Welsh Michael J, Stanback John, Shelton James
Best Pract Res Clin Obstet Gynaecol. 2006 Jun;20(3):323-38. doi: 10.1016/j.bpobgyn.2005.12.001. Epub 2006 Jan 26.
Access to modern contraception has become a recognized human right, improving the health and well-being of women, families and societies worldwide. However, contraceptive access remains uneven. Irregular contraceptive supply, limited numbers of service delivery points and specific geographic, economic, informational, psychosocial and administrative barriers (including medical barriers) undermine access in many settings. Widening the range of providers enabled to offer contraception can improve contraceptive access, particularly where resources are most scarce. International efforts to remove medical barriers include the World Health Organization's Medical Eligibility Criteria. Based on the best available evidence, these criteria provide guidance for weighing the risks and benefits of contraceptive choice among women with specific clinical conditions. Clinical job aids can also improve access. More research is needed to further elucidate the pathways for expanding contraceptive access. Further progress in removing medical barriers will depend on systems for improving provider education and promoting evidence-based contraceptive service delivery.
获得现代避孕方法已成为一项公认的人权,改善了全球妇女、家庭和社会的健康与福祉。然而,避孕服务的获取情况仍然不均衡。避孕药具供应不规律、服务提供点数量有限以及特定的地理、经济、信息、心理社会和行政障碍(包括医疗障碍)在许多情况下都阻碍了获取。扩大能够提供避孕服务的提供者范围可以改善避孕服务的获取情况,特别是在资源最为稀缺的地方。消除医疗障碍的国际努力包括世界卫生组织的《医学适用性标准》。这些标准基于现有最佳证据,为权衡特定临床状况女性避孕选择的风险和益处提供指导。临床工作辅助工具也可以改善获取情况。需要更多研究来进一步阐明扩大避孕服务获取途径。消除医疗障碍的进一步进展将取决于改善提供者教育和促进循证避孕服务提供的系统。