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MEC Fourth Edition Spread Critères de recevabilité pour l'adoption et l'utilisation continue de méthodes contraceptives CHC Méthode de l’aménorrhée lactationnelle Stérilisation chirurgicale féminine Progestatifs seuls DIU Pilules pour la contraception d’urgence DIU Méthodes mécaniques Contraceptifs hormonaux combinés CHC Méthodes naturelles de planification familiale Coït interrompu StérilisationQuatrième chirurgicalegica édition, 2009 CHC Méthode de l’aménorrhée lactationnelle StérilisationGUIDE c ESSENTIELhirurgicale OMS DE PLANIFICATION FAMILIALE féminine Progestatifs seuls DIU Pilules pour la contraception d’urgence DIU Méthodes mécaniques Contraceptifs hormonaux combinés CHC Méthodes naturelles de planification familiale Coït interrompu Stérilisation chirurgicale CHC Méthode de l’aménorrhée lactationnelle Stérilisation chirurgicale féminine Progestatifs seuls DIU Pilules pour la contraception d’urgence DIU Méthodes mécaniques Contraceptifs hormonaux combinés CHC Méthodes naturelles de planification familiale Coït interrompu Stérilisation chirurgicale CHC Méthode de l’aménorrhée lactationnelle Stérilisation chirurgicale féminine Progestatifs seuls DIU Pilules pour la contraception d’urgence DIU Méthodes mécaniques Contraceptifs hormonaux combinés CHC Méthodes naturelles de planification familiale Coït interrompu Stérilisation chirurgicale Catalogage à la source: Bibliothèque de l’OMS: Critères de recevabilité pour l’adoption et l’utilisation continue de méthodes contraceptives -- 4e éd. 1.Contraception - méthodes. 2.Services de planification familiale. 3.Détermination prise en charge - normes. 4.Garantie qualité soins. 5.Accessibilité service santé. I.Organisation mondiale de la Santé. ISBN 978 92 4 256388 7 (Classification NLM: WP 630) © Organisation mondiale de la Santé 2011 Tous droits réservés. Les publications de l’Organisation mondiale de la Santé sont disponibles sur le site Web de l’OMS (www.who.int) ou peuvent être achetées auprès des Editions de l’OMS, Organisation mon- diale de la Santé, 20 avenue Appia, 1211 Genève 27 (Suisse) (téléphone : +41 22 791 3264 ; télécopie : +41 22 791 4857 ; courriel : [email protected] . Les demandes relatives à la permission de reproduire ou de traduire des publications de l’OMS – que ce soit pour la vente ou une diffusion non commerciale – doivent être envoyées aux Editions de l’OMS via le site Web de l’OMS à l’adresse http://www.who.int/ about/licensing/copyright_form/en/index.html Les appellations employées dans la présente publication et la présentation des données qui y figurent n’impliquent de la part de l’Organisation mondiale de la Santé aucune prise de position quant au statut juridique des pays, territoires, villes ou zones, ou de leurs autorités, ni quant au tracé de leurs frontières ou limites. Les lignes en pointillé sur les cartes représentent des frontières approximatives dont le tracé peut ne pas avoir fait l’objet d’un accord définitif. La mention de firmes et de produits commerciaux ne signifie pas que ces firmes et ces produits com- merciaux sont agréés ou recommandés par l’Organisation mondiale de la Santé, de préférence à d’autres de nature analogue. Sauf erreur ou omission, une majuscule initiale indique qu’il s’agit d’un nom déposé. L’Organisation mondiale de la Santé a pris toutes les précautions raisonnables pour vérifier les informa- tions contenues dans la présente publication. Toutefois, le matériel publié est diffusé sans aucune garan- tie, expresse ou implicite. La responsabilité de l’interprétation et de l’utilisation dudit matériel incombe au lecteur. En aucun cas, l’Organisation mondiale de la Santé ne saurait être tenue responsable des préju- dices subis du fait de son utilisation. Imprimé en TABLE DES MATIERES Remerciements Résumé d’orientation et vue d’ensemble 1 Tableaux Contraceptifs hormonaux combinés (CHC) 17 (contraceptifs oraux combinés, contraceptifs injectables combinés, patch et anneau) Progestatifs seuls (PS) 53 Pilules pour la contraception d’urgence (PCU) 73 Dispositifs intra-utérins (DIU) 75 DIU au cuivre pour la contraception d’urgence (DIU-U) 91 Méthodes mécaniques (MM) 93 Méthodes naturelles de planification familiale (MN) 103 Méthode de l’aménorrhée lactationnelle (AL) 107 Coït interrompu (CI) 109 Méthodes de stérilisation chirurgicale (STER) 111 Stérilisation chirurgicale féminine 112 Stérilisation chirurgicale masculine 120 Tableaux récapitulatifs (RECAP) 125 Annexes Annexe 1. Contraceptifs hormonaux et traitements antirétroviraux 133 Annexe 2. Liste des participants 137 REMERCIEMENTS Ce document est le fruit d’une collaboration entre Pour de plus amples informations concernant ce le Département Santé et Recherche génésiques de document, contacter le : l’Organisation mondiale de la Santé et un grand Département Santé