The World Health Organisation (WHO) has called for an expansion of contraceptive options globally, which could significantly impact Nigeria and other African countries struggling with unmet family-planning needs. According to WHO, approximately 164 million women who want to delay or avoid pregnancy are not using contraception. The global health agency's latest Guidelines on Expanding Contraceptive Options aim to provide individuals and couples with greater opportunities to choose contraceptives based on their needs, circumstances, and preferences.
WHO's new guidance is intended to help countries expand access to contraceptive methods supported by the best available evidence. The organisation supports the use of contraceptive implants for up to five years, potentially reducing replacement procedures, health-facility visits, and associated costs. Additionally, WHO recommends alternative ways of using combined oral contraceptive pills, allowing them to be taken for extended periods of up to six months or continuously for up to one year.
The recommendations could be particularly relevant to countries like Nigeria, where access to healthcare services and family-planning commodities varies considerably across communities. WHO has further recommended mifepristone as an additional emergency contraceptive option, to be taken as soon as possible and within five days of unprotected sex. The organisation states that available evidence indicates mifepristone at doses ranging from 10 to 50mg is likely to be as safe and effective as other emergency contraceptive methods.
Pascale Allotey, Director of WHO's Department of Sexual, Reproductive, Maternal, Child and Adolescent Health and Ageing, emphasises that contraceptive choice is a gender-equality issue. She notes that men and women both need a range of options that reflect what science and innovation can now offer, weighed against convenience, invasiveness, behaviour, reliability, and accessibility. Allotey stresses that real choice means the confidence and control to choose a method, change it, or stop it.
While encouraging wider access, WHO cautions countries against introducing contraceptive methods without adequate evidence on their safety and effectiveness. The organisation calls for more research into ormeloxifene before it is considered for inclusion in family-planning programmes, citing limited evidence on safety. Conversely, WHO recommends against adding quinestrol-containing contraceptive pills to national contraceptive programmes due to limited evidence and reports of serious adverse events.
The WHO initiative also signals growing attention to male-controlled contraception. Currently, men have relatively few contraceptive options, principally condoms, withdrawal, and vasectomy. Despite this, WHO estimates that approximately 30 per cent of couples rely on a male contraceptive method. Research suggests considerable potential demand for new male contraceptives, with over 75 per cent of couples surveyed willing to use a new male contraceptive.
WHO has developed its first Target Product Profile for male contraceptive methods, identifying key characteristics that future products should meet, including safety, effectiveness, acceptability, and affordability. Several hormonal and non-hormonal male contraceptive candidates are currently being researched, with some promising methods already in advanced clinical trials. WHO suggests that new reversible male contraceptives could potentially become available within the next five to 10 years.
Key points
- WHO's expansion of contraceptive options aims to address unmet family-planning needs in Nigeria and other African countries.
- The organisation supports the use of contraceptive implants for up to five years and recommends alternative ways of using combined oral contraceptive pills.
- WHO emphasises that contraceptive choice is a gender-equality issue, and real choice means the confidence and control to choose a method, change it, or stop it.
