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a) At first visit and each follow-up visit, give as many as 13 cycles, although only 3 or 4 may be programmatically reasonable. The greatest need is to guarantee continuous, ready access.
b) Encourage a 3-month follow-up visit for counseling with initial acceptors to assess whether the client is satisfied with the method and is correctly using the method, to reinforce instructions, and to help clients with the management of side effects.
c) The number of cycles dispensed may be limited for programmatic, logistic or financial reasons, including client's ability to pay in a cost recovery system.
d) The re-supply system should be flexible, so that the client can obtain pills easily in the amount and at the time she requires.
e) There is no compelling medical reason for a routine return visit before one year, but clients should be encouraged to return at any time with concerns, problems and questions.
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a-e) While some providers suspect that clients who receive multiple pill cycles may "share" these with friends, this is likely to be as safe as over-the-counter distribution methods.
Some women (and/or some programs) may be able to afford to buy (dispense) many pill cycles at one visit.
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