E-DRUG: RFI - evidence that contraceptive choice matters
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Hi all
At the 14th meeting of the WHO Expert Committee on Essential Medicines,
a number of applications for new contraceptive medicines were considered
and rejected. As part of the discussion for these applications it was
noted that the approach to provision of medicines for family planning
was a philosophy of choice and therefore a wide list of options, whereas
for the Essential Medicines List generally, the approach is one of
identifying the minimum needed to provide health care. As the provision
of additional methods of contraception has an opportunity cost both with
reproductive health services and health services generally, it was
therefore suggested that to facilitate further consideration of
contraceptive applications in the future, it would be important to have
a review of the evidence supporting the value of the choice philosophy
undertaken, and presented to the Committee.
On behalf of the WHO Policy, Access and Rational Use (PAR)/Medicines
Policy and Standards (PSM) and Reproductive Health and Research (RHR) departments, the following research question is being addressed:
"Does a policy of providing a wide range of contraceptive methods, as
opposed to the provision of a limited range, improve health outcomes
including: contraceptive uptake, acceptability, adherence, continuation
and satisfaction; reduction of unintended pregnancy; and improved
maternal health and wellbeing."
E-druggers' help is requested in identifying evidence that would not
easily be identified from the usual abstract services, particularly:
* needs analyses of contraceptive requirements from countries or
regions.
* reports, opinion papers and position papers from contraceptive service
suppliers/product distributors.
However, pointers to head-to-head randomised and non-randomised
comparison studies on the effectiveness, safety, uptake, acceptability,
adherence and continuation of different contraceptive methods or to
observational studies on the introduction of a variety of contraceptives
which measure health outcomes and/or uptake, acceptability, adherence
and continuation or similar parameters will also be welcomed.
In particular, we are looking for evidence that uses the following types
of outcome measures: "intermediate" measures such as contraceptive
uptake, unmet need for contraception, contraceptive method
acceptability, adherence to contraceptive method, contraceptive method
continuation, reasons for method discontinuation, satisfaction with
contraceptive method OR "ultimate" measures such as rates of unintended
pregnancy, maternal mortality and maternal morbidity.
Please send materials and/or pointers to j.smit@rhru.co.za,
n.manzini@rhru.co.za and/or graya1@ukzn.ac.za and NOT to E-DRUG.
Posted on behalf of the review team:
Jennifer Ann Smit, PhD
Director: Contraception and Barrier Methods, Reproductive Health and HIV
Research Unit (Durban Office), Wits Health Consortium, University of the
Witwatersrand, South Africa.
Mags Beksinska, MSc
Deputy Executive Director, Reproductive Health and HIV Research Unit
(Durban Office), Wits Health Consortium, University of the
Witwatersrand, South Africa.
Ntsiki Manzini, MSc
Senior Researcher, Reproductive Health and HIV Research Unit (Durban
Office), Wits Health Consortium, University of the Witwatersrand, South
Africa.
regards
Andy