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.
Delivery Guidelines and Norms that include
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.
- Investigate what methods are included in the country’s
family planning norms, and the process by which norms are developed
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.
- 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.
- 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
- 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
Technology, 18th Edition, November 2004
Health Organization Medical Eligibility Criteria for Contraceptive
Health Technical Brief, Standard Days Method, a simple, effective
natural method. 2004 INFO Project Publication
Medical Bulletin 37(5): 3-4 (2003). The Standard Days Method
of Family Planning
the gap: responding to the global funding crisis in family planning,
James N. Gribble. 2004 Journal of Family Planning and Reproductive
Health Care 30(3)
Standard Days Method of Family Planning: A Response to Cairo
Guttmacher Institute, International Family Planning Perspectives
Volume 29, Number 4, 2003
Barriers to Offering the SDM, Technical Brief. Institute for
Reproductive Health, 2005
importance of screening and monitoring: the Standard Days
Method and cycle regularity. Sinai I, et al in Contraception 2004;