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Cardiovascular Disease and Steroid Contraception
Report of a WHO Scientific
Technical Report Series, No. 877
1998, vii + 89 pages [E, F*, S*]
ISBN 92 4 120877 5
Sw.fr. 20.-/US $18.00; in developing countries: Sw.fr. 14.-
Order no. 1100877
Evaluates the strength and significance of evidence linking use of combined oral contraceptives to an increased risk of cardiovascular disease in women. Recommendations and conclusions reflect the consensus reached by a group of scientists, including researchers directly involved in several recent large-scale investigations of cardiovascular disease and hormone contraception. The experts also considered evidence that other factors, such as smoking, hypertension, diabetes, age, and family history, might influence the risk of cardiovascular disease in users of combined oral contraceptives. In view of major recent changes in the hormonal content of these contraceptives and the prescribing patterns of providers, the assessment concentrates on data collected after 1980. The experts also aimed to determine whether the risk of disease is influenced by the estrogen or progestogen content of different preparations.
To facilitate the comparison and interpretation of study results, the report opens with a discussion of the strengths and weaknesses of the different epidemiological approaches used to assess the safety of steroid contraceptives. Also discussed is the important distinction between the use of relative risk to examine epidemiological associations and the use of absolute risk to examine clinical importance. Against this background, the main part of the report examines the strength of evidence linking steroid contraceptives to an increased risk of acute myocardial infarction, ischaemic stroke, haemorrhagic stroke, and venous thromboembolism. Studies of combined oral contraceptives and progestogen-only contraceptives are considered separately for each disease. An effort is also made to determine whether conclusions, based on studies conducted in industrialized countries, are also valid for women living in the developing world.
The assessment of findings from epidemiological studies is complemented by a review of possible biological explanations for the effects of combined oral contraceptives on cardiovascular functions. On the basis of all available evidence, the report concludes that mortality rates from cardiovascular disease are extremely low among women of reproductive age and that the added risk of using steroid contraceptives is also very low in users who do not smoke or have other risk factors for cardiovascular disease. A final section places these risks in perspective and offers balanced advice useful to providers of family planning when helping women to make informed choices about the use of hormonal contraceptives.
Community-based Distribution of Contraceptives
A Guide for Programme Managers
1995, xi + 135 pages [C, E, F, S]
ISBN 92 4 154475 9
Sw.fr. 32.-/US $28.80; in developing countries: Sw.fr. 22.40
Order no. 1150421
Presents guidelines for the community-based distribution of contraceptives as a strategy for helping countries to achieve their family planning goals. Addressed to programme managers, the book draws on successful experiences from around the world to show how community-based services can provide information and distribute temporary contraceptive methods, such as the pill and barrier methods. Such services are usually less costly than clinic-based services, easier for people to reach, available in a wider range of settings, and more likely to be accepted and used.
Chapters explain how to develop a programme that is appropriate to the needs of the community and receives adequate support. The book also issues advice on six of the most important issues raised by managers of community-based distribution programmes, service providers, policy-makers and researchers.
Contraceptive Method Mix
Guidelines for Policy and Service Delivery
1994, viii + 143 pages [C, E, F, S]
ISBN 92 4 154459 7
Sw.fr. 32.-/US $28.80; in developing countries: Sw.fr. 22.40
Order no. 1150409
A comprehensive guide to the many factors that must be considered when planning to expand the range of contraceptive methods offered by family planning programmes. Noting that the reproductive health needs of women vary greatly, the book shows how the provision of a range of different methods can improve user satisfaction, enhance a programme's reputation, increase contraceptive prevalence, and thus contribute to the ultimate goal of reducing unwanted fertility.
The most extensive chapter provides a detailed guide to the advantages and disadvantages of all currently available contraceptive methods. Each method is assessed in terms of recent data on effectiveness, safety, confirmed or suspected risks to health, contraindications, appropriateness to the specific needs of users, factors influencing user satisfaction, and demands on programme staff, time, and resources.
Subsequent chapters present information that can help programme managers understand the factors that influence a client's choice of method and then adjust their programmes to provide the best possible contraceptive method mix consistent with local needs and available resources. The importance of helping couples make informed choices is underscored in a chapter on information, education and communication, which includes extensive advice on counselling, supported by a series of decisions trees for use when assessing client needs. Additional guidelines, checklists, model forms, and sample protocols conclude the book.
