Festin Mario Philip R, Kiarie James, Solo Julie, Spieler Jeffrey, Malarcher Shawn, Van Look Paul F A, Temmerman Marleen
Department of Reproductive Health and Research, UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Switzerland.
Independent consultant.
Contraception. 2016 Oct;94(4):289-94. doi: 10.1016/j.contraception.2016.05.015. Epub 2016 Jun 7.
With the renewed focus on family planning, a clear and transparent understanding is needed for the consistent classification of contraceptives, especially in the commonly used modern/traditional system. The World Health Organization Department of Reproductive Health and Research and the United States Agency for International Development (USAID) therefore convened a technical consultation in January 2015 to address issues related to classifying contraceptives. The consultation defined modern contraceptive methods as having a sound basis in reproductive biology, a precise protocol for correct use and evidence of efficacy under various conditions based on appropriately designed studies. Methods in country programs like Fertility Awareness Based Methods [such as Standard Days Method (SDM) and TwoDay Method], Lactational Amenorrhea Method (LAM) and emergency contraception should be reported as modern. Herbs, charms and vaginal douching are not counted as contraceptive methods as they have no scientific basis in preventing pregnancy nor are in country programs. More research is needed on defining and measuring use of emergency contraceptive methods, to reflect their contribution to reducing unmet need. The ideal contraceptive classification system should be simple, easy to use, clear and consistent, with greater parsimony. Measurement challenges remain but should not be the driving force to determine what methods are counted or reported as modern or not. Family planning programs should consider multiple attributes of contraceptive methods (e.g., level of effectiveness, need for program support, duration of labeled use, hormonal or nonhormonal) to ensure they provide a variety of methods to meet the needs of women and men.
随着对计划生育的重新关注,需要对避孕药具进行清晰透明的一致分类,特别是在常用的现代/传统体系中。因此,世界卫生组织生殖健康和研究司与美国国际开发署(USAID)于2015年1月召开了一次技术磋商会,以解决与避孕药具分类相关的问题。该磋商会将现代避孕方法定义为在生殖生物学方面有坚实基础、有正确使用的精确方案且基于适当设计的研究有各种条件下的有效性证据。国家项目中的方法,如基于生育意识的方法[如标准日法(SDM)和两日法]、哺乳期闭经法(LAM)和紧急避孕,应报告为现代方法。草药、符咒和阴道灌洗不算作避孕方法,因为它们在预防怀孕方面没有科学依据,也不在国家项目中。需要更多研究来定义和衡量紧急避孕方法的使用情况,以反映它们对减少未满足需求的贡献。理想的避孕分类系统应该简单、易用、清晰且一致,更加简洁。测量方面的挑战仍然存在,但不应成为决定哪些方法被算作或报告为现代方法的驱动力。计划生育项目应考虑避孕方法的多个属性(如有效性水平、对项目支持的需求、标签使用期限、激素或非激素),以确保它们提供多种方法来满足妇女和男子的需求。