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”

An ounce of (after-sex) prevention: At the Family Planning Summit, let’s talk about emergency contraception

By Elizabeth Westley

Elizabeth Westley is the director of the International Consortium for Emergency Contraception, where this article first appeared. 

To meet the global Family Planning 2020 goals, a full range of family planning methods must be available, including user-controlled, short-acting methods. The Guttmacher Institute’s analysis , Adding it Up, estimates that 214 million women of reproductive age in developing regions want to avoid pregnancy but are not using a modern contraceptive method.  Half of unmarried women with an unmet need for family planning report infrequent sex as the reason that they do not use a family planning method. A quarter of married women not using contraception fall into the same category.  Not feeling themselves at high levels of risk, these women may wish to avoid the appointments and waiting times, dependence on providers, side effects, discomforts, and other commitments that long-acting contraceptive methods sometimes entail. Other women may not be using modern contraception because they are unaware of their options or are faced with inaccessibility due to distance barriers, poor health infrastructures, stock outs, or high prices. As well, many women are located in humanitarian and fragile settings where contraceptive access can be challenging.  For many women and girls not currently using a long-acting contraceptive method, a simple, discreet, user-controlled, low-commitment, one-time “on demand” form of contraception that can be accessed easily and quickly is a critically important option. This method already exists: emergency contraception. Continue reading “An ounce of (after-sex) prevention: At the Family Planning Summit, let’s talk about emergency contraception”

Emergency contraception is a simple part of post-rape care: Why is it not routinely provided?

By Melissa Garcia and Sarah Rich

Melissa Garcia is Senior Technical Officer for the International Consortium for Emergency Contraception and Sarah Rich is Senior Program Officer at Women’s Refugee Commission. This post originally appeared on the blog for the Sexual Violence Research Initiative

Emergency contraception (EC) can reduce the risk of pregnancy after unprotected sex, including in cases of sexual violence. Global guidance is clear that EC should be offered to women and girls within 120 hours of sexual violence to prevent the traumatic consequences of pregnancy resulting from rape.

Yet women and girls who have experienced unprotected sex, including through sexual violence, do not routinely have access to EC. The global aid communities must work together to increase access to EC for sexual violence survivors around the world, including for women and girls who are the most marginalized, like those living in crisis-affected settings. A range of strategies can be implemented to improve access to EC. Further research is also needed to identify, evaluate, and invest in new and innovative solutions. Continue reading “Emergency contraception is a simple part of post-rape care: Why is it not routinely provided?”

Emergency contraception: The reproductive health innovation everyone should know about

By Elizabeth Westley and Monica Kerrigan

Elizabeth Westley leads the International Consortium for Emergency Contraception. Monica Kerrigan is a global leader in family planning and previously served at the Bill & Melinda Gates Foundation and as a senior adviser to Family Planning 2020.

This article originally appeared on Devex.

Unintended pregnancies take a harrowing toll on women, young people, families and nations. When women are unable to decide whether and when to have children, maternal and newborn deaths rise, educational and economic opportunities are lost, families, communities and countries suffer greatly.

Global data highlights the tremendous challenge we face: 213 million pregnancies occur annually and an astonishing 40 percent — about 85 million — of these are unintended. In the United States alone, there are approximately 3 million unintended pregnancies each year, and in India, a staggering 18 million. A woman’s ability to make informed decisions about her reproductive health is one of the most basic human rights. It is a decision that can determine what kind of future she will have — and whether she will have one at all.

Emergency contraception is a unique tool for women to space and time their pregnancies. It is grossly underutilized, underfunded, and not fully optimized globally. It is the only contraceptive method that can be taken after unprotected sex and is effective for several days to prevent pregnancy. It is especially needed by women who have been sexually assaulted, who are often desperate to avoid becoming pregnant by their rapist. Continue reading “Emergency contraception: The reproductive health innovation everyone should know about”

A script-writer walks into a pharmacy…

By Melissa Garcia and Elizabeth Westley

Melissa Garcia is senior technical officer and Elizabeth Westley is the director of the International Consortium for Emergency Contraception (ICEC), hosted by Management Sciences for Health.

“What happened when you went to the pharmacy and asked for emergency contraception?” Melissa surveyed a room full of television and radio writers attending a workshop in the Democratic Republic of the Congo (DRC). The participants looked around, waiting for someone to speak up first.

