This item is sold in packs of 20. This wheel contains the medical eligibility criteria for starting use of contraceptive methods. It is based on the Medical Eligibility Criteria for Contraceptive Use, Third Edition and its 2008 Update. This update of the MEC Wheel contains 25 new recommendations that tell family planning providers whether a woman presenting with a known medical or physical condition is able to use various contraceptive methods safely and effectively. Notable changes include no restrictions on the use of any method for women diagnosed with mild cirrhosis, chronic hepatitis or who are carriers of viral hepatitis. In addition, the updated wheel includes new guidance on drug interactions. Now, women who take anticonvulsants (except lamotrigine), who are on antiretroviral therapy (except ritonavir-boosted ARVs), or have a deep vein thrombosis and are taking anticoagulant therapy are generally able to use any contraceptive method. The wheel includes recommendations on initiating use of six common types of contraceptives: 1. Combined pills (low dose combined oral contraceptives) 2. Combined injectable contraceptives 3. Progestogen-only pills 4. Progestogen-only injectable, DMPA and NET-EN 5. Progestogen-only implants 6. Copper-bearing IUD.

Medical Eligibility Criteria for Contraceptive Use reviews the medical eligibility criteria for use of contraception, offering guidance on the safety and use of different methods for women and men with specific characteristics or known medical conditions. The recommendations are based on systematic reviews of available clinical and epidemiological research. It is a companion guideline to Selected Practice Recommendations for Contraceptive Use. Together, these documents are intended to be used by policy-makers, program managers, and the scientific community to support national programs in the preparation of service delivery guidelines. The fourth edition of this useful resource supersedes previous editions, and has been fully updated and expanded. It includes over 86 new recommendations and 165 updates to recommendations in the previous edition. Guidance for populations with special needs is now provided, and a new annex details evidence on drug interactions from concomitant use of antiretroviral therapies and hormonal contraceptives. To assist users familiar with the third edition, new and updated recommendations are highlighted. Everyone involved in providing family planning services and contraception should have the fourth edition of Medical Eligibility Criteria for Contraceptive Use at hand.

Family planning allows people to attain their desired number of children and determine the spacing of pregnancies. It is achieved through use of contraceptive methods and the treatment of infertility. Promotion of family planning--and ensuring access to preferred contraceptive methods for women and couples--is essential to securing the well-being and autonomy of women, while supporting the health and development of communities. Family planning / contraception is key to slowing unsustainable population growth and the resulting negative global impacts on the economy, environment, and national and regional development efforts. It follows therefore that safe contraceptive methods need to be available to as many women as possible, including those that have a pre-existing medical condition. WHO's Medical Eligibility Criteria for Contraceptive Use, which was first published in 1996, provides family planning providers with guidance on helping those living with medical conditions to find a contraceptive method that works for them. For each medical condition or medically relevant characteristic, contraceptive methods are placed into one of four numbered categories. Category 1. A condition for which there is no restriction for the use of the contraceptive method Category 2. A condition where the advantages of using the method generally outweigh the theoretical or proven risks Category 3. A condition where the theoretical or proven risks usually outweigh the advantages of using the method Category 4. A condition which represents an unacceptable health risk if the contraceptive method is used. This simple classification enables family planning providers to provide contraception safely to women (and men) who previously may have been excluded from methods because of a lack of clinical guidance.

This document is one of two evidence-based cornerstones of the World Health Organization's (WHO) new initiative to develop and implement evidence-based guidelines for family planning. The first cornerstone, the Medical eligibility criteria for contraceptive use (third edition) published in 2004, provides guidance for who can use contraceptive methods safely. This document, the Selected practice recommendations for contraceptive use (second edition), provides guidance for how to use contraceptive methods safely and effectively once they are deemed to be medically appropriate. The recommendations contained in this document are the product of a process that culminated in an expert Working Group meeting held at the World Health Organization, Geneva, 13-16 April 2004.

"This fifth edition of the MEC is divided into two parts. Part I describes how the recommendations were developed and Part II contains the recommendations and describes how to use them" -- page 5.

he starting point for this guideline is the point at which a woman has learnt that she is living with HIV and it therefore covers key issues for providing comprehensive sexual and reproductive health and rights-related services and support for women living with HIV. As women living with HIV face unique challenges and human rights violations related to their sexuality and reproduction within their families and communities as well as from the health-care institutions where they seek care particular emphasis is placed on the creation of an enabling environment to support more effective health interventions and better health outcomes. This guideline is meant to help countries to more effectively and efficiently plan develop and monitor programmes and services that promote gender equality and human rights and hence are more acceptable and appropriate for women living with HIV taking into account the national and local epidemiological context. It discusses implementation issues that health interventions and service delivery must address to achieve gender equality and support human rights.