"... excellent ... contains valuable lessons
applicable well beyond the confines of family planning itself ... any and every
contraceptive service will find something in this book which would lead to
Journal of Public Health Medicine
Counselling Skills Training in Adolescent Sexuality and Reproductive Health
A Facilitator's Guide
1993, 179 pages [E, F, S]
Sw.fr. 15.-/US $13.50; in developing countries: Sw.fr. 10.50
Order no. 1930053
A complete and highly detailed guide to the planning and operation of a short five-day workshop for teaching workers how to counsel adolescents about sexuality and reproductive health and thus equip them to make wise decisions. Training described in the guide combines basic information about sexuality, reproductive health and the principles of non-directive counselling with training in specific interpersonal communication skills.
The guide is divided into six sections. The first describes preparatory activities and the facilities needed for the workshop. Each of the subsequent sections provides a model training programme for one day in the workshop. Some 22 topics are covered. These range from the psychodynamics of counselling to facts about sexual maturation and behaviour, from advice on how to deal with typical "difficult moments" in counselling to a discussion of obstacles that complicate efforts to prevent pregnancy and sexually transmitted diseases. The guide also features optional sessions that can be used during an expanded ten-day workshop, and includes over 70 pages of training material suitable for overhead transparencies.
The training methods described in the guide have demonstrated their effectiveness in workshops organized, since 1986, in over 60 countries throughout the world.
A Guide to Provision of Services
1992, x + 197 pages [C, E, F, R, S]
ISBN 92 4 154434 1
Sw.fr. 41.-/US $36.90; in developing countries: Sw.fr. 28.70
Order no. 1150383
A detailed guide to the organization and management of high quality services for female sterilization. While noting that sterilization is a highly effective and safe method of contraception, the book concentrates on the many issues and practical details that must be considered in order to ensure that services are voluntary, medically safe and effective, appropriate to the health care system, well managed, efficient, and acceptable to clients. Because the procedure involves surgery and is intended to be permanent, the book gives particular attention to the information and individualized counselling needed to ensure that each woman's decision is voluntary, fully informed, and free from inducements.
The book has 18 chapters. Background information is provided in the first three, which explain the advantages and disadvantages of sterilization as a contraceptive option and introduce service managers and providers to the main requirements in terms of facilities, personnel, skills, instruments, equipment and supplies. Factors that will influence client satisfaction receive particular attention.
General service issues of organization and management are covered in the next two chapters, which explain the special responsibilities and challenges attached to the management of a sterilization service, and outline the basic principles of financial planning and management. Two chapters on information and counselling provide especially detailed advice on the procedures needed to guard against coercive or misleading practices. Seven chapters are devoted to the sterilization procedure, moving from preoperative care, through anaesthesia and an illustrated guide to different surgical techniques, to postoperative care and the prevention and management of complications. The remaining chapters describe requirements in terms of the physical facility, instruments, equipment, supplies, and training.
Guide to Adapting Instructions on Condom Use
1992, 49 pages [E, F, S]
Sw.fr. 9.-/US $8.10; in developing countries: Sw.fr. 6.30
Order no. 1930038
A step-by-step didactic guide to the preparation of instructions for the correct use of condoms, whether for family planning purposes or for the prevention of AIDS and other sexually transmitted diseases. Addressed to staff in national AIDS programmes, the book aims to guide the writing and illustration of instructions that are both easily understood and appropriate to local attitudes and behaviours.
Central to this aim is the presentation of a sample flyer that illustrates and explains proper condom use. The model flyer, which was extensively reviewed and tested prior to finalization, is reproduced in two versions: one using close-up drawings and a second using full-body drawings. To facilitate adaptation of the flyer to the cultural conditions of any country, the guide gives exact advice on four basic steps required for adaptation, moving from pretesting, through the analysis of results, to revisions, final approval, printing, and distribution. The importance of pretesting is repeatedly stressed. Information ranges from a series of questions to be used during pretesting to advice on how to organize pretest results according to messages and topics, from instructions for graphic artists to a simple reminder of the importance of securing top-level approval.
The model flyer, in its two versions, is reproduced at the size to be used in pretesting, and as camera-ready copy which can be used directly by the printer or graphic artist. Additional drawings are included to aid the pretesting of the most appropriate illustration for condom disposal.
