by Sara Malakoff, Senior Program Associate, EngenderHealth
Female sterilization is the world’s most popular contraceptive method with more than 220 million users. Sterilization is convenient for women who desire to limit childbearing, as it requires no further visits to a health care provider. In addition, it does not have the side effects that contribute to the discontinuation of user dependent methods, such as hormonal contraception. However, access to both male and female sterilization varies significantly geographically, is limited in many parts of the world (particularly in rural areas), and has not increased at a pace comparable to that of the unmet need to limit childbearing.
In an attempt to address issues of full contraceptive choice and to ensure the availability of and access to a wide range of contraceptives, including permanent methods, Marie Stopes International (MSI) and EngenderHealth under the auspices of the Support for International Family Planning Organizations (SIFPO) project funded by USAID, convened a two-day technical symposium in Nairobi in March 2014 entitled Provision of Permanent Methods of Contraception in Low-Resource Settings. A dynamic group of over 40 participants from 27 organizations and 13 countries attended the event.
Participants discussed both minilaparotomy and laparoscopy. Minilaparotomy was acknowledged as the preferred technique in many settings, as it can be provided by a wider group of providers, including non-specialist doctors and clinical/medical officers. It can also be provided at a lower cost, can be performed at any time during the client’s reproductive cycle, and the required instruments are more widely available. Participants agreed that vasectomy represented an easier, safer, and quicker permanent method that deserves more dedicated attention and support, especially on the demand generation side and expanding provider competency to perform the procedure.
Consensus around a number of issues was reached as a result of the symposium as embodied in a statement endorsed by MSI, EngenderHealth, IntraHealth International, the International Planned Parenthood Federation, Population Council, Population Services International, Jhpiego, Pathfinder International, Wispivas, Dhaka Medical College, APROFAM, and PASMO Guatemala. In line with the vision of FP2020 and others, the statement’s vision is that all women and men should have access to appropriate information and a range of contraceptive methods to achieve their reproductive intentions. The signing organizations committed themselves to ongoing collaboration to achieve the goal of universal access to voluntary family planning, represented by a broad method mix that includes permanent methods, particularly in underserved areas.
Permanent methods constitute an essential component of comprehensive voluntary family planning services. Realizing the statement’s vision involves continued emphasis on the importance of clients’ rights and informed choice, adoption of effective and sustainable approaches to in-service training and service delivery, strengthening pre-service education and clinical training on permanent methods, researching facilitators and barriers to the voluntary use of permanent methods, and the adoption of effective interventions to increase demand for permanent methods.
The full text of the Consensus Statement can be accessed here.
Click here for the full text of the Consensus Statement on Female Sterilization Technique Addendum.