Uganda adapts the WHO medical eligibility wheel for improved quality Family Planning care

Authors: Emily Atuhaire Barigye, Reproductive health

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The medical eligibility wheel is a simple tool recommended by the World Health Organization for use by family planning providers. The tool utilizes information on the woman’s health or medical condition to determine the most suitable option for contraception basing on scientific evidence.

Women desiring to prevent unintended pregnancy or short birth intervals are encouraged to use contraceptives. However, before initiating contraceptives, it is recommended that providers work with the individual clients to identify the most suitable method based on the individual requirements.

Until recently, the national family planning policy on contraceptive was not up to date on the criteria used by providers when handling different client needs. This impacts on the uptake of family planning services by women in cases where certain methods are not recommended. The incentive for using the medical eligibility criteria (MEC) is that it empowers both provider and client with necessary information thus building confidence in the quality of services rendered .

It is against this back ground that the Reproductive Health Division of the MoH embarked on the journey to adapt the 2015 WHO criteria for improved quality of care for family planning users. The Uganda MEC guidance is in advanced stage following a series of stakeholder meetings by the RH division and partners during which it was customized to suit the local needs.
How to use the tool: The wheel matches up contraceptive methods shown in the inner disk, with specific medical conditions or characteristics shown in the outer rim. The numbers in the viewing slot indicate whether the woman who has this known condition or characteristic is able to start use of the contraceptive method. Recommendations on the choice of contraceptive are grouped into 4 categories based on availability of clinical judgment as shown below.

Fig 2: Categories of contraceptive choices

The beauty with this wheel is that is empowers the average woman to make an informed decision on their choice of contraceptive without coercion. If implemented, the medical eligibility criteria will go a long way to build confidence and encourage uptake of Family planning methods by women.

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