This document is one important step in a process for improving access to quality of care in family planning by reviewing the medical eligibility criteria for selecting methods of contraception. It updates the third edition of Medical eligibility criteria for contraceptive use, published in 2004, and summarizes the main recommendations of an expert Working Group meeting held at the World Health Organization, Geneva,1–4 April 2008. The Working Group brought together 43 participants from 23 countries, including nine agency representatives. The document provides recommendations for appropriate medical eligibility criteria based on the latest clinical and epidemiological data and is intended to be used by policy-makers, family planning programme managers and the scientific community. It aims to provide guidance to national family planning/reproductive health programmes in the preparation of guidelines for service delivery of contraceptives. It should not be seen or used as the actual guidelines but rather as a reference.

The document covers the following family planning methods: low-dose combined oral contraceptives (COCs), combined patch (P), combined vaginal ring (R), combined injectable contraceptives (CICs), progestogen-only pills (POPs), depot medroxyprogesterone acetate (DMPA), norethisterone enantate (NET-EN), levonorgestrel (LNG) and etonogestrel (ETG) implants, emergency contraceptive pills (ECPs), copper-bearing intrauterine devices (Cu-IUDs), levonorgestrel-releasing IUDs (LNG-IUDs), copper-IUD for emergency contraception (E-IUD), barrier methods (BARR), fertility awareness-based methods (FAB), lactational amenorrhoea method (LAM), coitus interruptus (CI), and female and male sterilization (STER).

WHO will update and add to the recommendations in this document at appropriate intervals through expert Working Group meetings every three to four years and through input from its family planning Guidelines Steering Group on an as-needed basis. These recommendations will be made available on the WHO web site (www.who.int/reproductivehealth). The web site will also provide additional information determined by WHO to be relevant to these recommendations, pending the next formal consensus Working Group meeting. Such updates may be particularly warranted for issues where the evidence base may change rapidly. WHO encourages research to address key unresolved issues for establishing medical eligibility criteria for contraceptive use. WHO also invites comments and suggestions for improving this guidance.