How do you take family planning to places with no doctors?

Women waiting at clinic
10 Dec 2012 | Family planning
We congratulate WHO on the publication of their tasksharing recommendations and welcome the progress they represent on improving access to life saving services.

The World Health Organization today published new ‘tasksharing’ guidelines on maternal and newborn healthcare that recommend governments enable more health workers below the level of doctor to provide key maternal and newborn health (MNH) care services including family planning. 

We congratulate WHO on the publication of these recommendations and welcome the progress they represent on improving access to life saving services.

If implemented by governments, the guidelines will not only help health systems run more efficiently and equitably but also partially address the chronic shortage of health care workers that constrains access to healthcare in many developing countries. 

Some health care interventions are rightly limited by national health policies to provision by high level health workers due to their complexity to administer or risks of complication.

Other interventions are simpler to provide and confer no or very low risk of health complications. We have long advocated for restrictions to be lifted on the provision of family planning methods as interventions that belong firmly in the latter category.

Teamed with the WHO’s interactive tool, the new guidelines represent confirmation that the world’s leading  health authority recognises the safety and efficacy of enabling lay health workers, auxiliaries, nurses, midwives and clinical officers to provide specified life saving health interventions that are all too often unnecessarily restricted to higher level professionals.

In the UK, the fact that a doctor’s prescription is required for women to access the oral contraceptive pill represents an inconvenient and inefficient barrier to access. In developing countries, where there may be as few as two doctors per 100,000 people, the requirement to see a doctor effectively puts health care out of reach for millions. 

In such settings, it is essential that access to services is not restricted to higher level health workers unnecessarily. Training and enabling lower level healthcare professionals to provide certain tasks has the potential to revolutionise access to MNH, especially in remote rural areas.

Tubal ligation, for example, is an intervention that the WHO’s interactive tool identifies as falling so comfortably within the skill set of associate clinicians that no assessment was required on formulating this specific recommendation. Yet in many countries, associate clinicians – who are often far more accessible in rural areas than doctors – are prevented from training to provide this service.

We strongly recommend the WHO ‘OptimizeMNH’ guidelines to governments and international partners who wish to implement swift, safe and effective policy reform to improve access to family planning and other life saving MNH interventions.

You can also read a testimony by one of our nurses, view a video below from Ethiopia and read some of our research: all of these demonstrate the dramatic improvements in healthcare that tasksharing can bring, and the fact that many aspects of care can be taskshared safely and effectively, as well as being acceptable to women and men.