WHO's four cornerstones of family planning guidance - A global partnership for strengthening the use of evidence in family planning
ESC Congress Library. Van Look P. May 2, 2008; 2079 Disclosure(s): None relevant.
Prof. Paul Van Look
Prof. Paul Van Look
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Learning Objectives
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1. The process of development of WHO\'s four cornerstones of family planning and how these materials are being kept up-to-date.
2. The content and scope of WHO\'s four cornerstones of family planning.
3. The importance of using evidence-based best practices in family planning services and how WHO\'s four cornerstones of family planning guidance can help with that.
WHO's four cornerstones of family planning guidance - A global partnership for strengthening the use of evidence in family planning

Paul F.A. Van Look, Director, Department of Reproductive Health and Research,
World Health Organization, Geneva, Switzerland

Within the field of health, family planning is no exception in that clinical practice is frequently based on tradition rather than on contemporary evidence. This has led on occasion to divergent, sometimes even contradictory, advice given to family planning practitioners by leading family planning handbooks. The result has been confusion among providers (\"Should I give prophylactic antibiotics when inserting an IUD or not?\") and often an overcautious approach in providing methods that has turned away clients, such as the insistence of doing a pelvic examination before prescribing hormonal contraceptives.

In an effort to put family planning on a stronger, evidence-based footing, WHO's Department of Reproductive Health and Research initiated in the mid-1990s a process of systematic review of all published evidence relevant to the provision of family planning methods. The work was purposely undertaken with the active involvement and collaboration of a large number of experts and all major family planning organisations to ensure that products resulting from this initiative would have a strong buy-in and be widely promoted and used. These aims have been achieved beyond expectations as evidenced by the large variety of languages in which the guidance documents have been translated, the number of organisations that have endorsed the guidelines, and the number of countries that have used the guidelines to update their own national protocols and regulations. The first two \"cornerstones\", the Medical eligibility criteria for contraceptive use (first published in 1996; now in its 4th edition) and the Selected practice recommendations for contraceptive use (first published in 2002; now in its 3rd edition) were both aimed at policy-makers and programme managers. The next two \"cornerstones\" are aimed at healthcare providers: they are the Decision-making tool for family planning clients and providers and the recently published Family planning: a global handbook for providers. In parallel with these developments, the Continuous Identification of Research Evidence (CIRE) system was set up to provide a mechanism for identifying and appraising new evidence as it becomes available in the literature and, if warranted, updating the \"cornerstones\". With the recent launch of the Handbook the stage is now set for a systematic, formal evaluation of the impact of this evidence-based guidance on the practice of family planning.
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