Policy and programmatic issues

WHO Strategic Approach

Young mother carrying an infant on her back in the waiting room of a maternal and child health clinic, Zambia

Faced with the challenge of putting into practice the ideals of the Millennium Development Goals, the International Conference on Population and Development (ICPD), and other global summits of the last decade, decision-makers and programme managers responsible for sexual and reproductive health ask how they can:

◊ improve access to and the quality of family planning and other sexual and reproductive health services;

◊ increase skilled attendance at birth and strengthen referral systems;

◊ reduce the recourse to abortion and improve the quality of existing abortion services;

◊ provide information and services that respond to young people’s needs; and

◊ integrate the prevention and treatment of reproductive tract infections, including HIV/AIDS, with other sexual and reproductive health services.

To help answer these and other such questions, 25 countries have used the WHO-sponsored Strategic Approach to Strengthening and Reproductive Health Policies and Programmes. Public-sector health-care programmes, in collaboration with non-governmental organizations and international agencies, typically use the Strategic Approach. It involves a three-stage process for assisting countries to assess reproductive health needs and priorities, test policies and programme adaptations to address these needs, and then scale up successful interventions. Table 1 gives selected examples of its application.

The Strategic Approach unites concepts and practices from public health and the social and management sciences with the principles of the ICPD in its essential features:

◊ a staged implementation process that links assessment, pilot-testing, and scaling-up;

◊ a systems framework to highlight the relevant factors for decision-making about appropriate services;

◊ a reproductive health philosophy of reproductive rights, gender equity, and empowerment;

◊ a focus on improving equitable access to and quality of care so that services are client-centred and responsive to community needs;

◊ a participatory process to consider the concerns of all relevant stakeholders; and

◊ country ownership of the process and the results.

Table 1. Examples of application of the Strategic Approach

Country/region	Issues addressed
Ethiopia Lao People’s Democratic Republic Myanmar Rajasthan, India Yunnan, China	Comprehensive reproductive health policies and programmes
Brazil China Ghana Latvia	Reproductive tract infections, including
Bolivia Nepal Paraguay	Maternal health and family planning
Brazil Chongqing, China Oman Viet Nam Zambia	Contraceptive introduction and quality of care in family planning
Moldova Mongolia Romania Viet Nam	Preventing unsafe abortion
Kyrgyztan	Adolescent health
Bolivia Uttar Pradesh, India	Cervical cancer

From the The WHO Strategic Approach to strengthening sexual and reproductive health policies and programmes - 8 pages (pdf 739 kb)

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