SDM Implementation Guidelines

Establishing Norms and Service Delivery Guidelines

The integration of the SDM is facilitated by clear norms and service delivery guidelines for providing the method, though they are not pre-requisites for introducing the method.

Ideally these norms and guidelines should exist at both the national MOH level as well as the program level. Including the SDM in national norms ligitimazes the method and encourages programs to offer it.

Service Delivery Guidelines and Norms that include the SDM

Norms refer to statements that reflect a program’s philosophy about offering family planning or specific methods. Guidelines are more detailed documents that describe how SDM services will be offered. A number of countries have incorporated the SDM into their national family planning norms, and several international organizations have developed evidence-based service delivery guidelines for the SDM.

Key Actions

  1. Investigate what methods are included in the country’s family planning norms, and the process by which norms are developed and approved.
    Because the SDM is a relatively new method, many countries have not yet included it in their national family planning norms. Even if the SDM is not specifically cited in the norms, usually it can still be offered because norms often refer to natural methods in general or to making a variety of methods available. It is be important to determine when the national or program norms will next be updated, who the key stakeholders are and if they are considering the incorporation of the SDM in the next revision of the norms. The timetable and process for including norms in national programs needs to be locally determined. In some places, governments are reluctant to include the SDM until they are convinced about how acceptable it is among clients and providers, and how feasible is it to offer in their service delivery. In other instances, incorporating the SDM into norms might be one of the first steps undertaken by the government to encourage programs to integrate it into their services.
  2. Identify key stakeholders and keep them informed of the introduction of the SDM.
    Many programs that have introduced the SDM have done so independently of the public sector, while others have worked in close collaboration —even when services were offered in MOH facilities. In countries where the SDM is being introduced for the first time, it is important to identify the key stakeholders in different sectors to obtain support for SDM introduction. The process of developing norms offers an opportunity to engage key policymakers and stakeholders and build their support for the SDM.
  3. Utilize international SDM service delivery guidelines that have been developed and disseminated.
    Programs can rely on and consult international sources for SDM service delivery guidelines such as the latest edition of Contraceptive Technology and the World Health Organization’s Medical Eligibility Criteria for Contraceptive Use. Publications in peer-reviewed journals also present research findings with important service delivery implications. All of these publications will serve as an important resource for programs incorporating the SDM into their norms and service delivery protocols. Norms must be evidence-based and should be reviewed by experts to ensure accuracy.
  4. Ensure that SDM guidelines are incorporated into the appropriate organizational documents.
    At the organizational level, the service delivery protocol for the SDM must be incorporated into the organization’s guidelines, procedures, and materials (e.g. training manuals, IEC materials, etc). This will offer guidance to providers on how the SDM should be offered in their facilities, and ensures standardization in SDM service provision.

Key Guidelines and Policy Materials

Copyright 2006 Institute for Reproductive Health