Improving Family Planning

Providing Contraceptive Guidelines 

Since 1994, CDC’s Division of Reproductive Health (DRH) has provided assistance to the World Health Organization (WHO) to develop and update WHO’s authoritative contraceptive guidelines for family planning providers based on scientific evidence. WHO uses this information to update their guidelines, the Medical Eligibility Criteria for Contraceptive Use and the Selected Practice Recommendations for Contraceptive Use. CDC has adapted these guidelines for use in the United States.

CDC monitors, assesses, and synthesizes new research on contraceptive safety and efficacy using the CIRE (Continuous Identification of Research Evidence) system. The CIRE system was developed by CDC/DRH, WHO, and Johns Hopkins University to facilitate the process of providing WHO with the best evidence in a timely manner. This system allows CDC/DRH to—

• Identify new evidence as it is published.
• Conduct systematic reviews and meta-analyses.
• Solicit peer reviewer feedback on the systematic reviews and the need to update guidance.
• Present the evidence and feedback to WHO.

WHO then holds expert meetings to decide if and how to adapt their guidance on the basis of the new findings.

Reproductive Health Surveys

CDC’s Division of Reproductive Health (DRH) helps countries throughout the world to develop, implement, and analyze national reproductive health surveys. These population-based surveys provide high quality data on a wide variety of reproductive health indicators such as fertility, contraceptive prevalence, antenatal care, and sexually-transmitted infections. Each country’s needs guide the survey content. Countries use the survey findings to assess reproductive health status, develop policy, and evaluate their programs and interventions. While carrying out the surveys, CDC staff works with in-country staff to build their survey skills. 

Review the list of countries where DRH  conducted surveys and link to reports and datasets.

CDC’s Division of Reproductive Health created the Reproductive Health Survey Toolkit based on decades of experience conducting surveys in Latin America. Available only in Spanish, it provides the necessary tools to produce high quality, internationally-comparable demographic and reproductive health information without external technical assistance. The Toolkit (Paquete de Herramientas para Encuestas de Salud Reproductiva) contains reference materials and software programs in four modules, each focused on a key technical component of the CDC Reproductive Health Surveys:  Model Questionnaire; Data Entry and Processing; Sample Design and Analysis Weights; and Statistical Analysis. It was created  as part of the USAID MEASURE project.

CDC’s Division of Reproductive Health continues to provide global technical assistance in survey design and implementation.

Preventing the Transmission of Sexually Transmitted Infections, Including HIV

DRH is engaged in several PMTCT activities:

• Integration of family planning and HIV Services in Russia and Ukraine
  In Russia, CDC/DRH has been involved in a study to prevent unintended pregnancies in HIV-positive women. Most women never wanted to become pregnant in the future or were uncertain that they ever wanted children. This study involves investigating the safety and effectiveness of long-term contraceptives for HIV-infected women, and integrating family planning and reproductive health services with HIV services. In Ukraine, CDC/DRH has been involved in an intervention to prevent HIV infection and unintended pregnancies among street and out-of-school youth.
• Breastfeeding, Antiretrovirals, and Nutrition (BAN) Study
  The Breastfeeding, Antiretrovirals, and Nutrition (BAN) Study was a randomized-controlled clinical trial in Malawi to evaluate the following objectives: 1) the benefit and safety of antiretroviral prophylaxis given either to infants or to their mothers to prevent HIV transmission during breastfeeding, 2) the benefit of nutritional supplementation given to women during breastfeeding to prevent maternal depletion, and 3) the feasibility of exclusive breastfeeding followed by early, rapid breastfeeding cessation. Both the infant nevirapine arm and the maternal prophylaxis arm were effective and safe methods for preventing HIV transmission through breast milk. Additionally, women on the nutritional supplement lost significantly less weight than the no-supplement group. 

CDC/DRH is also conducting the Accessing Counseling Message Effectiveness (ACME) Study. The ACME Study began in March 2011, and aims to develop effective counseling to help women avoid unprotected sexual activity while being treated for a sexually transmitted disease (STD) and potentially help curb STD transmission.

Assessing Your Program's Contraceptive Supply Needs

Every family planning program must have a good supply of contraceptives on hand at all times. To help countries and programs calculate the quantity of contraceptives they need, CDC has developed the CastCost (Contraceptive Forecast and Cost Estimate) tool. This user-friendly spreadsheet uses data from Reproductive Health Surveys (or Demographic and Health Surveys) to estimate the quantity and cost of contraceptives that will be needed in a country or by a family planning service provider for each of the next five years. The CastCost tool is available in both English and Spanish. Read about our past work in Contraceptive Logistics.