Chhaya is an oral contraceptive pill which does not contain any hormone. It is available in the market in some places as 'Saheli' tablet. It has been introduced in the public health system in the name of 'Chhaya' to benefit more women at no cost. It is a safe spacing option for both breast feeding and non-breast feeding women and needs to be taken only twice a week for the first 3 months and then once a Week.

2. Chhaya
(Centchroman)
Presented by
Preeti Thakur
Speciality
Community Health Nursing

3. • India has strengthened its family
planning programme and enhanced
the basket of contraceptive choices
in the public health system, to meet
the changing needs of people.
Chhaya
(Centchroman)

4. CENTCHROMAN TABLETS I.P (CHHAYA)

5. NEW ORAL CONTRACEPTIVE
The second contraceptive
that you will learn about in
this update is Centchroman
(Chhaya)

6. What is Centchroman (Chhaya)?
Chhaya is an oral contraceptive pill
which does not contain any hormone.
It is available in the market in some
places as 'Saheli' tablet. It has been
introduced in the public health
system in the name of 'Chhaya' to
benefit more women at no cost. It is a
safe spacing option for both breast
feeding and non-breast feeding
women and needs to be taken only
twice a week for the first 3 months
and then once a Week.

7. • a woman's body prepares for conception. An egg is released
and uterus also prepares to nurture the baby. Hence inner
lining of the uterus becomes thick and soft as it gets more
blood supply. If she does not conceive that month, this inner
lining of blood is thrown out of her body as menstrual flow.
This is repeated every month, causing menstrual cycles. But
with MPA, the monthly preparation for pregnancy in woman's
body does not occur. There is no release of egg/ovum and
thickening of inner lining of uterus. The menstrual cycle
gradually comes to a stop after irregular bleeding for some
time.”

8. Why Chhaya is the right choice?
• Chhaya is an effective reversible
method of contraception
• It is safe for women of all age groups.
• It is safe for breastfeeding women,
even immediately after childbirth
• Return to fertility on stopping the pills
is prompt.

9. Who can use Centchroman (Chhaya)?
•Centchroman (Chhaya) can be safely used by all women
once it is confirmed that they are not pregnant.
•Can be used by women of any age, whether she has
children or not.
•Women who had side effects with MALA N/ MALA D can
also opt for this method.
•It can be used by postpartum women who are
breastfeeding as soon as she feels comfortable.
Centchroman does not affect quantity, quality and
composition of breast milk.

10. Where can women get Centchroman (Chhaya)?
• It is available in all public health facilities and can be
provided by doctors (MBBS and above, AYUSH), SNs,
LHVs and ANMs. It would also be a part of your ASHA kit
which can be distributed by you to the clients. However the
first dose should be provided only by a trained provider
after proper screening at a health facility.
• Availability: Centchroman (Chhaya) is available in two
packages: ASHA supply and free supply. Each pack
contains 8 tablets. ASHA supply is for home distribution
and free supply is for distribution at health facilities.

11. Schedule
• Centchroman (Chhaya) is to be taken twice a week for the
first 3 months followed by once a week thereafter.
• To begin the use of Chhaya, the woman is advised to take the
first pill on the first day of period (which is the first day of
bleeding) and the second pill three days later (on 4th day of
bleeding). This pattern of days is repeated through the first 3
months.
• Starting from the fourth month, the pill is to be taken once a
week on the first pill day and should be continued on the
weekly schedule regardless of her menstrual cycle.

12. Schedule Centchroman (Chhaya)

13. What should be suggested to clients in case of
'missed pills'?
• you should tell the woman, that if she forgets to take the pill, she
should take the missed pill as soon as she remembers that it has
been missed. If she misses taking the tablet by 1-2 days (less than 7
days), she should take the missed pill as soon as she remembers
and continue the normal schedule. In addition she should use a
backup method like condom, just to ensure complete protection.
• If she forgets to take pills by more than 7 days, then the current
pack should be discarded and she needs to start taking a new pack
like a new user; that is, twice a week for first 3 months followed by
once a week thereafte

14. What are the benefits, side effects and
limitations of Centchroman (Chhaya)?
•BENIFITS
•Chhaya causes less bleeding during the monthly
period, and also makes the interval between two
menstrual cycles longer. This is beneficial for anemic
women
•Safe for breast feeding women.
•Women, who are not recommended to use hormonal
method, can use this method.

15. • Side effects:
• Chhaya has very few side effects. In a few women there
is delay in periods in the first three months.
• Limitations:
• Every client should be screened by a trained provider
before starting Centchroman, just like other oral pills

16. Do not take the pill if you have the following
conditions(contraindication)
• Women with the following condition should not
use chhaya:-
• Polycystic ovarian disease.
• Cervical hyperplasia
• Recent history of clinical evidence of jaundice or
liver disease.
• Severe allergic states,chronic illnesses such as
tuberculosis,renal diseases,etc.

17. If one is taking chhaya,when she should consult a
doctor?
• after initial medical checkup please
consult a doctor every twelve months.
In addition, consult a doctor if your
periods are delayed by more then 15
days.

18. The Role of ASHA
• Undertake regular follow up visits to those women who choose to use
Chhaya
• If the woman complains of any changes in theduration and amount of
bleeding during menstrual cycle, reassure her that these are temporary
changes and will subside with regular intake of pills.
• If there is a delay in the menstrual cycle by over 15 days then you should
help the woman to test for pregnancy.
• Support the woman to remember the schedule of taking Chhaya.
• Maintain line listing of eligible couples that require spacing.
• Record all relevant information like name, address and contact number.
• Maintain monthly record of contraceptives distributed to each couple.
• Submit the record of distribution of contraceptives on monthly basis to
ANM.

19. Useful links
• Ministry of Health & Family Welfare
(MOHFW)
• MyGov
• National Health Mission (NHM)
• National Health Portal (NHP)
• National Institute of Health & Family Welfare
(NIHFW)
• National Portal of India