Supportive policies lay the groundwork for family planning service delivery. Up-to-date and evidence-based family planning guidelines help programs and providers offer quality services that are free from unnecessary requirements and medical barriers.

All individuals and couples have the basic human right to decide freely and responsibly the number and spacing of their children and to have the information, education, and means to do so. Because female and male sterilization are intended to be permanent, it is especially important to provide careful and thorough counseling to help men, women, and couples make a voluntary and informed decision. Counseling should address the following:

• Sterilization is considered to be permanent and probably cannot be reversed.
• The procedure will prevent the client from ever having any more children, although a small chance of method failure exists.
• Other effective and reversible contraceptive methods are available to the client (including reversible long-acting methods).
• Sterilization is a surgical procedure and review details of the procedure to be used.
• The client can decide against having the procedure at any time before it takes place.

Informed decision-making and informed consent are fundamental to providing good quality health care services and are a fundamental human right. International human rights treaty law protects individuals’ rights to informed decision-making and consent for sexual and reproductive health services, including sterilization. This law is intended to protect the right to decide freely and responsibly on the number and spacing of children by legally obligating health care providers to provide and obtain full informed consent prior to performing a sterilization procedure. Nevertheless, forced and coerced sterilizations have and likely continue to occur around the world. Groups particularly vulnerable to forced and coerced sterilization include adolescents, ethnic and indigenous minorities, disabled women and girls, and women with HIV/AIDS. Many of these violations occur during the provision of health services and are perpetrated by health service personnel.

The World Health Organization has issued and periodically updates global technical guidelines that cover how to provide contraceptive methods and to whom. National family planning and reproductive health programs can use the WHO global recommendations about female and male sterilization and other resources with international guidance, provided in this section of the toolkit, as a basis for developing, reviewing, or updating their own national family planning guidelines on sterilization. Also included in this section of the Permanent Methods Toolkit are examples of national family planning guidelines on sterilization that Ministries of Health and other stakeholders can use as a guide for developing their own national guidelines.

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