Access to high-quality, affordable sexual and reproductive health services and information, including a full range of contraceptive methods, is fundamental to realizing the rights and well-being of women and girls, men and boys. Universal access to effective contraception ensures that all adults and adolescents can avoid the adverse health and socioeconomic consequences of unintended pregnancy and have a satisfying sexual life. Key global initiatives, including the Sustainable Development Goals and the Global Strategy for Women’s, Children’s and Adolescents’ Health, call for universal access to family planning services as a right of women and girls and crucial to a healthy life.
However, reducing the vast unmet need for family planning remains a massive challenge to countries and the global health community. Services are still poor-quality or unavailable in many settings, while service delivery and social constraints persist.
Family planning providers are at the core of health system responses to these challenges. The Global Handbook offers clear, up-to-date information and advice to help providers meet clients’ needs and inform their choice and use of contraception. The Handbook is also an excellent resource for training and can help to reinforce supervision.
The 2018 edition of the Handbook includes new WHO recommendations that expand contraceptive choices. For example, WHO now recommends that breastfeeding women can start progestogen-only pills or contraceptive implants any time after childbirth. More contraceptive options are now included: ulipristal acetate for emergency contraception; subcutaneous injection of DMPA; and the progesterone-releasing vaginal ring. Also, guidance on starting ongoing contraception following emergency contraception is provided. An important message throughout is WHO’s recommendation that adolescent girls and young women are medically eligible to use any contraceptive method. In addition, the Handbook highlights opportunities for task sharing among providers to make contraceptive methods more available. This edition also includes the latest WHO guidance on hormonal contraception and HIV and advice for counselling clients at risk of HIV infection on their contraceptive choices.
WHO encourages all national health systems and other organizations providing family planning to consider this new edition of the Global Handbook a key document to help ensure the quality and safety of family planning services.
WHO appreciates the contributions of the many people, named in the Acknowledgements, who supported updating and expanding this edition of the Handbook. Also, WHO thanks the Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs for management and the United States Agency for International Development for financial and technical support of the Handbook.
Ian Askew, PhD
Director, Department of Reproductive Health and Research
World Health Organization