In May 2012, the Population Council, the International Federation of Gynecology and Obstetrics (FIGO), and the Reproductive Health Supplies Coalition (RHSC) hosted a meeting at the Rockefeller Foundation’s Bellagio Center to discuss opportunities to increase access to Long Acting Reversible Contraceptions (LARCs) to accelerate progress toward meeting the Millennium Development Goal of universal access to reproductive health services. Participants, including service providers, donor representatives, policymakers, procurement specialists, manufacturers, and public health officials, reached consensus on analysis and several recommendations.
Highly effective LARCs, which include intrauterine contraceptive devices (IUDs) and contraceptive implants, are often inaccessible to women in developing countries. Family planning programs in those countries are unable to fulfill this need, due to the low priority they take in programming.
The Bellagio meeting brought about several recommendations, some of which are explained below.
- Change policies: Policymakers should increase the priority given to efforts to reduce unintended pregnancies by meeting the unmet need for highly effective, long-acting, reversible contraceptive methods as part of a comprehensive range of method options. This priority should be reflected in financing, procurement, and human resource policies as well in the registration, introduction, and distribution of contraceptive methods.
- Reduce cost: For many women in developing countries, LARCs are unavailable or are attainable at a cost much greater than women are able to pay. For these women, access to LARCs is dependent on programs largely financed by donors and national governments. Despite the relatively high initial cost of LARCs, developing-country governments, working with donors and NGOs, have expanded the level of LARC use over the past five years. To sustain this progress, manufacturers, international donors, and national procurement systems should collaborate to develop strategies to increase the affordability of procuring and supplying LARCs. They should also work to maintain a reliable supply of LARCs within countries to allow use of these methods as desired by women. Greater availability and use of LARCs will help increase affordability.
- Integrate LARCs into health systems: To ensure that women have a range of choices across product classes, public and private health care delivery systems should integrate LARCs into their training, counseling, service provision, logistics, and information management. Because many providers of postabortion and postpartum care have the counseling and clinical skills needed for initiation of LARCs, more attention should be focused on postabortion and postpartum provision of LARCs as one of the simplest ways to increase access to those in greatest need.
For more information about the meeting and the full list of key recommendations, please click here.