Combined Oral Contraceptives (COCs)

Important Note, September 2015: The WHO has released the full revision to its Medical Eligibility Criteria, and expects to release revisions to the Selected Practice Recommendations for Contraceptive Use in 2016. This module will be updated to reflect those changes once the Selected Practice Recommendations are available. You may still use the existing TRP resources, but in the meantime, please consult the MEC Executive Summary, the revised MEC Wheel, or the full Medical Eligibility Criteria for important changes.

This module on Combined Oral Contraceptives (COCs) is designed for the providers in developing countries who most often are tasked with providing FP services—primarily nurses and nurse-midwives, as well as primary care physicians—and assume trainees will have at minimum a nurse’s level of clinical training. Although the module can be used for Community Health Workers (CHWs), they would need basic literacy skills.

Designed to actively involve the trainees in the learning process, sessions include:

  • PowerPoint presentations,
  • simulation skills practice in the form of roleplays,
  • discussions,
  • case studies and practice, and
  • using objective competency-based skills checklists.

Learning Objectives

By the end of the training, trainees should be able to:

  1. List the key messages about COCs
  2. Describe the characteristics of COCs in a manner that clients can understand, including:
    1. What COCs are and how they work (mechanism of action)
    2. Effectiveness
    3. Side effects
    4. Non-contraceptive health benefits
    5. Other characteristics (STI/HIV protection, ease of use, return to fertility)
    6. Possible health risks (complications)
  3. Demonstrate the ability to:
    1. Screen clients for medical eligibility for COC use
    2. Explain to clients how to use COCs and what to do when pills are missed
    3. Explain when to return to the clinic
    4. Address common concerns, misconceptions, and myths
    5. Conduct follow-up for COC clients in a way that enhances continuing safety, satisfaction, and acceptance
  4. Describe when to initiate COCs (postpartum, switching from another method)
  5. Explain how to manage side effects
  6. Identify new conditions that may require a client to switch to another method or to temporarily stop COC use
  7. Identify clients in need of referral for COC-related complications

Read the Quick Start guide below, if you haven't already--and then explore the tabs at right to walk through the Facilitator's Guide, illustrative examples, presentation slides, handouts, and more--all of which you are free to adapt for your training participants' needs.