Soap (bottle, 500ml)

Alcohol (bottle, 500ml)

ELIGIBILITY

The packaging process is designed to provide opportunities for clients of the
CHAMPION-IDU project to become more familiar with the CHAMPION-IDU project
and to attract clients to the drop-in center. As such, it is recommended that priority
be given to IDUs to conduct the packing.

Approximately two weeks before the packing begins, DIC managers should make an
announcement to all clients (through posters at the DIC and outreach workers)
about recruitment opportunities to pack safe injecting kits. All clients interested in
participating in the process should write their names on a piece of paper and put
their names in a box. A few days before packing begins, the DIC manager (with at
least one witness) should draw the names to make a list of selected clients to handle
the packing activity.

In the case that not enough clients can be recruited for the packing, it is
recommended to invite the partners of clients who have submitted their names.
This will provide opportunities for each site to work more closely with partners of
IDUs and sensitize them to the services offered by the project.

A small compensation will be provided to clients who conduct the packing (see
Payment section below). Please note that outreach workers (field staff and
volunteers) will not be compensated for packing safe injecting kits payment will
only be provided to clients and their partners (see PAYMENT section below).

STEPS

Below is a detailed process for each step of the packing activity. Note that during the
packing, at least one staff should oversee the process at the DIC. In addition, it is
recommended that all peer educators participate at least once in the training and
provide assistance in the packing process supervision.

Training
! Prior to starting the packing, it is required that selected clients doing the
packing undergo a short training session to clarify all the steps in the
process. The training should be delivered by a person assigned by the DIC
manager. The training should not be longer than 2 hours.

Setting up the work space

1. Select the area where the

packing will take place. You will
need enough space for people

to sit comfortably and spread
the commodities for packing so
they are accessible by all
packers. Once the space has
been selected, the area should
be cleaned (broom, soap).
2. Once the area is clean, spread a
number of flip chart papers to
cover the area. Spread all the
commodities on top of the flip

chart paper.
3. Place the tweezers holder for
easy access.

Keeping things clean

1. Before inserting commodities

into the CHAMPION-IDU bags, it
is important to ensure that
items do not get contaminated
before they are inserted into
the bag. As such, it is important
for all packers to wash their
hands thoroughly (see poster).

2. Once hands are washed, put on

a pair of latex gloves. Be careful
not to touch anything before
starting to pack!

3. Slip on a mask to cover your

nose and mouth.

4. Disinfect the tweezers with the

alcohol and place them in the
holder.

Packing needles and syringes

1. Needles and syringes will be
delivered at the DIC separately.
Needles and syringes come in
boxes of 100 pieces. Each
injecting kit should contain 5
needles and 5 syringes.
2. Open the boxes containing the
needles and the syringes.
3. Use your hands to pick strips of
5 units and place them in the
CHAMPION-IDU bag.
4. Ensure that the needle/syringe
size corresponds to the right
bag. As a reminder:
a. Orange bag: #27 needle,
1ml syringe, detachable
b. Black bag: #27 needle,
1ml syringe, non-
detachable
c. Blue bag: #25 needle,
1ml syringe
d. Green bag: #25 needle,
3ml syringe

Packing sterile water

1. Sterile water will be delivered
at the DIC in large boxes
containing smaller boxes. Each
small box will contain 50 pieces.
2. Open the boxes containing the
sterile water.
3. Pick strips of 5 units of sterile
water and place them in the
CHAMPION-IDU bag.

Packing cotton balls
1. Cotton balls will come to the
DIC in a large box containing
200 small packs of 5 units of
cotton balls.
2. Open the box containing the
cotton balls.
3. Pick each small pack of 5 units
and place the pack in the
CHAMPION-IDU bag.

Packing alcohol swabs

1. Alcohol swabs will come to the
DIC in a box containing 200
units of alcohol swabs.
2. Open the box containing the
alcohol swabs.
3. Pick each small unit of alcohol
swabs and place the 5 units in
the CHAMPION-IDU bag.
Packing filters

1. CHAMPION-IDU provides
clients with two different
options for filters. One of the
filters will come in a box
containing six plastic bottles
(each bottle contains ~600
pieces). The other filter will
come in a bag containing 10,000

2.
3.

4.

5.
6.

pieces (Apothicom).
Open the bottles and bags
containing the filters.
Using the tweezers, place a
quantity of filters on the
stainless steel medicine
counting table. Be careful not to
mix the two different type of
filters!
Use the tweezers to count 5
units of filters and place them
into a small plastic bag. Seal the
small plastic bag.
Place the small plastic bag in
the CHAMPION-IDU bag.
For CHAMPION-IDU bags
containing Apothicom filters,
punch a hole in the lip of the
bag for easy identification.

In addition, at the discretion of the DIC
manager, additional items can be
included in the kit:
! condoms
! spoons
! tourniquets

PLEASE USE THE TWEEZERS TO GRAB EQUIPMENT. IF YOU TAKE A BREAK, LEAVE
YOUR TWEEZERS IN THE HOLDER. WHEN YOU ARE READY TO START AGAIN, GO
BACK TO THE KEEPING THINGS CLEAN SECTION AND FOLLOW THE
INSTRUCTIONS.

MONITORING AND EVALUATION

The form below will allow you to record the number of kits prepared by each
person. It is critical that DIC managers record the number of packs onto the M&E
form before storing and distribution. All forms should be collected by the DIC
manager, scanned and sent to the PSI M&E Officer.

1. Note the date in the first column.
2. Use the form to record the name/UIC number for each client.
3. Indicate the number of kits prepared for each needle/syringe size.
a. A DIC staff should always double check the final count before
finalizing payment.
4. Note the date that the client received the financial incentive for packing.
5. Once the client has received the funds, it is important that he/she signs the
form.
6. Once the client has signed the form, the Admin/Finance officer should co-
sign to confirm that payment has been delivered.

PAYMENT

This section clearly defines the terms and conditions of payment of the client
stipend for packing safe injecting kits in the context of the CHAMPION-IDU project.

As noted in the ELLIGIBILITY section above, it should be clear that only clients (and
their partners) should be allowed to receive project funds for conducting the
packing activities at DIC level CHAMPION-IDU peer outreach workers and staff are
not eligible to receive project funds for packing safe injecting kits.

Payment to clients can only be provided under the conditions listed below:
! The client has been recruited by the CHAMPION-IDU team;
! The client has accurately filled out the M&E form (see M&E section above);
! The Admin/Finance Officer has verified and signed the form and double
checked the quantity of safe injecting kits prepared;
! A CHAMPION-IDU staff supervised the packing process.

The terms of payment are as follows:
! For each kit packed, the client will be provided THB 2.5;
! Each client can claim a maximum of THB 250 per day (maximum of 100
bags);
! The funds should be paid directly to the client in cash;
! The Admin/Finance Officer signs the form to confirm receipt of the funds by
the client.