Expanding Contraceptive Access Through Clinical and Programmatic Guidelines TEP

By Susan Moskosky

A critical component for widely accessible contraception is the implementation of clinical and programmatic guidelines to work toward providing the best care for all patients. CECA convened a virtual technical expert panel (TEP) of 23 professionals to discuss how to expand contraceptive access through transforming, updating, and recommending new clinical and programmatic guidelines. Nearly 90 percent of the TEP participants had either previously worked to write or disseminate guidelines. 

The panel discussed existing federal and programmatic guidelines to determine their impact and identified some challenges that guidelines, or lack thereof, present in making contraception accessible. Identified challenges included a lack of national recommendations that provide access to contraception as a basic preventative service, delays due to the political climate, and the high burden of evidence needed to maintain high-quality standards. 

Participants brainstormed actionable strategies to improve existing guidelines, with a focus on sexual and reproductive health equity and on ensuring that guidelines remain relevant to an evolving health care landscape. The following strategies were identified:  

• Strengthen existing guidelines by creating best practices for telehealth, supporting person-centered care for transgender and gender non-conforming people, honoring patients’ values, and incorporating information for contraceptive counseling and abortion.

• Address fragmentation and lack of alignment across guidelines, viewing alignment as a continuum which ranges from ensuring that guidelines do not conflict with each other to combining all sexual and reproductive health (SRH) guidelines into a single set of SRH guidelines.

• Prioritize the development of evidence-based guidelines focused on population health, which could impact access to contraception by focusing on broader scale public health interventions rather than clinical interactions.

• Incorporate diverse perspectives throughout the process by using patient-centered goals to frame guidelines, defining and engaging stakeholders, developing mechanisms for engagement and policy change, and holding systems and agencies accountable.

• Invest resources to align guidelines with real-life implementation by ensuring guidelines are relevant and widely available to both primary care providers and specialists, fostering systems change and accountability, supporting providers with implementation, and monitoring and evaluating guidelines development, dissemination, and implementation processes. 

Going forward, CECA will continue to collaborate with TEP participants and other stakeholders to shape and develop the recommendations. 

Click here to learn more about the importance of clinical and programmatic guidelines.