Abstract
With the renewed focus on family planning, a clear and transparent understanding is needed for the consistent classification of contraceptives, especially in the commonly used modern/traditional system. The World Health Organization Department of Reproductive Health and Research and the United States Agency for International Development (USAID) therefore convened a technical consultation in January 2015 to address issues related to classifying contraceptives.The consultation defined modern contraceptive methods as having a sound basis in reproductive biology, a precise protocol for correct use and evidence of efficacy under various conditions based on appropriately designed studies. Methods in country programs like Fertility Awareness Based Methods [such as Standard Days Method (SDM) and TwoDay Method], Lactational Amenorrhea Method (LAM) and emergency contraception should be reported as modern. Herbs, charms and vaginal douching are not counted as contraceptive methods as they have no scientific basis in preventing pregnancy nor are in country programs. More research is needed on defining and measuring use of emergency contraceptive methods, to reflect their contribution to reducing unmet need.The ideal contraceptive classification system should be simple, easy to use, clear and consistent, with greater parsimony. Measurement challenges remain but should not be the driving force to determine what methods are counted or reported as modern or not. Family planning programs should consider multiple attributes of contraceptive methods (e.g., level of effectiveness, need for program support, duration of labeled use, hormonal or nonhormonal) to ensure they provide a variety of methods to meet the needs of women and men.
Highlights
The global community came together in July 2012 at the London Summit on Family Planning and set the goal that an additional 120 million women and girls will have access to effective family planning (FP) information and services by the year 2020
The system of classifying contraceptives can influence calculations of key indicators, such as unmet need and contraception prevalence rate (CPR), that affect what counts towards reaching FP2020 goals
Indicators impacted by any classification of contraceptive methods include CPR, unmet need for FP, contraceptive method mix, contraceptive discontinuation and others
Summary
The global community came together in July 2012 at the London Summit on Family Planning and set the goal that an additional 120 million women and girls will have access to effective family planning (FP) information and services by the year 2020. There remain inconsistencies in the definition and criteria for classifying methods as modern. Would count LAM and SDM users as having an unmet need even though these methods have been found to be highly effective when used correctly and are preferred by some women. Program managers and decision makers prefer to invest in supporting provision of “modern methods” When even those methods that can be highly effective are classified as “traditional”, program managers and providers may be less likely to consider including them in programs. This affects what methods a client can choose from and what would be offered at their local clinic or pharmacy. A strong program ensures accurate information so that women and men truly understand the relative effectiveness, mode of action and side effects of different methods and they can make an informed choice
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