3.5.5 Voluntary Contraception

Voluntary contraception is a necessary part of reproductive health service delivery. This is an important part of SRHR interventions to reduce maternal and newborn mortality and morbidity. Access to modern contraception could reduce maternal deaths, STI/HIV transmission, as well as the occurrence of unintended pregnancies and adverse consequences associated with unintended pregnancies. Method mix is essential for the acceptance and continuation of FP/VC use; therefore, services should ensure availability of short-acting (ex. barrier methods and birth control pills), and long-acting reversible (ex. IUD and implants). When the situation transitions to a more stable setting, permanent methods of contraception (such as sterilization) may be offered, based on the demand from the community. This should also include emergency contraception (EC) as a post-coital method of contraception. EC is also critical for post-rape crisis care. See GBV Section.

Contraceptive counselling should emphasize client privacy and confidentiality. Counselling must promote informed choice with description of the methods available as well as effectiveness and potential side effects of them. Full knowledge of side effects (positive and negative) have been linked to higher continuation rate of the chosen method. Currently, contraceptives are included in Kits 1,3,4,5, and 7. Refer to the WHO Medical Eligibility Criteria for Contraceptive Use and the MEC Wheel tool in Annex 26.5.16 to help identify medical conditions that determine the safety of a method based on client’s clinical conditions. The information from the MEC Wheel as well as the client’s own choice determines what contraceptive methods are best for the client.

If possible, activities to encourage community awareness of where and how to seek contraception should occur. This should be inclusive of not only women and adolescents of reproductive age, but also men and boys as well as other potential influencers – determined by analysis of the cultural context. Engaging key community religious, ethnic, or women’s group leadership and sponsoring their support can be incredibly helpful as well.