At the planning level, the guide also contains information that can help programme managers think through a project for developing and distributing condom instructions, define needs, identify potential problems, and know in advance the demands on staff and financial resources.
Health Worker's Manual on Family Planning Options
Western Pacific Education in Action Series, No. 7
1994, 66 pages + 24 colour illustrations [E]
ISBN 92 9061 137 5
Sw.fr. 7.-/US $6.30; in developing countries: Sw.fr. 4.90
Order no. 1500007
- Quick Reference Chart on Family Planning Options
1994, 33 pages + 14 colour illustrations [E]
Distributed together with the manual at no additional cost
A spiral-bound manual, accompanied by a quick reference booklet, for use in the day-to-day counselling of women and couples interested in planning their families. Addressed to health workers in family planning services, the manual uses simple text and abundant full-colour illustrations to communicate essential information about sixteen different family planning options. Throughout, emphasis is placed on the importance of helping clients select a family planning option that is safe, effective, acceptable, and affordable.
The manual has two parts. The first offers a practical guide to the daily operation of family planning services. Information ranges from advice on when and how to initiate discussions about family planning, through a list of sample replies to common misconceptions about birth control methods, to charts indicating the appropriateness of different methods according to a woman's age and reproductive stage. The second and most extensive part provides detailed, yet straightforward information about 16 family planning methods. Each is presented in terms of its mode of action, advantages and disadvantages, contraindications, and the exact steps that the health worker should follow when a client is either considering the method or has selected it as the first-choice option. A glossary of terms commonly used in family planning concludes the manual.
The manual is accompanied by a 33-page quick reference booklet which repeats, in a convenient format, the information and illustrations for each of the 16 family planning options.
Improving Access to Quality Care in Family Planning
Medical Eligibility Criteria for Contraceptive Use. Second Edition
2001, 118 pages [E, F]
Sw.fr. 20.-/US $18.00; in developing countries: Sw.fr. 14.-
Order no. 1931095
Advances in scientific knowledge, research and development in recent decades have resulted in an increasingly wider choice of new contraceptive methods and improvements in the safety and effectiveness of existing methods. However, the full range of modern family planning methods still remains unavailable to at least 350 million couples worldwide, many of whom wish to space or prevent another pregnancy, despite their individual right to the benefits of scientific progress.
To meet people's needs and close the existing large gap in quality services, reproductive health care providers, programmes and contraceptive suppliers will need to expand rapidly over the next several years, and information will need to be disseminated about new contraceptive developments, appropriateness of methods and introduction strategies.
This document is one important step in a process for improving access to quality of care in family planning by reviewing the medical eligibility criteria for selecting methods of contraception. It updates the first edition of Improving access to quality care in family planning: medical eligibility criteria for contraceptive use, published in 1996, and summarizes the main recommendations of a scientific Working Group meeting held at the World Health Organization, Geneva in March 2000. The Working Group brought together 32 participants from 17 countries, including representatives of several agencies and organizations.
The document provides recommendations for appropriate medical eligibility criteria based on the latest clinical and epidemiological data and is intended to be used by policy-makers, family planning programme managers and the scientific community. It aims to provide guidance to national family planning/reproductive health programmes in the preparation of guidelines for service delivery of contraceptives. It should not be seen or used as the actual guidelines but rather as a reference.
The document covers the following family planning methods: low-dose combined oral contraceptives (COCs), combined injectable contraceptives (CICs), progestogen-only pills (POPs), depot medroxy-progesterone acetate (DMPA), norethisterone enanthate (NET -EN), Norplant implants I and II (NOR), emergency contraceptive pills (ECPs), copper intrauterine devices (Cu-IUDs), levonorgestrel-releasing IUDs (LNG-IUDs), copper-IUD for emergency contraception (E-IUD), barrier methods(BARR), fertility awareness-based methods (FAB), coitus interruptus (CI), lactational amenorrhoea method (LAM), and female and male sterilization (STER).
