1. Introduction

The female condom has been studied in many settings around the world with a great number of positive results. In the World Health Organization (WHO) and Joint United Nations Programme on HIV/AIDS (UNAIDS) monograph The Female Condom: An information pack (April 1997), it was concluded that, “The female condom has been shown to contribute to women’s sense of empowerment, especially if supported by education and informational activities.”

WHO and UNAIDS are encouraging the introduction of the female condom as a new method of preventing both pregnancy and infection and as an additional tool in efforts to respond to the needs of women and men in sexual and reproductive health. In the 1997 information pack they explain:

“The public health rationale for introducing a method that provides protection against pregnancy and STI/HIV is clear. Globally, health and human rights advocates have been demanding that scientists develop fertility regulation methods that are safe and reversible, under the control of the user, not systemic in action, which protect the user against STIs and HIV, and do not need to be provided by a health service. The female condom comes closer to these requirements than any other family planning method.”

The Female Condom: An information pack provides important information about what the female condom is, why it is important, and what is known about its safety, effectiveness and acceptability. A brief summary of this information is presented below, but readers should refer to the Information Pack for more in-depth information.

This new document – The Female Condom: A guide for planning and programming – aims to complement the Information Pack by providing guidance on how to plan for integrating the female condom into already existing activities as well as how to effectively promote it and train providers to adequately educate potential users about it. Its aim is to help programme managers in public and private sector health systems and nongovernmental organizations (NGOs) and community-based organizations (CBOs) who are interested in developing or expanding programmes to include the female condom and to address some of its more operational and promotional aspects.

This document is intended to help design, implement and monitor programmes that incorporate the female condom in a range of different settings. It is based on real experiences from projects from all over the world. Because the female condom is still a relatively new method, the way in which it is introduced is essential to its acceptance by policy-makers, programme managers, service providers, non-governmental organizations and potential users. Intended to support all these audiences in communicating effectively about the need for and use of the female condom, this Guide addresses:

· the public health role of the female condom and the policy and strategy decisions that need to be considered – see especially Sections 1,2,3 and 4 on the important strategic issues to be considered and Section 5 on the strategic planning process;

· programme development and implementation for programme managers, including lessons learned from existing projects – see especially Section 6 on the operational issues;

· message development and media selection ideas for the successful presentation of the female condom to potential users – see the Communications portion of Section 6;

· the role for NGOs and CBOs in the implementation of female condom programmes – see Section 5 about the role of NGOs and CBOs in planning and Section 6 on the role of NGOs and CBOs in programme implementation;

· tools to assist in communicating effectively on how to introduce and use the female condom – see the Communications portion of Section 6 and the Resource materials in Section 8;

· information needs of potential users, including how to use the female condom and frequently asked questions by existing and prospective users – see Section 7 for information for users and Section 8 for a list of resources.

The female condom is manufactured by The Female Health Company to the highest quality standards. Each batch is tested to the US Food and Drug Administration (FDA) standard and carries the European Union’s CE Mark for Quality. Each female condom comes with visual instructions on how to use it.

Source: John Edwards

The materials used to compile these documents include responses to WHO questionnaires sent to female condom researchers in late 1997, published articles on the female condom, unpublished material available for consultation at WHO and direct communications with researchers and programme managers.

Since 1996, through a collaboration between UNAIDS and The Female Health Company (FHC), currently the sole manufacturer of the female condom, the female condom has been available to public sector agencies at a special price.

Through this collaboration, the female condom has been supplied to ministries of health and NGOs in over 35 countries in Africa, Asia and Latin America.

A wide range of donor agencies have supported initiatives in these countries, including the British Government, the Netherlands Government, the European Union, UNAIDS, the United Nations Population Fund (UNFPA), the United States Agency for International Development (USAID), the World Bank and WHO. These organizations are working with other partners to provide on-going technical support to facilitate the effective, strategic introduction and integration of the female condom into reproductive health programmes.

There are numerous on-going female condom programmes, and new information is being generated continuously. This exciting and innovative area of reproductive health is, therefore, one that will be growing and maturing over the years ahead.

This Guide for planning and programming is meant to provide overall guidance and orientation to designing and implementing programmes to introduce the female condom. The following box briefly describes each of the remaining sections of this Guide.