This manual provides guidance to health-care personnel on improving the quality of care available to women seeking uterine evacuation services. It has been updated to be consistent with the World Health Organization’s Safe Abortion: Technical and policy guidance for health systems (2012) and other important evidence-based resource documents and articles. It explains the manual vacuum aspiration (MVA) uterine evacuation procedure in detail and also explains uterine evacuation methods that use the pills misoprostol and mifepristone (often called medical abortion). It is designed to be used as a participant’s manual during trainer-facilitated courses and as a as a learner’s resource to help refresh and strengthen skills.  Special features include modules that address broader service delivery and access issues such as women’s sexual and reproductive rights, including the rights of young women; client-provider communication; provider and community partnerships; quality of care; and monitoring to improve services.