RECOMMENDATIONS FOR ACTION

Consensus was reached on the following recommendations, many of which are addressed specifically to the Special Programme. The essence of the recommendations has been preserved here, but they have been condensed and expressed in a broadly applicable form. In this form they are addressed to all agencies that undertake and/or fund research on fertility regulation methods, method introduction, and service delivery.

Participation by women

• Ensure that women's health advocates are incorporated into policy and programmatic activities.

• Promote national and regional exchanges between scientists and women's groups, in order to help the scientific community, international agencies and national governments to incorporate women's perspectives into their health and family planning priorities.

• Convene special meetings for scientists and women's health advocates, along the lines of this meeting, to discuss key topics, including:

  - the development of new methods;
  - the development of contraceptive vaccines;
  - the use and further development of barrier methods;
  - induced abortion.

• Involve women, and include women's perspectives, in the identification of research needs and priorities and in the implementation of research on reproductive health at country and regional levels.

Research

• Revise technical, methodological, and ethical guidelines for research, in line with women's perspectives and experiences; promote widespread awareness of these guidelines; and foster their implementation at the country level.

• Promote the institutionalization of ethics committees at country level, with the participation of women's health advocates.

• Establish minimum standards for the quality of care in clinical and introductory trials, and mechanisms for promoting and monitoring quality of care.

• Discuss and revise, incorporating women's perspectives, the definitions of and relative weight to be assigned to safety, efficacy, afford ability and acceptability in selecting and introducing fertility regulation methods.

• Encourage the formation of multidisciplinary research teams which include women's health advocates, and the use of participatory research methods at national, regional, and international levels.

Support research on:

• women's and men's views on and experiences with existing methods, and the attributes they most like or dislike;

• the comparative effects on women's health of fertility regulation methods, with attention to both pregnancy prevention and pregnancy termination;

• the use-effectiveness and acceptability of the withdrawal method;

• the safety and appropriateness of RU486 compared to surgical or vacuum aspiration abortion;

• the balance among safety, efficacy, afford ability and acceptability for particular methods, in relation to other methods, in particular settings.

Training

• Promote training in reproductive health issues including family planning, in medical, midwifery and nursing schools and other key institutions. Such training should pay attention to women's perspectives and to the "human" as well as technical dimensions of fertility regulation and reproductive health.

• Increase the number of women scientists; incorporate women's perspectives into scientific curricula and programmes; and train women's health advocates to participate in research on fertility regulation.

Introduction of fertility regulation methods

• Encourage the introduction of safer, more user-controlled methods.

• Involve women's health advocates in all phases of introductory trials including design, provider training, management, implementation, monitoring and evaluation.

• Review approaches to method introduction to encourage use of integrated health services, other aspects of quality of care, and more participatory approaches.

• Develop criteria and methods to evaluate the settings into which particular fertility regulation methods might be introduced, including the characteristics of health care infrastructure, the recurring costs of providing the method on a national scale, the quality and quantity of existing family planning services, and the status and roles of women.

• Encourage governments to do everything possible to prevent and eliminate unsafe abortion.

Information dissemination

• Disseminate results of research as widely as possible, in particular to women's health advocates and women's groups worldwide, in appropriate languages.

• Support existing women's health advocacy networks and publications, and promote dissemination of their information widely among the scientific community.

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