Their Role in Family Planning Care
1990, x + 117 pages [C, E, F, S]
ISBN 92 4 154402 3
Sw.fr. 21.-/US $18.90; in developing countries: Sw.fr. 14.70
Order no. 1150339
Presents comprehensive guidelines for family planning programme managers considering the introduction or expansion of injectable contraceptives as an option for women seeking fertility control. Thoroughly grounded in research as well as practical experience, the book concentrates on the facts and advice needed to help managers understand what the decision to offer injectables means in terms of both demands on staff and services and the health and welfare of clients. Emphasis is placed on the safe and effective use of depot-medroxyprogesterone acetate (DMPA) and norethisterone enantate (NET-EN), the most widely used injectables currently licensed in some 100 countries.
The book has nine chapters. The first provides essential technical information about injectables, their mode of action, advantages, disadvantages, and contraindications. Readers are also given a thorough explanation of the controversy surrounding safety evaluations, particularly concerning the marketing of DMPA in the USA. The second chapter explains the place of injectables within family planning programmes, including important distinctions between clinic-based and community-based services. The remaining chapters concentrate on practical and logistic problems encountered in the day-to-day organization, management, and evaluation of a programme. Details range from a 13-point checklist of activities required for the introduction of injectables, through points to be covered during a counselling session, to advice on the design of programme evaluation.
Technical and Managerial Guidelines for Services
1997, xiv + 175 pages [E, F*, S*]
ISBN 92 4 154497 X
Sw.fr. 54.-/US $48.60; in developing countries: Sw.fr. 37.80
Order no. 1150457
An authoritative and highly detailed guide to the provision of intrauterine devices (IUDs) in family planning programmes. Addressed to the managers of clinic-based services, the book aims to help programmes update their policies and practices, including counselling services, in line with the latest knowledge and specific devices. Throughout, particular attention is given to the newest copper-bearing IUDs, which have been shown, in numerous clinical and epidemiological studies, to offer considerable advantages in terms of safety, acceptability, and a life span of 10 years or more.
As use of this extremely reliable, reversible method remains constrained by the unjustified fears of health professionals and clients alike, the book also responds to the urgent need for services to update their prescribing protocols and simplify screening procedures, so that many women, previously precluded from IUD use, can be reconsidered as medically eligible.
The book has ten chapters. Background information is provided in the first, which summarizes current knowledge about the mechanisms of action, effectiveness, and safety of IUDs, giving particular attention to recent studies that confirm the method's safety and reliability. Chapter two, on the role of IUDs in family planning programmes, discusses the advantages and disadvantages of IUDs in terms of different client needs and medical eligibility criteria, the benefit-risk ratio, and the demands on services, including costs. The vital importance of information and communication is addressed in chapter three. Subsequent chapters offer advice on the logistic planning of material requirements, and explain how the different components of programme organization and management - from clinic location and patient flow to equipment, staff, and budget - can be adapted to ensure the provision of high-quality IUD services.
Against this background, technical chapters provide detailed step-by-step instructions for preventing infection, providing services, including the counselling and screening of clients, and post-insertion and follow-up care. The remaining chapters cover training requirements and programme evaluation.
Norplant Contraceptive Subdermal Implants
Managerial and Technical Guidelines
1990, vi + 134 pages [C, E, F, S]
Sw.fr. 16.-/US $14.40; in developing countries: Sw.fr. 11.20
Oder no. 1930014
Provides comprehensive practical guidelines for the programmed introduction into family planning services of Norplant subdermal implants. Norplant is a new long-acting reversible hormonal contraceptive that provides effective protection for five years. Because Norplant is a provider-dependent method, the book emphasizes the factors in the organization and management of services, the training of personnel, and the counselling of clients that can help assure user satisfaction.
The first half of the book is addressed to programme managers. Chapters answers the questions most often posed by health professionals, explains how this contraceptive's particular profile and delivery mode will influence services, discuss the contents of a training curriculum, outline the needs for information and education, and offer advice on the management of purchases, supplies, storage, and distribution.
The second part presents technical information for specialists. The first chapter summarizes the comprehensive clinical and preclinical research carried out on Norplant. Other chapters describe the aseptic procedures needed to avoid infections at the insertion and removal sites and to prevent the transmission of diseases such as hepatitis B and AIDS, set out a sample training curriculum, and provide a detailed, illustrated step-by-step guide to the procedures to be followed during the insertion and removal of Norplant implants.
