Reviving permanent contraception: New medical procedures or new service delivery modalities?

Despite the prevalent increase of permanent contraception, there are still 222 million women with unmet needs for contraception; a large proportion of these women could opt for permanent contraception. New approaches to permanent contraception are in development; in the meantime, services need to be accessible, affordable, safe, and convenient to allow women, men, and couples to realize their reproductive intentions. Among the available approaches, we recommend minilaparotomy and no-scalpel vasectomy. These are proven as safe, effective, and feasible surgical techniques that can be offered through a wide range of service modalities such as static clinics, mobile outreach, and using task sharing. Both of these approaches have low complication rates, these being mostly minor complications, and low failure rates. Programs must ensure that they address the provision of these services under a human rights-based approach that will allow services to thrive and individual needs will be fulfilled.