Integrating sexual and reproductive health in primary health care in Europe: position paper of the European Forum for Primary Care.

Sexual health and reproductive health are relatively new concepts in Europe. They were introduced and recommended during and after the International Conference on Population and Development (ICPD) in Cairo, 1994. At the ICPD a 20-year Programme of Action was adopted by the vast majority of world states. This article is an edited version of the European Forum for Primary Care (EFPC) position paper on the potential role of primary health care (PHC) in the field of sexual and reproductive health (SRH) in Europe. The EFPC commissioned two European SRH experts to set out its position on the subject, which is presented here. The experts were assisted by a working group of eight European SRH and PHC experts from six countries, while the WHO Regional Office for Europe and the WHO Reproductive Health and Research Department at the organisation's Geneva office provided valuable support and input during the process of developing this position paper. Because both these concepts, i.e. SRH and PHC, are often poorly understood, their meaning and substance are explained in some detail. For a variety of reasons SRH should be a primary responsibility of PHC and it should be approached as one integrated field of health care. In actual practice, SRH is very differently organised across Europe and in many cases poorly integrated in PHC. SRH care is often fragmented, not easily accessible, of poor quality and needlessly expensive. It is therefore recommended that SRH care is better integrated in PHC, and that it meets a variety of quality criteria.