The 2022 edition of Family Planning: A Global Handbook for Providers reflects the most up-to-date World Health Organization (WHO) recommendations issued since the publication of the 3rd edition in 2018. Of note, revisions to Chapters 4, 22, and 25 incorporate recommendations published by WHO that address medical eligibility for the use of progestin-only injectables among woman at high risk for HIV (1); syndromic management of sexually transmitted infections (2); screening, prevention, and treatment of cervical cancer (3,4,5); and postabortion contraception (6). Expanded guidance on implant insertion and removal techniques in Chapter 9 was added based upon new information provided by the product manufacturer to improve client care.
The development of the new chapter titled Family Planning for Adolescents and Women at High Risk for HIV was informed by recommendations issued by a WHO Guideline Development Group that met in July 2019 to review contraceptive eligibility for women at high risk of HIV (7), and also presented in a July 2020 policy brief by WHO and the Joint United Nations Programme on HIV/AIDS (UNAIDS) highlighting recommended actions for improved clinical and prevention services and choices (8). The new chapter titled Providing Family Planning Services During an Epidemic is based on interim WHO operational guidance on maintaining essential services during an outbreak (published in March and updated in June 2020) (9) and a WHO Q&A web page responding to questions on COVID-19 and family planning (10).
A multidisciplinary group of experts, including experts in family planning, sexually transmitted infections, abortion care, cervical cancer, and HIV, as well as representatives from affected populations, and clinicians, epidemiologists, pharmacologists, program managers, and policy-makers, contributed to the development and review of the revised chapters and newly developed chapters (see Acknowledgements).
Definitions Used in This Handbook
Effectiveness: Rates are largely the percentages of US women estimated to have unintended pregnancies during the first year of use, unless noted otherwise. See Appendix A.
Side effects: Conditions reported by at least 5% of users in selected studies, regardless of evidence of causality or biological plausibility, listed in order of frequency with the most common at the top.
Terms describing health risks (percentage of users experiencing a risk):
Common: ≥15% and <45%
Uncommon: ≥1% and <15%
Rare: ≥0.1% and <1% (<1 per 100 and ≥1 per 1,000)
Very rare: ≥0.01% and <0.1% (<1 per 1,000 and ≥1 per 10,000)
Extremely rare: <0.01% (<1 per 10,000)
Reference List for the Methodology
1. Contraceptive eligibility for women at high risk of HIV: guidance statement: recommendations on contraceptive methods used by women at high risk of HIV. Geneva: World Health Organization; 2019 (https://apps.who.int/iris/handle/10665/326653).
2. Guidelines for the management of symptomatic sexually transmitted infections. Geneva: World Health Organization; 2021 (https://apps.who.int/iris/handle/10665/342523).
3. WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention, second edition. Geneva: World Health Organization; 2021
4. WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention, second edition: use of mRNA tests for human papillomavirus. Geneva:World Health Organization; 2021 (https://apps.who.int/iris/handle/10665/350652).
5. Human papillomavirus ( HPV) nucleic acid amplification tests ( NAATs) to screen for cervical pre-cancer lesions and prevent cervical cancer: policy brief. Geneva: World Health Organization; 2022 (https://apps.who.int/iris/handle/10665/352495).
6. Abortion care guideline. Geneva: World Health Organization; 2022 (https://apps.who.int/iris/handle/10665/349316).
7. Contraceptive eligibility for women at high risk of HIV: guidance statement: recommendations on contraceptive methods used by women at high risk of HIV. Geneva:
World Health Organization; 2019 (https://apps.who.int/iris/handle/10665/326653).
8. Actions for improved clinical and prevention services and choices: preventing HIV and other sexually transmitted infections among women and girls using contraceptive services in contexts with high HIV incidence. Geneva: World Health Organization; 2020 (https://apps.who.int/iris/handle/10665/332287).
9. Maintaining essential health services: operational guidance for the COVID-19 context: interim guidance. 1 June 2020. Geneva: World Health Organization; 2020
10. Coronavirus disease (COVID-19): contraception and family planning. Geneva: World Health Organization; 2020 (https://www.who.int/emergencies/diseases/novelcoronavirus-2019/question-and-answers-hub/q-a-detail/coronavirus-disease-covid-19-contraception-and-family-planning, accessed 12 November 2020).