Jonathan Torgovnik/Images of Empowerment
Family planning services in the community
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Contraception

    Overview

    Family planning allows people to attain their desired number of children, if any, and to determine the spacing of their pregnancies. It is achieved through use of contraceptive methods and the treatment of infertility.

    Contraceptive information and services are fundamental to the health and human rights of all individuals. 

    The prevention of unintended pregnancies helps to lower maternal ill-health and the number of pregnancy-related deaths. Delaying pregnancies in young girls who are at increased risk of health problems from early childbearing, and preventing pregnancies among older women who also face increased risks, are important health benefits of family planning.

    By reducing rates of unintended pregnancies, contraception also reduces the need for unsafe abortion and reduces HIV transmissions from mothers to newborns. This can also benefit the education of girls and create opportunities for women to participate more fully in society, including paid employment.

    According to 2017 estimates, 214 million women of reproductive age in developing regions have an unmet need for contraception. Reasons for this include:

    • limited access to contraception 
    • a limited choice of methods
    • a fear or experience of side-effects
    • cultural or religious opposition
    • poor quality of available services
    • gender-based barriers.
    Satisfying demand

    It is important that family planning is widely available and easily accessible through trained health workers to anyone who is sexually active, including adolescents. 

    There are many cadres of health care workers who are trained to provide (where authorised) locally available and culturally acceptable contraceptive methods including doctors and midwives. Other trained health workers, for example community health workers, also provide counselling and some family planning methods, for example pills and condoms. For methods such as sterilization, women and men need to be referred to a clinician.

    The Sustainable Development Goals set for 2030 will need to ensure that sexual and reproductive health services are widely available and used. This includes supporting contraceptive services through effective government policies and the provision of high-quality services for individuals.

    WHO is working to promote contraception by producing evidence-based guidelines on safety and service delivery of contraceptive methods and on ensuring human rights in contraceptive programmes. It is also developing quality standards and providing pre-qualification of contraceptive commodities. 

    WHO assists countries to adapt and implement these tools to strengthen contraceptive policies and programmes. Additionally, WHO participates in developing new contraceptive technologies to and leads and conducts implementation research for expanding access to and strengthening delivery contraceptive information and services. 

    Contraceptive methods

    There are many different types of contraception, with varying rates of effectiveness depending on correct usage. Some methods may be obtained over the counter, others may require medical advice or even surgical intervention. 

    Health care providers play an important role in helping people find and use a method that is both effective and acceptable. Methods include:

    Hormonal contraceptive methods 

    Usually oral pills or implants, patches or vaginal rings. They release small amounts of one or more hormones which prevent ovulation. 

    Intrauterine devices (IUDs)

    Devices inserted into the uterus where they release either a copper component or a small amount of a hormone (Levnorgesterol) to prevent the sperm from reaching the egg.  

    Emergency contraception

    It is possible to prevent pregnancy after unprotected sex or if contraception has failed, either with a pill or with an IUD. There is a five-day window for this.

    Condoms

    Male condoms sheath a penis. Female condoms fit loosely inside a vagina. Both form a barrier that prevent sperm and egg from meeting.  Sterilization Considered a permanent method that blocks sperm in men and eggs in women. Voluntary and informed choice is essential. 

    Lactational amenorrhea method

    A temporary method of contraception for new mothers whose monthly bleeding has not returned. During this period, eggs are not released and so pregnancy cannot occur.

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    Family planning and comprehensive abortion care toolkit for the primary health care workforce: volume 1

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    Self-administration of injectable contraception, 2022 update

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