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This bulletin is being sent by the Health Care Authority (HCA) in partnership with the Reproductive Health Access Project (RHAP).
Written by Angeline Ti, MD, MPH
Earlier this month, the World Health Organization (WHO) released the 6th edition of the Medical Eligibility Criteria for Contraceptive Use (MEC) and the 4th edition of the Selected Practice Recommendations for Contraceptive Use (SPR). Clinicians in the US may be familiar with the similarly named guidance, the US MEC and US SPR from the Centers for Disease Control and Prevention (CDC), but many US clinicians may not be aware that the CDC guidance was originally adapted from guidance from the WHO.
The first edition of the MEC was published in 1996 with the intention of creating evidence-based guidance to help inform the provision of contraceptive care and to reduce unnecessary medical barriers to care.1 Epidemiologists at CDC and WHO applied principles of evidence-based medicine (a growing field at that time) to conduct literature reviews examining the safety of various contraceptive methods for people with medical conditions. Scientific experts, representatives from international agencies, and women’s health advocates convened to formulate recommendations, including creating the MEC categorization system in order to move beyond the binary of contraindications.
View the MEC categorization system
Following the creation of the MEC, WHO also published the SPR in 2002 to provide guidance around common contraceptive management questions. The intended audience for the MEC and SPR includes policymakers, family planning program managers, and the scientific community, who use these recommendations to guide policy, programming, and inform research priorities. The guidance is meant to be adapted to local contexts and populations and has notably been adapted for national guidance, such as in the US2 and the UK.3 To further support the implementation of high-quality family planning services, WHO has also created the “Decision-making tool for family planning clients and providers,” “Family planning: a global handbook for providers,” the MEC Wheel, and an app. To learn more about the latest edition of the MEC and SPR, watch the recorded WHO webinar. As the future of the US MEC and US SPR remains uncertain, clinicians in the US should also be aware of global guidelines that can inform evidence-based reproductive health care practice.
References
See RHAP's original post for sources.
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