Screening Checklists for Family Planning Services

Tools for Service Providers

Family Health International, 2008

See Also:

Modern contraceptive methods are generally safe and effective for use by the majority of women. However, depending on a woman's current or past medical conditions, a specific contraceptive method may or may not be appropriate for use. Research findings have generated epidemiological and clinical evidence demonstrating the suitability of various contraceptive methods for women with specific individual characteristics (e.g., age, history of pregnancy) or with a known pre-existing medical/pathological condition (e.g., diabetes, hypertension). Experts have reviewed and organized this scientific evidence, following a consensus-driven process coordinated by the World Health Organization (WHO). The result of their effort is a set of international family planning guidelines published by WHO entitled Medical Eligibility Criteria for Contraceptive Use. These guidelines allow providers to determine an individual's medical eligibility to initiate and continue to use various contraceptive methods.

With support from the U.S. Agency for International Development, Family Health International (FHI) has used the most recent version of these guidelines (2004, updated 2008) to develop a series of easy-to-use screening checklists to help both clinical and non-clinical providers determine if a woman is medically eligible to initiate use of any of four popular contraceptive methods: combined oral contraceptives (COCs), injectables (DMPA and NET-EN), the copper intrauterine device (IUD), and implants. A fifth checklist, entitled "How to Be Reasonably Sure a Client Is not Pregnant," enables providers to rule out pregnancy among nonmenstruating women seeking to initiate a contraceptive method at the time of their visit. These women may otherwise be denied contraception by providers who rely on the presence of menses as an indicator that a woman is not pregnant. The questions used to assess for pregnancy are embedded in the COC, DMPA, IUD, and Implant checklists. The Pregnancy Checklist can also be used to rule out pregnancy for other purposes (i.e., to avoid prescribing teratogenic drugs to pregnant women). The Pregnancy Checklist is also based on criteria established by the WHO to identify situations that effectively prevent a woman from getting pregnant. The checklists are available in various languages and may be accessed by clicking on any of the following links.

• Checklist for Clients Who Want to Initiate COCs
• Checklist for Clients Who Want to Initiate DMPA (or NET-EN)
• Checklist for Clients Who Want to Initiate Use of the Copper IUD
• Checklist for Clients Who Want to Initiate Use of Implants
• How to Be Reasonably Sure a Client Is Not Pregnant

Checklists Adapted to Country Settings

FHI and various partners have worked with the governments of several countries to adapt the screening checklists for consistency with their national family planning guidelines. The following country-adapted checklists have been endorsed by the respective Ministries of Health and are available by clicking the links below.

• Kenya Screening Checklists for Family Planning Services
• Uganda Screening Checklists for Family Planning Services

Training and Reference Guides: Application of Checklists in Service Delivery Practice

FHI has also developed a series of training and reference guides to accompany the checklists. The guides have been developed for program managers, administrators, trainers, and service providers interested in learning how to use the checklists when delivering family planning services. They are designed to serve as both training and reference tools. Each guide has two parts: a training module and a collection of essential, up-to-date reference materials on the method in question as well as on the validity, effectiveness, and use of the checklists. The training and reference guides are designed to be adapted locally, as needed.

Related Resources

• Combined Oral Contraceptives (COCs) FAQ
• Progestin-Only Injectables FAQ
• Intrauterine Devices (IUDs) FAQ
• Medical Barriers Often Unnecessary – Article from Network, FHI's scientific bulletin on family planning and reproductive health published from 1978 to 2007.

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