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  • Title: Contraceptive method mix menu: providing healthy choices for women.
    Author: Greenwell KF.
    Journal: World Health Stat Q; 1996; 49(2):88-93. PubMed ID: 9050186.
    Abstract:
    This article addresses expansion of the contraceptive method mix, in the specific context of underserved women in developing countries who, like all women, expect to maintain their health status while successfully regulating their fertility. It is a critical review of the health implications of the contraceptive methods most commonly included on a menu of options and includes fertility awareness methods as essential non-supply method options where barriers currently exist for supply methods. In developing countries, many couples have little or no choice of contraception. Thus, underserved couples include those who wish to control their fertility but use no method as well as those who have only a limited number of choices available and would switch to a more acceptable method if they could. The barriers to use of contraceptives requiring supplies or medical services include fear of health risks, lack of good quality services and products, and religious or cultural taboos. Contraceptive method mixes must include a variety of "safe" contraceptives (those that protect against pregnancy and minimize health risks and side effects), because individual women must have the opportunity to judge how a contraceptive may affect the short- and long-term quality of their lives. The standard menu of contraceptives offered includes female sterilization, the IUD, oral contraceptives, condoms, and nonsupply methods such as fertility awareness methods and traditional methods. Each of these methods has comparative benefits and disadvantages. As the number of contraceptive users worldwide increases from 381 million couples in 1990 to 567 million in 2000, the challenge to provide safe, effective, acceptable, and affordable contraceptive options will also increase. A variety of such options will be necessary because no single method is appropriate for all couples. Because barriers to use of methods requiring supplies or medical services will continue to exist, fertility awareness methods must be considered an essential option. The effectiveness of fertility awareness methods must be improved, however, to achieve wider acceptability. Each couple must receive information about the benefits and disadvantages of each method offered so they can make a fully informed choice.
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