Oral Contraceptives and Neoplasia
Report of a WHO Scientific Group
Technical Report Series, No. 817
1992, vi + 46 pages [C, E, F, R, S]
ISBN 92 4 120817 1
Sw.fr. 9.-/US $8.10; in developing countries: Sw.fr. 6.30
Order no. 1100817
Reports the conclusions of a WHO Study Group convened to evaluate the strength of evidence linking use of combined oral contraceptives to the risk of neoplasia in women. The group was specifically concerned with the need to resolve several inconsistencies in reported findings that have created confusion about the safety of oral contraceptives.
For some cancers, clear conclusions could be reached: use of combined oral contraceptives protects against epithelial ovarian cancer, reduces the risk of endometrial cancer, and does not influence the risk of either malignant melanoma of the skin or pituitary tumours. For neoplasia of the liver, data on short-term use of oral contraceptives, including evidence from studies conducted in populations where infection with hepatitis B virus is common, showed no association with increased risk; data on the effects of long-term use were inadequate. While the report found no overall association between oral contraceptive use and the risk of breast cancer, a number of recent studies were noted to show a weak association between long-term use of oral contraceptives and breast cancer diagnosed before the age of 36, an age group which represents a very small proportion of all breast cancers. For women over the age of 45, when breast cancer becomes more common, the report found no evidence of an increased risk of breast cancer associated with prior use of oral contraceptives. No evidence of a decreased or increased risk of breast cancer was found in either low-risk or high-risk subgroups, such as women with a family history of breast cancer. For other cancers, evidence of an association was either weak or inconsistent. The report concludes that currently available evidence about neoplasia does not provide grounds for revising the generally favourable assessment of the benefits of oral contraception.
Recent Advances in Medically Assisted Conception
Report of a WHO Scientific Group
Technical Report Series, No. 820
1992, 111 pages [E, F, S]
ISBN 92 4 120820 1
Sw.fr. 15.-/US $13.50; in developing countries: Sw.fr. 10.50
Order no. 1100820
A state-of-the-art summary of procedures used in medically assisted conception, emphasizing what is known about the medical indications for specific procedures, their safety, and the factors influencing their success. Procedures covered include in vitro fertilization, gamete intrafallopian transfer, and similar procedures, as well as established techniques for artificial insemination by the husband or a donor. Addressed to the managers of programmes for the treatment of infertility, the book makes a special effort to distinguish procedures of demonstrated efficacy from those whose potential advantages remain to be confirmed. More than 600 references to the literature are included.
Background information is provided in the opening sections, which outline the most common causes of infertility and address the need to reduce the psychological stress linked to infertility and its treatment. Advances in in vitro fertilization are covered in five sections. Information includes an outline of the medical indications for treatment, followed by discussions of the procedures and preferred protocols for the induction of multiple follicular development, for oocyte fertilization and subsequent embryo culture, and for intrauterine and intrafallopian transfer. Results of in vitro fertilization, embryo transfer and related procedures are also reviewed in an effort to identify the many factors affecting success rates. Artificial insemination is covered in three sections, which offer advice on the collection, storage and preparation of donor semen, outline indications and techniques, and provide guidance on the assessment of results. The remaining sections identify requirements for personnel, equipment, and quality assurance, as well as for future research in such areas as sperm abnormalities, oocyte quality, embryo culture, and cryopreservation.
Reproductive Health: A Key to a Brighter Future
Special Programme of Research, Development and Research Training in Human Reproduction
Biennial Report 1990-1991
Special 20th Anniversary Issue
edited by J. Khanna, P.F.A. Van Look, and P.D.
1992, xiii + 171 pages [E]
ISBN 92 4 156153 X
Sw.fr. 35.-/US $31.50; in developing countries: Sw.fr. 18.-
Order no. 1150385
Assesses changes in human reproductive health over the past two decades, concentrating on the specific ways in which scientific research has responded to the expanding needs for fertility regulation in developing countries. The book, which features 16 review articles, was issued to commemorate the 20th anniversary of the WHO Special Programme for Research, Development, and Research Training in Human Reproduction. Apart from its leading role in research on human reproduction, the Programme has helped numerous developing countries to acquire the material and human resources needed to conduct their own research on priority problems.
