World Population Day 2018 highlights ineffective and unsafe pregnancy prevention behaviors and practices. What about emergency contraception?

By Melissa Garcia

Melissa Garcia is a Technical Advisor for the International Consortium for Emergency Contraception, hosted by MSH. This article originally appeared on the ICEC website

For this year’s World Population Day on 11 July, our community celebrated and affirmed the right to family planning. On this day, the United Nations Population Fund (UNFPA) also called attention to the many people around the world unable to realize this right.

The Guttmacher Institute’s analysis , Adding it Up, estimates that globally, 214 million women of reproductive age in developing regions want to avoid pregnancy but are not using a modern method of contraception. One hundred and fifty five million women are not using a contraceptive method. Some 59 million women use traditional practices and remedies for pregnancy prevention. UNFPA has listed some of these practices in this article and accompanying photo essay. They are cause for concern because the users of such “pseudo” contraceptive practices act in the belief that they are protecting themselves from the risk of unintended pregnancy. But in fact they are exposing themselves to that risk, and potentially to further health consequences.

This phenomenon affects emergency contraception (EC) as well. The majority of women are not aware that a contraceptive option after sex exists, in most countries that capture EC knowledge in their most recent Demographic and Health Survey (DHS) data.  Most women have never heard of the dedicated, safe and effective pill, and copper- IUD regimens that are the only effective post-coital method. Continue reading “World Population Day 2018 highlights ineffective and unsafe pregnancy prevention behaviors and practices. What about emergency contraception?”

In Mali, community volunteers strive to stem the practice of female genital mutilation

Community volunteers display flipcharts they use to inform community members about harmful consequences of gender-based violence, including female genital mutilation. Photo by Adama Sanogo/MSH

I started practicing female circumcision when I was 20 years old. I learned the practice from my grandmother and mother as a way to make money. One day, after seeing the consequences of circumcision, I realized the extent to which women and girls suffered in terms of health, psychology and morale. So I am committed as a community focal point in the village of Waïlirdé and as a woman and mother to fight against this practice that is harmful to health.

My main responsibility is to share information and knowledge with members of my community.  Informing people about the consequences of female circumcision allows those who suffer to seek the help they need and help prevent future occurrences.  Additionally this can help people understand the link between current health issues and circumcision.  Above all, I work to raise everyone’s awareness of the danger of the practice to spare young girls from facing this torture.  

–Fatouma, Waïlirdé village, Mali

In the Mopti region of central Mali, about 88% of women aged 15-49 have undergone female circumcision–or female genital mutilation (FGM); almost 69% of these women were circumcised by the time they were five years old (Mali DHS, 2012-2013). As such practices are deeply rooted in the cultural, religious, economic, and social heritage of Mopti, ending them requires strong and concerted community engagement and action.

The FCI Program of MSH mobilizes leaders and communities in Mopti to advance women’s and girls’ health and rights and to end sexual and gender-based violence (SGBV) and harmful practices such as female genital mutilation (FGM) and child marriage. With funding from the Embassy of the Netherlands in Bamako, and in partnership with the Malian non-governmental organization Conseils et Appui pour l’Education à la Base (CAEB), the FCI Program of MSH leads the Debbo Alafia Consortium of multi-sectoral, national, and international organizations to carry out social and behavior change activities and to provide essential medical and psychosocial support to women and girl survivors of gender-based violence, female genital mutilation, and other harmful practices. Leveraging political and religious leaders’ significant influence on public opinion and acceptance, Debbo Alafia also strengthens political commitment and recruits champions to publicly call for the end of harmful practices and promote sexual and reproductive rights for women and girls.

UNICEF and the SGBV Humanitarian Subcluster (awarded through UNFPA) have supported the FCI Program’s work with trained community volunteers, like Fatouma, to discourage the practice of FGM by informing community members about the harmful short-term and chronic health consequences, such as excessive bleeding, infections, swelling, menstrual problems, maternal health complications, even death. These volunteers also refer SGBV survivors to free medical, psychosocial, and legal support services; providers of these services work with the FCI Program of MSH to ensure they are giving respectful, confidential, and safe care to survivors of SGBV.

Community volunteers, forming protection teams that support SGBV prevention and response, have successfully stopped circumcision ceremonies. During a Debbo Alafia meeting of partners and government officials last year, FCI Program staff received news about a circumcision ceremony in progress in the village of Koro. Debbo Alafia partners and government officials went to the ceremony site to convince the circumciser to stop and the parents to take their girls home. Although several girls had already been cut, several more were spared.

As women and girls in the North and surrounding regions remain particularly vulnerable to sexual and gender-based violence (SGBV) and often do not seek or receive appropriate care, the FCI Program of MSH is leading a study, with support from Amplify Change, to investigate the barriers that deter SGBV survivors from accessing care. Using the findings from this study, the FCI Program of MSH will bring together local actors to develop advocacy and program strategies to reduce these barriers to care.

A door-to-door campaign for antenatal care

This story originally appeared on the Management Sciences for Health website.

When her rapist was arrested, 16-year old Brigitte* thought the worst was behind her. But when she discovered she was pregnant, she had little choice but to drop out of school and work the family fields in her village, in the Manika health zone of the Democratic Republic of Congo (DRC). She certainly could not afford antenatal care (ANC) visits.