et Recherche génésiques nombre d’institutions et d’organisations internationales Organisation mondiale de la Santé actives dans le domaine des politiques et programmes 1211 Genève 27 de planification familiale. Nous remercions chaleureu- Suisse sement le Gouvernement des Etats-Unis d’Amérique Télécopie : + 41 22 791 4171 (l’US Agency for International Development, les Centers Adresse électronique : [email protected] for Disease Control and Prevention, et le National Institute of Child Health and Human Development), la Les demandes d’exemplaires peuvent être adressées Fédération internationale pour la Planification familiale, au : ainsi que le Fonds des Nations Unies pour la Popula- Centre de Documentation tion, qui ont apporté leur soutien financier ainsi que Département Santé et Recherche génésiques leur appui à ce projet. Organisation mondiale de la Santé 1211 Genève 27 Des représentants de 9 institutions et organisations, Suisse ainsi que 34 autres intervenants, ont participé en tant qu’experts à une réunion qui a permis de dégager Télécopie : + 41 22 791 4171 un consensus sur les recommandations énoncées Téléphone : + 41 22 791 4447 dans ce rapport, relatives à l’utilisation des méthodes Adresse électronique : [email protected] contraceptives. Nous les remercions vivement, eux Il est également possible de télécharger ce document qui ont tous mis leur temps et leurs compétences au à partir du site web OMS/Santé génésique : service de l’élaboration de ce consensus. www.who.int/reproductivehealth. Les mises à jour Les données sur lesquelles reposent les décisions que de l’information contenue dans ce document sont renferme ce document proviennent en grande partie indiquées en premier sur le site. d’examens systématiques de la littérature effectués et récapitulés par le Dr K. L. Culwell, le Dr K. M. Curtis, le Dr M. E. Gaffield, le Dr N. Kapp, le Dr K. Nanda, Mme M. Paulen et le Dr I. Tilley. Nous leur adressons à toutes et à tous nos plus vifs remerciements ainsi qu’au Dr T. McKay et au Dr J. Shelton qui nous ont soutenus lors de l’élaboration de ce document. Nous exprimons notre reconnaissance aux personnes suivantes qui ont contribué au projet en tant qu’examinateurs des données du système d’inventaire en continu des données issues de la recherche (CIRE : Continuous Identification of Research Evidence) : Dr H. Akhtar, Dr W. Cates, Dr T. Chipato, Dr P. Corfman, Dr M. Cravioto, Dr V. Cullins, Dr J. Diaz, Dr S. Diaz, Dr A. Glasier, Dr M. Gùlmezoglu, Dr K. Hagenfeldt, Dr P. Hannaford, Dr R. Hatcher, Dr D. Huber, Dr C. Huezo, Dr V. Jennings, Dr R. Lu, Dr P. Lynam, Dr P. Lumbiganon, Dr P. Marchbanks, Dr O. Meirik, Dr S. Mittal, Dr C. Morrison, Dr K. Nanda, Dr E. Otolorin, Dr H. Peterson, Dr A. Pollack, Dr H. Rees, Dr R. Rivera, Dr D. Skegg, Dr C. Smith, Dr N. Simelala, Dr B. Sood, Dr M. Vekemanns et Dr E. Weisberg. RESUME D’ORIENTATION RESUME D’orientatiON ment d’autres informations jugées en rapport avec ces recommandations, en attendant la prochaine Le présent document constitue une étape importante réunion officielle du Groupe de Travail de consen- du processus visant à améliorer l’accès à des soins sus. Ces mises à jour se justifient particulièrement de qualité en matière de planification familiale par lorsqu’il s’agit de questions pour lesquelles la base l’examen des critères médicaux qui président au de données est à même d’évoluer rapidement. choix d’une méthode de contraception. Il correspond L’OMS encourage les recherches visant à appor- à la version actualisée de la troisième édition de ter des réponses aux questions non résolues, en Critères de recevabilité médicale pour l’adoption et vue d’établir des critères de recevabilité relatifs l’utilisation continue de méthodes contraceptives, à l’utilisation de méthodes contraceptives. L’OMS publiée en 2004, et il intègre les principales recom- invite également à formuler des commentaires et mandations formulées lors de la réunion d’un Groupe des suggestions en vue d’améliorer ces éléments d’experts qui s’est tenue à l’Organisation mondiale de d’orientation. la Santé, à Genève, du 1er au 4 avril 2008. (La liste des participants constitue l’Annexe 2.) Ce Groupe de VUE D’ENSEMBLE Travail a réuni 43 participants venus de 23 pays, dont des représentants de 9 institutions. Le document En 1999, l’OMS a analysé les éléments d’orientation contient des recommandations relatives aux critères qu’elle offrait en matière de planification familiale, d’acceptabilité médicale basées sur les données et déterminé que la création de nouvelles lignes cliniques et épidémiologiques les plus récentes et directrices basées sur des données concrètes s’adresse aux responsables de l’élaboration des était justifiée. En conséquence, l’OMS a entrepris politiques, aux responsables des programmes
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