Essential Package of Sexual and Reproductive Health Services

Planning and Implementing an Essential Package


Sexual and Reproductive Health Services

Guidance for Integrating Family Planning and STI/RTI with other Reproductive Health and Primary Health Services

Author: Population Council, UNFPA No. of pages: 56 Publication date: 2011 Publisher: Population Council, UNFPA

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The goal of this guidance document is to provide a framework for developing an essential sexual and reproductive health (SRH) package. It focuses on two priority areas: 1) integrating family planning into maternal and newborn care services, and 2) integrating services for preventing and managing sexually transmitted infections/reproductive tract infections into primary healthcare services.

This guidance document comprises three sections. The Introduction explains and justifies why the development and implementation of an essential SRH package should be planned and framed within the World Health Organization’s six Building Blocks of Health Systems.

The second section presents the “How To” steps and checklist tools for planning, implementing and scaling up, including specific examples for the two priority areas indicated above.

The third section provides the evidence-base supporting the recommendations and action-points proposed in each tool. This evidence-base includes key findings and summary recommendations from a literature review (in matrix format) and a bibliography of the references included in the literature review.





Reproductive Health

Improving Reproductive Health Services

UNFPA supports a gender- and rights-based approach to reproductive and sexual health, one that empowers women throughout their lives.

Reproductive rights become tangible, however, only when reproductive health services that offer a high quality of care are made widely available. Availability includes both affordability and convenience, which generally implies a range of services under one roof.

The critical importance of reproductive health was endorsed at the highest level at the 2005 World Summit. At that convocation, the largest-ever gathering of world leaders recognized that reproductive health is critical to achievement of the Millennium Development Goals. They reaffirmed the need to keep reproductive health high on the development agenda, and to make universal access to reproductive health by 2015 a reality.

Priority concerns

UNFPA gives priority to providing basic reproductive health services to young people, pregnant women, and hard-to-reach populations, including those displaced by humanitarian crises. Linking reproductive health services to HIV and AIDS prevention, treatment and care is increasingly being seen as a critical strategy to expanding access to both types of care. In recognition that men are integral to reproductive health, the Fund also is expanding its support to services that can make men healthier and more responsible sexual partners.

Both men and women need access to information and appropriate health services throughout their lives. Such information and services should be gender sensitive and allow:

  • All individuals to make informed choices about sexuality and reproduction, and to have a safe and satisfying sexual life, free of violence and coercion
  • Women to go safely through pregnancy and childbirth
  • Couples to have the best chance of having a healthy infant
  • Women to avoid unwanted pregnancy and to address the consequences of unsafe abortion
  • Access to prevention, treatment and care for sexually transmitted infections, including HIV.

Offering essential services

Almost all programme countries struggle to expand access to services. Because of limited resources, many countries initially offer a core package of basic services, which can be expanded as resources become available. For the convenience of users, and streamlining of management, reproductive and sexual health services should be integrated within a system that offers primary health care and referrals for more specialized needs.

A full sexual and reproductive health package includes:

  • Family planning/birth spacing services
  • Antenatal care, skilled attendance at delivery, and postnatal care
  • Management of obstetric and neonatal complications and emergencies
  • Prevention of abortion and management of complications resulting from unsafe abortion
  • Prevention and treatment of reproductive tract infections and sexually transmitted infections including HIV/AIDS
  • Early diagnosis and treatment for breast and cervical cancer
  • Promotion, education and support for exclusive breast feeding
  • Prevention and appropriate treatment of sub-fertility and infertility
  • Active discouragement of harmful practices such as female genital cutting
  • Adolescent sexual and reproductive health
  • Prevention and management of gender-based violence

Reproductive and sexual health is a societal concern

Reproductive and sexual health is a societal issue — not only the responsibility of the health sector. It is important to build partnerships with other public and private sectors, as well as with civil society.

Effective health service delivery can be achieved by:

  • Partnerships with civil society
  • Community involvement
  • Integration of services
  • Inclusion of health promotion activities
  • Advocacy for sexual and reproductive health and rights
  • Coordination across services, sectors, ministries

Communities can play an important role in building demand for appropriate reproductive health services. For instance, they can mobilize and build awareness at the local level about reproductive health issues. They can organize to pool resources in micro-insurance schemes. They can collectively exert more pressure for public health service improvements than individuals. Such efforts can be especially effective and timely as health reform and decentralization is underway in many countries. Innovative and participatory approaches are needed to ensure that reproductive health issues receive adequate attention during this transition. The UNFPA-supported Stronger Voicesproject is a good example of how this can work.

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