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Enumerate the guidelines for case selection fit for sterilization.
(Self-declaration by the client will suffice as the basis for this information.)
1. Clients should be ever married.
2. Male clients should be at least 22 years old and ideally be below the age of 60 years.
3. Female clients should be below the age of 49 years and above the age of 22 years.
4. The couple should have at least one child whose age is above 1 year unless the sterilization is medically indicated.

The Injectable Contraceptives contain synthetic female hormones. When administered intramuscularly of subcutaneously, these are slowly released into the blood stream and provide protection from pregnancy for a long duration.

There are two main types of injectable contraceptives:

Method of use
• To be worn by the female before the intercourse
• The smaller closed end ring fits on cervix and the larger outer ring remains outside vagina
No lubrication is required as it is prelubricated with silicon.8
What is its failure rate?
Ranges from 5 to 21 pregnancies per HWY.9
Advantages
• Provides some protection from STD/HIV also
• No systemic side effects
• Empowers women to protect herself against STD/HIV and conception
Disadvantages
• Expensive
• Needs action just before coitus

Unmet need for family planning is defined as the percentage of women of reproductive age, either married or in a union, who want to stop or delay childbearing but are not using any method of contraception.
Unmet need for family planning= (Women of reproductive age (15-49) who are married or in a union and who have an unmet need for family planning)/(Total number of women of reproductive age (15-49) who are married or in a union) X 100

How is the efficacy of a contraceptive measured?
Efficacy of a contraceptive method is measured by two methods:
1. Pearl index
2. Life table analysis

What is "Pearl index”?
Pearl index is used for measuring the failure rate of a contraceptive. It is defined as the number of contraception failures per 100 woman years (HWY) of exposure. It is calculated by the formula:
Failure rate per HWY = Total accidental pregnancies/Total months of exposure × 1200

The desired features of an "ideal contraceptive” are as follows:
• Safe (S)
• Effective (E)
• Acceptable (A)
• Inexpensive (I)
• Reversible (R)
• Simple to administer (S)
• Independent of coitus (I)
• Long lasting (L)
• Requires little or no medical supervision (M)
(Mnemonic: SEAL M SIR)

What type of contraceptive is this?
• Barrier contraceptive (physical)

What are the instructions for using condom?
• The condom is to be fitted over the erect penis.
• Remove the air from the teat.
• Place over the erect penis before coitus.
• Must be held carefully while withdrawing from vagina after intercourse.
• A new condom should be used for each sexual act.
• Never use oil or fat soluble lubricant with condoms. Always use water-based lubricants such as glycerin or spermicidal jelly.

Type of contraceptive
• Nonsteroidal oral contraceptive

Name the active ingredient and what is its pharmaceutical action?
The active ingredient is “Ormeloxifene”16 also known as “centchroman.” Centchroman is a selective estrogen receptor modulator (SERM). It has some estrogenic effect (e.g., in bones) and some antiestrogenic effect (e.g., in uterus and breast).

What is AEFI?
Adverse event following immunization (AEFI) is defined as any untoward medical occurrence which follows immunization and which does not necessarily have a causal relationship with the usage of the vaccine.
The adverse event may be any unfavorable or unintended sign, abnormal laboratory finding, symptom or disease.

What is vaccine vial monitor?
VVM is a small label stuck on the vial of a vaccine which changes color as the vaccine vial is exposed to heat.
The color of the VVM central square indicates if the vaccine is safe for use or not. It is a small light purple circle with a white square in the center. The square remains white if there is no exposure to heat. With heat exposure the square begins to darken. It registers the cumulative heat exposure over time.