WHO updates recommendations to guide family planning decisions

PATTAYA, 15e November 2022 — Today, the World Health Organization (WHO) released important updates to its historic site family planning manualwhich provides health workers and policymakers with the most up-to-date information on contraceptive options.

Drawing lessons from recent outbreaks, this new edition details concrete steps for frontline health workers to protect access to family planning services in emergencies, such as expanded access to self-administered contraceptives. administered and the use of digital technologies by providers. It also expands counseling for women and young people at high risk of contracting HIV.

“Family planning promotes self-realization, empowerment, and health and well-being, and reduces maternal and child deaths through the prevention of unwanted pregnancies and unsafe abortions,” said Dr Pascale Allotey, WHO Director for Sexual and Reproductive Health and Rights. “This updated family planning manual is a vital resource, helping health workers help contraceptive users around the world make informed choices about the contraceptive options that are right for them.

Experience from recent epidemics shows that family planning services can be seriously compromised in an emergency. During the initial phases of the COVID-19 pandemic in 2020, approximately 70% of countries reported disturbances to these vital services – increasing the risk of unwanted pregnancies and sexually transmitted infections.

To help prevent such outcomes in the future, the manual details practical measures that support the continuity of family planning services during epidemics. These include wider access to self-administered contraceptives and direct distribution of contraceptives through pharmacies. Health practitioners can also take steps to support continued access to contraceptives even when physical mobility is reduced, such as providing multi-month supplies.

Self-administered contraceptives include condoms, birth control pills, some diaphragms, spermicides, and more recently the option of self-injecting DMPA (a progestogen-only contraceptive) as this can now be safely administered. safety just under the skin rather than in the muscle. Many women prefer injectable contraceptives because they are private and non-intrusive, requiring action only every 2-3 months, with the self-injection option likely to further increase uptake.

“The updated recommendations in this handbook show that almost all family planning methods can be used safely by all women, and therefore all women should have access to a range of options that meet their unique needs and goals in life,” said
Dr. Mary Gaffield, scientist and lead author of the manual. “Family planning services can be delivered safely and affordably so that, regardless of where they live, couples and individuals can choose from safe and effective family planning methods.”

For the first time, the 2022 edition of the Handbook includes a dedicated chapter to guide family planning services for women and adolescents at high risk of HIV, including people living in settings with high HIV prevalence, those who have multiple sex partners, or whose regular partner is living with HIV.

While only condoms protect against HIV and other sexually transmitted infections, all contraceptive options – with the single exception of nonoxynol-9 spermicide – are now considered safe for women and young people at high risk of HIV, that is, it has not been shown to increase the risk of transmitting HIV or acquiring the infection. For people at high risk of contracting HIV, the manual states that testing, counseling and first-line clinical care and referral should all be offered as part of family planning services.

Additionally, the manual incorporates the latest WHO guidelines on cervical cancer and pre-cancer prevention, screening and treatment all of which can be provided by family planning services; management sexually transmitted infections, and family planning in postabortion care.

Now in its fourth edition, the WHO Family Planning Manual is the most widely used reference guide on the subject in the world, with more than one million copies distributed or downloaded to date. It is complemented by the Medical Eligibility Criteria Tool for Contraceptive Use, also downloadable as a Dedicated app.

The updated manual was released at the International Conference on Family Planning in Pattaya, Thailand. Support for its production and dissemination was provided by the Johns Hopkins Bloomberg School of Public Health and the United States Agency for International Development (USAID).

Contact

Laura Keenan, [email protected] and [email protected]

At ICFP: Sarah Kesler, [email protected]

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