The book has four parts. The first, which assesses the global status of reproductive health, reviews the remarkable scientific achievements that have led to a wider choice of safe and effective contraceptive methods for women and men throughout the world. The second part traces the evolution of the Programme from its inception in 1971, through changes in policy and management, to its present research objectives and the challenges that lie ahead. In view of the importance given to the strengthening of research capacity in developing countries, the book also features reviews documenting the Programme's impact on research initiatives in Asia, Africa, and Latin America. Part three highlights progress made by the Programme during the past biennium. The final part acknowledges the contributions made by donors, collaborating centres, individual scientists throughout the world, and Programme staff.
Reproductive Health Research at WHO: A New Beginning
Biennial Report 1998-1999
2000, 108 pages [E]
ISBN 92 4 156200 5
Sw.fr. 30./US $27.00
In developing countries: Sw.fr. 15.
Order no. 1150480
Provides a report on the many research and other activities undertaken by the UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction during 1998-1999. Issued at a time of rapid reform at WHO, the report reflects the Programme's new organizational structure and expanded research agenda in line with a broader concept of sexual and reproductive health.
The report has six main chapters. The first describes a range of studies aimed at understanding people's reproductive health needs. Topics covered include men's attitudes and contraceptive preferences, the reproductive health needs of adolescents, human rights issues, and the impact of laws and regulations on reproductive health. Chapter two summarizes extensive research into the development of new methods of fertility regulation, ranging from immunocontraceptives for women to hormonal contraceptives for men.
The need to expand family planning options is
addressed in chapter three, which describes the Programme's efforts to increase
access to emergency contraception, the female condom, and the diaphragm. Chapter four
concentrates on the important work being done to monitor the long-term safety of specific
contraceptive methods. Projects described include large studies of the safety of Norplant,
the influence of hormonal contraception on bone mineral density, cardiovascular risks
associated with steroid hormone contraception, and approaches to the prevention of
postpartum haemorrhage. The remaining chapters describe measures for strengthening
reproductive health services and national research capability.
Research on Reproductive Health at WHO
Biennial Report 2000-2001
2002, 67 pages [E]
ISBN 92 4 156208 0
Swiss francs 30.—/US $27.00
In developing countries: Sw.fr. 15.—
Order no. 1150502
Sexual and reproductive health is at the core of people’s lives and well-being. As a key global player in its field, the UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP) investigates the extent and nature of sexual and reproductive health problems and finds ways of alleviating or solving them. While fertility regulation has remained a core area of HRP's work, its research agenda has expanded in recent years to include the entire spectrum of sexual and reproductive health.
Much of HRP’s comparative advantage in the reproductive health community springs from the global research network it has built up. This report describes studies conceived and coordinated by HRP and carried out during the 2000–2001 biennium by research groups belonging to the HRP network. The work covers a wide range of reproductive health issues—the safety and effectiveness of existing, and the promise of new, family planning methods; how to make pregnancy and childbirth less life-threatening; preventing reproductive tract infections, including HIV infection; doing away with unsafe abortion; and, as the threat of HIV/AIDS looms ever-larger over the planet, how to make adolescent sexual behaviour less hazardous. The report introduces each issue with basic facts and an outline of the main questions that HRP-backed research sets out to answer.
Reproductive health care relies increasingly on sound scientific evidence for its effectiveness. This report reflects the work of a global programme dedicated to providing that evidence.
UNDP/UNFPA/WHO/World Bank Special Programme of
Research, Development and Research Training in Human Reproduction
Biennial Report 1994-1995
1996, 111 pages [E]
ISBN 92 4 156183 1
Sw.fr. 26.-/US $23.40; in developing countries: Sw.fr. 13.-
Order no. 1150443
A report on the many research and other activities undertaken by the UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction during 1994-1995. The report has eight main chapters. A summary of research on the prevalence of lower genital infection with Chlamydia trachomatis is followed by a report of what is being done to improve the effectiveness of reproductive health services. Particular attention is given to the Programme's three-stage approach for helping governments to expand the range of contraceptive options.
Subsequent chapters cover research on the sociocultural factors that influence contraceptive use, and summarize recent developments in the safety testing, production, and availability of selected contraceptive methods. The Programme's major commitment to investigate the safety and efficacy of existing contraceptive methods and to develop a range of new options is reflected in reports of significant recent research. New products under development include a long-acting injectable hormonal contraceptive, a levonorgestrel-releasing vaginal ring, various immunocontraceptives, and an especially promising injectable hormonal contraceptive for men. The remaining chapters summarize activities carried out to strengthen research capabilities in developing countries