WHO’s Family Planning
Guidance Documents and
Job Aids
Slide 1
Objectives
At the end of this session, participants will be able
to:
Explain the purpose and intended use of WHO’s
guidelines and job aids:
• Medical Eligibility Criteria for Contraceptive Use
(MEC) including job aids
• Selected Practice Recommendations for
Contraceptive Use (SPR)
• Family Planning: A Global Handbook for
Providers
Slide 2
Medical Eligibility Criteria for
Contraceptive Use
• Evidence-based
recommendations
• Use by policy-makers and
program managers to improve
access to, and quality of,
family planning services
• 19 contraceptive methods
• Variety of medical conditions
and client characteristics
• Periodic reviews and updates
Slide 3
Selected Practice Recommendations
for Contraceptive Use
• Evidence-based recommendations
on safe and effective use
• 33 questions related to
contraceptive methods
• Range of issues including initiation,
continuation, incorrect use,
treatment of side effects, and
some programmatic issues
• Use by policy-makers and program
managers
• Periodic reviews and updates;
latest update 2008
Slide 4
Family Planning:
A Global Handbook for Providers
• Essentials needed to provide
family planning clients with
good-quality care
• Latest guidance for delivering
19 contraceptive methods
appropriately and effectively
• Use by clinical providers
• Periodic reviews and updates;
latest update 2011
Slide 5
WHO’s Medical Eligibility Criteria
Categories for IUDs, Hormonal and Barrier Methods
Category
Description
When clinical
judgment is
available
1
No restriction for
use
Use the method under
any circumstances
2
Benefits generally
outweigh risks
Generally use the
method
3
Risks usually
outweigh benefits
Use of method not
usually recommended,
unless other methods
are not
available/acceptable
4
Unacceptable
health risk
Method not to be used
Source: WHO, 2010.
Slide 6
WHO’s Medical Eligibility Criteria
Categories for IUDs, Hormonal and Barrier Methods
Category
When clinical judgment
is limited
1
Use the method
2
3
Do not use the method
4
Source: WHO, 2010.
Slide 7
Categories for IUDs, Hormonal and Barrier Methods
Medical Eligibility Criteria: Examples
Medical Condition/
Characteristic
Contraceptive
Method
Category
Uterine fibroids
COCs
1
Anemia
Copper IUD
2
Blood pressure
≥160/100 mm Hg
DMPA
3
Current
breast cancer
Hormonal implants
4
Source: WHO, 2010.
Slide 8
WHO’s Medical Eligibility Criteria
Categories for Male and Female Sterilization
Category
Definition
Accept
No medical reason to deny method
Caution
Provide with extra precautions
Delay
Delay until condition is evaluated
Special
Requires specialized equipment,
experienced surgeon and staff
Source: WHO, 2010.
Slide 9
Medical Eligibility Criteria for Male
or Female Sterilization: Examples
Category
Conditions
Accept
Have few or no children
Caution
Diabetes
Delay
Active STIs (e.g., chlamydia or
gonorrhea)
Special
Coagulation disorders
Source: WHO, 2010.
Slide 10
WHO’s Medical Eligibility Criteria
Categories for Fertility Awareness-based Methods
Category
Definition
Accept
No medical reason to deny method
Caution
Provide with extra precautions
(e.g., special counseling)
Delay
Delay until condition is evaluated
NA
Not applicable
Source: WHO, 2010.
Slide 11
Medical Eligibility Criteria for
FAB Methods: Examples
Category
Conditions
Accept
Non-breastfeeding ≥ 4 weeks postpartum can use symptoms method
Caution
Life stages (post-menarche and
peri-menopause)
Delay
Breastfeeding < 6 weeks postpartum
NA
Pregnancy
Source: WHO, 2010.
Slide 12
MEC Wheel
Includes COCs,
POPs, DMPA,
NET-EN,
implants, and
copper IUDs
Slide 13
MEC Quick Reference Chart
Includes all
category 3 & 4
conditions for
COCs, DMPA,
IUDs, and
implants
Slide 14