WHO updates recommendations to guide family planning decisions

PATTAYA, 15^th November 2022 — Today, the World Health Organization (WHO) announced important updates to its landmark Handbook for family planningwhich provides healthcare professionals and policy makers with the latest information on contraceptive options.

Drawing on lessons from recent outbreaks, this new edition details tangible measures for frontline health workers to protect access to family planning services during emergencies, such as wider access to self-administered contraceptives and providers’ use of digital technologies service. It also expands the guidelines for women and young people at high risk of HIV.

“Family planning promotes self-realization, empowerment, as well as health and well-being, and reduces maternal and infant mortality by preventing unintended pregnancy and unsafe abortion,” said Dr. Pascale Allotey, WHO Director for Sexual and Reproductive Health and Rights. “This one updated Family Planning Manual is a vital resource to help health professionals support contraceptive users around the world in making informed choices about the right contraceptive options for them.”

Experience from recent outbreaks shows that family planning services can be seriously compromised during emergencies. During the initial stages of the 2020 COVID-19 pandemic, approximately 70% of countries reported disorders to these vital services – increasing the risk of unwanted pregnancy and sexually transmitted infections.

To avoid such outcomes in the future, the handbook details practical measures to support the continuity of family planning services during epidemics. This includes wider access to self-administered contraceptives and direct distribution of contraceptives through pharmacies. Health professionals can also take steps to support continued access to contraception even where physical mobility is reduced, such as providing several months’ supply.

Self-administered contraceptives include condoms, birth control pills, some diaphragms, spermicides, and more recently the ability to self-inject DMPA (a progestin-only contraceptive) since it can now be safely administered directly under the skin rather than into a muscle. Many women prefer injectable contraceptives because they are private and unobtrusive, requiring action only after 2-3 months, with the possibility of self-injection likely to further increase intake.

“The updated recommendations in this Handbook show that all women can safely use almost any family planning method and, accordingly, all women should have access to a range of options that meet their unique needs and life goals,” said Dr. Mary Gaffield, scientist and main author of the manual. “Family planning services can be provided safely and affordably so that no matter where they live, couples and individuals can choose between safe and effective family planning methods.”

For the first time, the 2022 edition of the Handbook includes a specific 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 sexual partners, or whose permanent partner lives with HIV.

While only condoms protect against HIV and other sexually transmitted infections, all contraceptive options—with the sole exception of nonoxynol-9 spermicide—are now consider safe for women and young people at high risk of HIV, i.e. not found to increase the risk of HIV transmission or infection. For those at high risk for HIV, the manual states that testing, counseling, and first-line clinical care and referrals should be offered as part of family planning services.

In addition, the Handbook includes the latest World Health Organization guidelines on cervical cancer and precancers prevention, examination and treatment which can all be provided through family planning services; management sexually transmitted infections and family planning in post-war care.

Now in its fourth edition, the WHO Family Planning Handbook is the most widely used reference guide on the subject in the world, with more than a million copies distributed or downloaded to date. It is supplemented by the Medical Eligibility Criteria Tool for Contraceptive Use, which can also be downloaded as dedicated application.

The updated Manual was released on 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

In ICFP: Sarah Kessler, [email protected]