Key Points for Providers and Clients
  • Family planning services should be maintained throughout an epidemic.
  • Medical eligibility criteria for safe use of contraceptive methods do not change during an epidemic.
  • Some contraceptive methods can be safely and effectively self-initiated and continued with or without support from health care providers.
  • More widespread use of digital health technologies and direct pharmacy access may improve access during an epidemic.

Introduction

Epidemics of life-threatening infectious diseases are becoming more common, and cause significant disruptions to the health care system, affecting the delivery of both routine and urgent health services and care. Family planning providers need to balance the demands of responding to outbreaks, while simultaneously maintaining family planning services in all three phases of an epidemic response: mitigation and preparedness, emergency, and post-emergency.

In epidemics, large numbers of people may require medical attention, health care systems may be over-stretched, and public order may be threatened. The impact of an epidemic on reproductive health can be a direct result of the infectious disease, or an indirect consequence of excessive pressures on the broader health care system, including limited resources, commodity stock-outs, challenges in accessing the usual service-delivery sites, reduced availability of health care providers, fears of disease transmission and acquisition, and misconceptions about safety.

When health care systems are overwhelmed due to an outbreak, both direct mortality from the outbreak disease and indirect mortality from other preventable and treatable conditions are likely to increase. Family planning promotes both physical and mental health, and reduces maternal and infant morbidity and mortality through the prevention of unintended pregnancy and unsafe abortion. Unintended pregnancy during an epidemic is associated with increased risks. Family planning is a lifesaving, essential service, and should be maintained throughout an epidemic.