HRP at 40 – Among key achievements
For 40 years, HRP – The UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction – has been the main instrument within the United Nations system for research in human reproduction, bringing together policy-makers, scientists, health care providers, clinicians, consumers and community representatives to identify and address priorities for research to improve sexual and reproductive health.
Widening choice and access to family planning
In the developing world, 215 million women have an unmet need for contraception, and another 64 million have an unmet need for a modern method. Up to a third of maternal deaths can be averted by use of effective contraception by women wishing to postpone or cease further childbearing. There is a high unmet need for family planning, particularly for some selected populations such as adolescents, those in low socioeconomic classes, and in conflict and disaster situations.
HRP has led, conducted and coordinated a large number of multicentre trials on the safety and efficacy of a variety of contraceptive methods, providing important tools and conclusive evidence that contribute significantly in prevention of unplanned pregnancies, thus reducing maternal deaths and morbidities, decreasing the numbers of unsafe abortions, and leading to stronger and healthier families and communities. HRP research results have been applied towards improving quality of care in service delivery and improving access to family planning and reproductive health services.
HRP has contributed to the development of new methods of contraception with the goal of providing expanded choices to couples, an indicator of quality of care. Methods such as the contraceptive vaginal ring, a monthly injectable, and emergency contraception regimens have been made available to couples worldwide, thanks in part to HRP global research initiatives.
The goals of the HRP research agenda, established in 1972, to provide relevant information to country programmes on the long-term safety and effectiveness of IUDs have been fully and successfully achieved.
Conlcusion of the External Evaluation of HRP, 2003–2007
Intrauterine device (IUD)
From the 1970s, a number of different kinds of IUDs were produced and marketed for use, necessitating rigorous evidence to guide decisions on choosing the safest, most effective, reversible long-acting method. Through a series of international trials in impressively large cohorts of women, HRP has, over the past three decades, monitored the performance and safety record of many popular IUDs. Thanks to these trials, HRP has been able to provide data on the safety and efficacy of a variety of IUDs, which facilitate informed choices by programme managers and providers, significantly contributing to prevention of unintended pregnancies.
Hormonal contraceptive implants
These are also long-acting methods using slow-releasing mechanism for hormones that produce a contraceptive effect over several years. Currently there are studies looking into the effectiveness of implants that work for longer periods, requiring fewer implants, and with fewer side-effects. Due to the work of HRP, these studies are being conducted in many countries with promising results that could lead to facilitated access to more long-acting methods that may be more easily provided to a wider group of women.
Guidelines and tools
HRP develops and disseminates evidence-based family planning guidelines and tools, among which The WHO Medical eligibility criteria for contraceptive use (4th edition), or “MEC”, was awarded the first prize in the Obstetrics and Gynaecology category in the 2011 British Medical Association Book Awards. This family planning guidance tool has been a pillar of the work of HRP since its inception 40 years ago. It has been shared thousands of times over in countries, with each update, and it remains one of our most long-standing and flagship achievements for its impact on the lives of women and their families in countries, by its role in strengthening family planning care.