Implants can be used by almost all women of reproductive age. This brief outlines the World Health Organization's Medical Eligibility Criteria for who can (categories 1 and 2) and cannot (categories 3 and 4) use implants.

This wheel contains the medical eligibility criteria for starting use of contraceptive methods. It is based on the Medical Eligibility Criteria for Contraceptive Use, 3rd 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.

Family Health International (FHI) developed a simple checklist to help health care providers screen clients who have been counseled about contraceptive options and who have made an informed decision to use implants. FHI’s Implant Checklist is based on recommendations included in the Medical Eligibility Criteria for Contraceptive Use (WHO, 2004; updated 2008).

The Pregnancy Checklist contains a series of questions to rule out pregnancy. These questions, based on criteria established by the World Health Organization (WHO) for determining with reasonable certainty that a woman is not pregnant, are also included in the COC, DMPA, IUD, and implant checklists, eliminating the need to use two separate checklists.

The World Health Organization (WHO) develops detailed criteria that health care workers can follow to determine which contraceptive methods are medically suitable for their clients. These criteria are based on the most current scientific knowledge about the effectiveness, risks, and benefits of various family planning methods, and they can help providers guide their clients in making safe and informed decisions. The WHO recently revised the criteria in response to recommendations made by an expert working group who met in Geneva, Switzerland, in April 2008.

With proper counseling, many young women who plan to use oral contraceptives or DMPA will opt for implants instead. A prospective cohort study is exploring the acceptability and effectiveness of contraceptive implants among young women (18 to 24 years old) in Nairobi, Kenya. Results observed in the first six months suggest that young women who plan to use oral contraceptives or injectables will often choose implants if they are properly counseled on the relative merits of different contraceptive methods.

The Balanced Counseling Strategy (BCS) is a practical, interactive, client-friendly counseling strategy that uses three key job aids (visual memory aids) for counseling clients about family planning. The process, tested and refined in several countries, involves a set of steps to determine the method that best suits the client according to her/his preferences and reproductive health intentions. 

The information in this document is compiled from the Contraceptive Myths and Counseling Messages Database. It provides evidence-based information and counseling messages that providers around the world have used to dispel commonly-held contraceptive myths and misperceptions. Health care professionals can use this resource to correct misinformation and support informed decisions by helping clients understand the facts on how contraceptive methods work, on who can use them, their possible side effects, and much more.

During counseling, family planning providers can ensure that women interested in implants understand their effectiveness and side effects, are assured of their safety, and know how they are used. Providers can use the information in this table to inform women about implants and help them make decisions.

A client who has chosen implants needs to know what will happen during insertion and removal procedures. Explaning the following important steps in the procedures tells the client what to expect.

Providers, clients, and programs all have a role to play in ensuring good client-provider interaction. This brief provides an overview of what these three audiences can do to support good client-provider interaction.

This flipchart is a decision-making aid for clients, a job-aid and reference manual for providers; and a training resource. With one page for the client and a corresponding page for providers, it has helpful pictures, key points and detailed reference information covering 14 family planning methods. It includes medical eligibility criteria, side-effects, when to start and how to use each method.

This resource helps to visualize the length of Jadelle contraceptive implants.

This announcement from the U.S. Agency for International Development (USAID) provides guidance about safe disposal of the new disposable trocar for Jadelle.

These flipcharts for providers gives illustrations and instructions for the insertion of Jadelle contraceptive implants. The 'detailed' flipchart includes images and detailed instructions for each step. The 'simple' flipchart includes larger images with less text. Jadelle is now provided with a disposable trocar that is sharp enough to penetrate the skin directly. Thus the disposable trocar can be used to puncture the skin and insert the rods, without the need for an incision.

These one-page posters or flyers include photos and short instructions on how to insert and remove Jadelle implants. They are intended as a training tool to help providers who are being trained to insert and remove Jadelle implants remember the steps. They can also be used as a job aid for providers who have already been trained to insert and remove Jadelle implants. 

Although insertion and removal of implants are minor surgical procedures, careful infection prevention procedures must be followed with every client. Infection prevention during insertion and removal involves aseptic technique (performing the procedures under sterile conditions). Proper infection prevention procedures minimize the chances of blood-borne infections such as HIV and hepatitis B and of infections at the insertion site. Infection at the insertion site may require early removal or cause spontaneous expulsion of implants.

Learning to insert and remove implants requires training and practice under direct supervision. Therefore, the following illustrations and description serve as a summary and not detailed instructions for providers. The instructions apply after providing anesthetic.

Infection Prevention: A Reference Booklet for Health Care Providers is a quick desk reference on important infection prevention (IP) topics: handwashing, gloving, aseptic technique, use and disposal of sharps, instrument processing, housekeeping, and waste disposal. Designed for use by a wide range of health care workers in low-resource settings, this comprehensive booklet introduces the importance of good IP practices and provides step-by-step instructions for performing critical IP procedures.

Implants users do not need any routine follow-up visits until it is time to remove the implants. However, every client should be assured that she is welcome to return at any time—for example, if she has questions, problems or want another method; has a major change in health status; or thinks she might be pregnant. This brief provides information about follow-up for users of hormonal implants and how to help continuing implants users use their method successfully.

Providers can follow simple approaches to manage side effects of implants. This involves informing women about what side effects to expect, providing reassurance that common side effects such as bleeding changes are not harmful, and encouraging women to return whenever they have questions or concerns. Brief, clear descriptions of the most common side effects—before the implants are inserted—reduces complaints and makes management easier. Counseling about bleeding changes may be the most important help a woman needs to keep using the method.