Choice
The ability of women and men to have a range of contraceptive and other RH options from which to choose. An individual’s need for contraception evolves throughout his or her life cycle and is a function of both psychosocial and physiological factors. The ability to access the “right” contraceptive method increases the likelihood that one’s RH needs will be met; a mismatch, research shows, is more likely to lead to dissatisfaction, lower continuation rates, and often method failure.
Pathways to success
Institutionalize the concept of “choice” in planning and decision making
At the country level, instances abound of policy decisions or other actions that, consciously or otherwise, inhibit choice. Many countries, for example, include an impressive range of methods within their essential medicines lists but in reality only procure adequate supplies of a few of these methods. Often this is done in the belief that just a few options are all that people want—and that procuring a wider range would be wasteful. In other instances, efforts undertaken in the hopes of expanding choice, such as single-method introductions, end up having the opposite effect, inadvertently favoring some methods over others or leading to provider biases. Institutionalizing the concept of choice, therefore, is critical if it is ever to become a routine part of key decision making processes.
The Coalition is critically positioned to help stakeholders confront many of the challenges associated with operationalizing choice. Through effective advocacy, policy dialogue, and consensus building, we can help build global and local commitment to make choice not only understood but also a standard practice.
Bridge the gap between global marketplace and country context
The second pathway to choice involves opening the door to supply options not yet available locally. The Coalition is well positioned to help strengthen national policies that would enable procurers, and ultimately users, to more easily access the range of supplies in the global marketplace. Such work could leverage the Coalition’s privileged access to information on new and underutilized technologies. It would also build on the Coalition’s intellectual capital to support the adoption of country-level policies that encourage choice such as standard treatment guidelines, task shifting, essential medicines lists, registration guidelines, and other similar high-level decisions. And finally, through market shaping, the Coalition is demonstrating its potential to facilitate market entry.