The Bellagio Consensus: Professional Recommendation for the Summit
Tomorrow, July 11 is World Population Day. It’s also the day when world leaders meet with the government of the United Kingdom, and the Bill and Melinda Gates Foundation at the Global Family Planning Summit to discuss the need to improve access to modern contraception, through better funding, delivery and monitoring.
Melinda Gates hopes to raise up to four billion dollars to help over 200 million women world-wide, who have unmet needs for family planning.
So far, the hosts of the summit have endorsed family planning as a human rights issue. They hope to empower women by allowing them to choose if and when they want to have a child, to make decisions on the size of their families, and to delay or space pregnancies that may hinder the progress of their lives.
In advance of this Global Summit on Family Planning, the Population Council, the International Federation of Gynecology and Obstetrics, and the Reproductive Health Supplies Coalition released a statement on July 9, with recommendations for action to increase access to highly effective, Long-Acting, Reversible Contraception (LARC). The statement is the outcome of a meeting held on May 2012 at the Rockefeller Foundation’s Bellagio Center, and has been titled the Bellagio Consensus.
The family planning summit will promote the need for national governments to acknowledge a woman’s right to birth control, but no details are available yet on which contraceptives will be made available. The Bellagio consensus endorses the view that women and men have rights to the entire gamut of contraceptives, but recommends LARCs in particular.
Highly-effective LARCs include intrauterine contraceptive devices (IUDs), and contraceptive implants that women in developing countries do not always have the access to. The barriers are plenty: lack of a comprehensive policy on family planning; lack of adequate health services; lack of awareness; social, cultural and religious restriction; and myths on birth control. The consensus recommends ways to overcome these, and provide all women with modern contraception.
Highlights of The Bellagio consensus are as follows.
•Change Policies: Policymakers should work toward improving access to LARCs, by integrating them into their family planning programs, and by improving the funds available for the procurement and distribution of these contraceptives.
•Reduce Cost and Ensure access: LARCs are not inexpensive, and so many women in developing countries cannot afford them. The consensus points out that governments and NGOs have worked together at cutting costs in the last five years, but recommends that they develop strategies to ensure that there is a constant supply of these contraceptive to all women who may be in need of them. Governments and donors should promote informed choice, and ensure that there is a reliable supply in public and private markets.
•Integrate LARCs into health systems: Health care systems should integrate LARCs into their information management system, and ensure that their staff is trained and qualified to inform the patient, insert contraceptives, and remove them on demand
•Engage Support of Professional Associations: To ensure that these modern contraceptive are available and used appropriately, professional medical and nursing organizations should work with national governments, private sectors and NGOs to train medical and non-medical providers.
•Monitoring: Governments and NGOs should gather data from the health services to constantly evaluate the service. This data should be reviewed by organizations like the WHO, or FIGO, and then used to improve service, and health care.
•Develop a strategy to accomplish these goals: National governments and donors should work together to come up with realistic plans to deal with the barriers to contraception and to ensure the constant supply of contraceptives to women across all economic classes.
The consensus recommends that governments implement these plans completely by 2020, and significantly by 2015 in order to meet with the MDGs.
Unfortunately, the summit will not address safe abortions, or the need to include men in all dialogue on contraception. So, the Bellagio consensus sticks to the points that will be addressed in the agenda.
However it does acknowledge that husbands and families deny several women around the world access to contraceptives. These women are at risk of unintended pregnancy and unsafe abortions.
