Sexual and reproductive health

How human rights help ensure high-quality contraceptive services

26 September 2017: World Contraception Day

Recognition that human rights are of critical importance in the design and provision of contraceptive services and programmes is growing. How healthcare providers and facility managers ensure that human rights aspects are integrated into services is a challenge with many dimensions including the right of access to high-quality contraceptive services, autonomy and a choice of methods as well as the respectful provision of care.

It is currently estimated that some 214 million women have an unmet need for modern contraception. This need is greatest among the most vulnerable and where the risks of maternal mortality are correspondingly highest. The application of human rights in designing and delivering contraceptive information and services can be instrumental in helping to ensure that individuals receive high-quality health care that meets their needs.

A family planning user and a health promoter discuss contraceptive methods, Guatemala
Haydee Lemus/Photoshare

Improving access to, and quality of, contraceptive information and services by applying a human rights focus needs to happen at a number different levels. International and regional human rights treaties, national constitutions, and national laws provide guarantees relating to access to contraceptive information, commodities and services. Additionally, regional, national and international human rights bodies have been increasing their focus on the issue of access to high-quality contraceptive information and services over the past decades. They are increasingly drawing attention to the need for States to ensure that acceptable contraceptive services are delivered in a timely and affordable way, are based on fully-informed decision making, respect dignity, autonomy, privacy and confidentiality, and are sensitive to individuals’ needs and perspectives.

In 2014, to help guide its Member States, WHO published Ensuring human rights in the provision of contraceptive information and services, providing recommendations addressed to policy-makers, programme managers and other stakeholders.

A second key area for intervention is with healthcare providers and facility managers at the point of service delivery. Providing high quality services in real-world settings that fully respect individuals’ human rights is where the most potential exists for violations or omissions of rights. These challenges are further exacerbated in low-resource settings. High quality care is clearly an essential requirement for any contraceptive services. Studies show that where people feel that they are receiving good-quality care, contraceptive use is higher. Achieving higher standards of quality improves the effectiveness of sexual and reproductive health services and attracts people to use them. Elements of high-quality care include: choice among a wide range of contraceptive methods; evidence-based information on effectiveness, clear information on the risks and benefits of different methods, respectful provider user relationships, a guarantee of privacy and confidentiality and appropriate, accessible, follow-up.

User-friendly checklist for healthcare providers focusing on the quality of care in contraceptive information and services

To address this issue, WHO has recently published (2017) a user-friendly checklist for healthcare providers focusing on the quality of care in contraceptive information and services, based on human rights standards. The checklist focuses on five areas of competence needed by healthcare providers. Based on both human rights standards and available public health evidence, these are:

  • Respecting users’ privacy and guaranteeing confidentiality
  • Choice of contraceptive
  • Fostering an accessible and acceptable service
  • Involving users in improving services
  • Fostering continuity of care and follow-up to ensure efficacy

Diagram: The relationship between quality of care and human rights

Diagram: The relationships between quality of care and human rights.

The checklist if available for download free of charge. (link below)

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