Checklist for Screening Clients Who Want to Initiate DMPA (or NET-EN), part b

	Injectable Contraceptives: Tools for Providers
December 2006 Issue No. 8	The INFO Project • Johns Hopkins Bloomberg School of Public Health • Center for Communication Programs • 111 Market Place, Suite 310 • Baltimore, Maryland 21202, USA • 410-659-6300 • 410-659-6266 (fax) • www.infoforhealth.org • infoproject@jhuccp.org

PDF version of the INFO Reports, December 2006, Number 8, Injectable Contraceptives: Tools for Providers

Checklist for Screening Clients
Who Want to Initiate DMPA (or NET-EN)

To determine if the client is medically eligible to use DMPA, ask questions 1–7. As soon as the client answers YES to any question, stop, and follow the instructions below.

NO	1. Have you ever had a stroke, blood clot in your legs or lungs, or heart attack?	YES
NO	2. Have you ever been told you have breast cancer?	YES
NO	3. Do you have a serious liver disease or jaundice (yellow skin or eyes)?	YES
NO	4. Have you ever been told you have diabetes (high sugar in your blood)?	YES
NO	5. Have you ever been told you have high blood pressure?	YES
NO	6. Do you have bleeding between menstrual periods, which is unusual for you, or bleeding after intercourse (sex)?	YES
NO	7. Are you currently breastfeeding a baby less than 6 weeks old?	YES

If the client answered NO to all of questions 1–7, the client can use DMPA. Proceed to questions 8–13.

If the client answered YES to any of questions 1–3, she is not a good candidate for DMPA. Counsel about other available methods or refer.

If the client answered YES to any of questions 4–6, DMPA cannot be initiated without further evaluation. Evaluate or refer as appropriate, and give condoms to use in the meantime. See explanations for more instructions.

If the client answered YES to question 7, instruct her to return for DMPA as soon as possible after the baby is six weeks old.

Ask questions 8–13 to be reasonably sure that the client is not pregnant. As soon as the client answers YES to any question, stop, and follow the instructions below.

YES	8. Did your last menstrual period start within the past 7 days?	NO
YES	9. Did you have a baby less than 6 months ago, are you fully or nearly-fully breastfeeding, and have you had no menstrual period since then?	NO
YES	10. Have you abstained from sexual intercourse since your last menstrual period or delivery?	NO
YES	11. Have you had a baby in the last 4 weeks?	NO
YES	12. Have you had a miscarriage or abortion in the last 7 days?	NO
YES	13. Have you been using a reliable contraceptive method consistently and correctly?	NO

If the client answered YES to at least one of questions 8–13 and she is free of signs or symptoms of pregnancy, you can be reasonably sure that she is not pregnant. The client can start DMPA now.

If the client began her last menstrual period within the past 7 days, she can start DMPA immediately. No additional contraceptive protection is needed.

If the client began her last menstrual period more than 7 days ago, she can be given DMPA now, but instruct her that she must use condoms or abstain from sex for the next 7 days. Give her condoms to use for the next 7 days.

If the client answered NO to all of questions 8–13, pregnancy cannot be ruled out.

She must use a pregnancy test or wait until her next menstrual period to be given DMPA.

Give her condoms to use in the meantime.

Johns Hopkins Bloomberg School of Public Health: The INFO Project

Injectable Contraceptives: Tools for Providers

Checklist for Screening Clients Who Want to Initiate DMPA (or NET-EN)

Checklist for Screening Clients
Who Want to Initiate DMPA (or NET-EN)