The DRC government has made maternal health one of its highest priorities, and partners like the USAID-funded Integrated Health Project Plus (IHPplus) have collaborated with the Ministry of Health to make that vision a reality. Knowing that ANC visits are out-of-reach for many women, IHPplus subsidizes free and reduced-cost care for expectant mothers. And knowing that many women are not aware of the benefits of ANC visits, IHPplus has organized a variety of campaigns to educate mothers-to-be. Continue reading “A door-to-door campaign for antenatal care”

Top tips for advocates working on emergency contraception

By Melissa Garcia and Cristina Puig Borrás

Melissa Garcia is Technical Adviser for the International Consortium for Emergency Contraception (ICEC), hosted by MSH. Cristina Puig Borrás is the Coordinator for the European Consortium for Emergency Contraception. This article orginally appeared on ICEC’s website

Photo: Susana Galdos/MSH

With the current largest generation of young people, there is much to celebrate on August 12, International Youth Day. In particular, there is the growing recognition that as agents of change, adolescents and young people and their organisations are essential stakeholders who contribute to inclusive, just, sustainable and peaceful societies. Crucially, advocates working on sexual and reproductive health (SRH) and reproductive rights (RR) advance access for young people in meaningful ways. Continue reading “Top tips for advocates working on emergency contraception”

Healthy Women, Healthy Nations

By Fatimata Kané

Fatimata Kané is Project Director of the FCI Program of MSH in Mali. This article originally appeared on the MSH Health Impact Blog. Read this article in French

Photo: Catherine Lalonde

Putting a child on the earth is a whole different type of work. Not everyone can guide a woman and her baby safely through pregnancy and childbirth.

I know what it means to keep women and babies alive and healthy because I am a midwife. Continue reading “Healthy Women, Healthy Nations”

Femmes saines, nations en santé

Par Fatimata Kané

Fatimata Kané est directrice  du programme FCI de MSH au Mali.

Photo: Catherine Lalonde

Mettre un enfant au monde est tout un travail différent. Tout le monde peut aider quelqu’un qui est malade, mais tout le monde ne peut pas faire le travail d’une sage-femme–guider une femme et son bébé en toute sécurité pendant la grossesse et l’accouchement. Je sais ce que signifie garder les femmes et les bébés vivants et en bonne santé parce que je suis une sage-femme. Continue reading “Femmes saines, nations en santé”

PROGRES requires a keen gender perspective

By Alanna Savage and Andrew Gaydos

Alanna Savage is a Senior Communications Specialist for the FCI Program of Management Sciences for Health (MSH) and Andrew Gaydos is a Project Support Associate at MSH.

In our ambitious vision to reach all people, everywhere, it is ever more necessary to examine the varying life experiences–the actual realities–of the people whose health we work to improve. Part of this examination requires a critical look at how gender plays out in the power structures of society, the daily lives of people, and more concretely, in the “who, what, where, when, and how” of health-seeking behavior and access to essential reproductive and maternal health care.

Maternal mortality in Mali remains high–587 women die for every 100,000 live births–but only 28 percent of sexually active women of reproductive have satisfied their demand for family planning.  Women and girls continue to confront widespread sexual and gender-based violence, including female genital mutilation/cutting (FGM/C); in 2015, about 126,000 women and girls received prevention services, protection, and care related to FGM/C. And thanks to the work of the FCI Program of MSH, traditional and faith leaders are advocating for family planning and coming together to provide support to survivors of gender-based violence and to identify early warning signs of imminent violence.

Gender inequality undoubtedly plays a role in high maternal mortality and unmet need for family planning and the continuance of sexual and gender-based violence. As long as women and girls must continue to fight for equal voice and an equal share of opportunity and power, their lives and health will remain under threat. Gender influences health outcomes, access to care, providers’ treatment of patients, relationships among health workers and supervisors, and health career barriers and opportunities.

Photo by Catherine Lalonde

Continue reading “PROGRES requires a keen gender perspective”

Trump’s global gag rule silences doctors and midwives and harms their patients

By Catharine Taylor

Catharine Taylor is Vice President for health programs at Management Sciences for Health. This post originally appeared on STAT News

Midwifery students in Sierra Leone, which has one of the highest maternal mortality rates in the world. Funding for safe pregnancy and delivery worldwide is threatened by President Trump’s reinstatement of the global gag rule. (Photo by MARCO LONGARI/AFP/Getty Images)

President Trump’s reinstatement of the Mexico City Policy, better known as the global gag rule, came as no surprise to anyone working in the field of global health. We have been through this before — in 1984, when the policy was first put into effect by President Reagan, and then in 1993, 2001, and 2009, when it was repealed, reinstated, and repealed again.

The Mexico City Policy is called a gag rule because it limits not just what organizations and health providers do but what they are permitted to say. It prevents foreign organizations that receive US government funding from performing abortions — even if they are using funds from non-US government sources and even if abortion is completely legal in their countries.

The global gag rule also steps right between a woman and her doctor, nurse, or midwife, preventing these frontline health providers from telling their patients about the full, legal range of health options available to them. It forbids trusted advisers from giving honest, comprehensive health advice and information. I started my career as a nurse-midwife, and then worked in maternal and newborn health programs in Africa and Asia, so I know what this will mean for the lives and health of women and their families. Continue reading “Trump’s global gag rule silences doctors and midwives and harms their patients”

LAC 2016: Reducing inequities in sexual and reproductive health among adolescents

Ariadna Capasso is senior technical advisor at the FCI Program of Management Sciences for Health. 

Reducing inequities in sexual and reproductive health–especially for adolescents and youth–remains a priority focus among policymakers, healthcare practitioners, and advocates in Latin America and the Caribbean (LAC). In September 2016, twenty-two governments and a broad range of partners–including international and regional technical, professional, funding and research organizations, INGOs and the private sector–came together for the LAC 2016 Conference in Cartagena, Colombia. Continue reading “LAC 2016: Reducing inequities in sexual and reproductive health among adolescents”