“The pharmacist gave me a look, so I had to show him my PMC badge to prove I was there for research, not for myself!” said a woman from Population Media Center, an organization that produces educational soap operas to improve the health and well-being of people around the world. Writers in Nigeria had similar stories to tell. An older man in flowing traditional robes confessed “I walked up and down the street three times before I summoned the courage to enter the store.” A young family planning (FP) advocate joined the media training in Senegal, and wearing her hijab, reported that the pharmacist demanded to know who the pill was meant for.

Melissa visits actors and writers on the set of C'est la vie in Senegal.
Melissa visits actors and writers on the set of C’est la vie in Senegal.

Continue reading “A script-writer walks into a pharmacy…”

Preventing pregnancy after sexual assault: Do women and girls have access to emergency contraception?

Sarah Rich is Senior Technical Advisor at the International Consortium for Emergency Contraception, hosted by Management Sciences for Health.

Mapingure was raped and sought EC at a hospital. The provider told her that she needed a police report. But by the time she came back… she was told it was too late to assist her. She became pregnant as a result of the rape.

–Zimbabwe case from 2014, presented by Godfrey Dalitso Kangaude in “Country overviews of legal grounds/policies related to health, rape, and safe abortion,” April 2016

Emergency contraception (EC) can prevent pregnancy after unprotected sex, including in cases of rape. Global guidance on EC access for sexual assault survivors is clear: EC should be offered to women and girls within 120 hours of the assault to prevent the traumatic consequences of pregnancy resulting from rape. The World Health Organization’s (WHO) clinical and policy guidelines for sexual assault and clinical handbook  include strong recommendations to provide EC as part of comprehensive, woman-centered care. Continue reading “Preventing pregnancy after sexual assault: Do women and girls have access to emergency contraception?”

EML Search: New resource for reproductive and maternal health advocates

Shafia Rashid is Senior Technical Advisor at the FCI Program of Management Sciences for Health.

In June 2013, Imtiaz Kamal–a crusader for midwifery and women’s health–celebrated Pakistan’s official recognition of the essential maternal health medicine, misoprostol, which has proven easy to administer, safe and effective for preventing and treating excessive postpartum bleeding. “Given the high prevalence of home births,” Imtiaz explained, “we need to invest in solutions, such as misoprostol, that save lives now, until we can achieve the long-term goals of strengthening health systems and increasing rates of facility births.” Continue reading “EML Search: New resource for reproductive and maternal health advocates”

A new chapter for FCI’s lifesaving mission!

Amy Boldosser-Boesch is the Senior Technical Director for the FCI Program of Management Sciences for Health (MSH). To receive updates in your inbox from the FCI Program and other MSH programs, please subscribe here.

Photo: Catherine Lalonde
Photo: Catherine Lalonde

A lot has happened since we first announced, a couple of months ago, the exciting news that a new chapter has begun for FCI’s mission to save women’s lives!

Now a part of Management Sciences for Health, the FCI Program of MSH has hit the ground running. Continue reading “A new chapter for FCI’s lifesaving mission!”

Action on the global stage: Life-saving reproductive health commodities getting much-needed attention

Ann Starrs is FCI’s president and co-founder.

During the third week of May, I was in Geneva — together with an impressive collection of global health leaders from governments, UN agencies, and civil society — for the 66th session of the World Health Assembly (WHA). I am in Geneva fairly often, for meetings with WHO, the Partnership for Maternal, Newborn & Child Health (PMNCH) and other partners, but the annual World Health Assembly meeting is unique. The WHA is the governing body of the World Health Organization, and so it is attended by high-level delegations – usually led by the Minister of Health – from WHO’s member states. That makes WHA a great opportunity for networking and strategizing: finding an available seat, much less a table, in the famous (but oddly named) Serpent Bar at the Palais de Nations is always a challenge, as many conference participants spend virtually all of their time huddled there in intense discussion.

WHA delegates at work in the Serpent Bar (WHO/Pierre Albouy)

Issues around reproductive, maternal, newborn, and child health featured strongly in this year’s agenda, which is why I was there. The MDGs, and development goals beyond 2015universal health coverage; life-saving commodities; and frameworks for holding countries and donors accountable for fulfilling their health commitments were all on the agenda, for formal discussion, side events, and hours of conversation at the Serpent Bar.

Perhaps most importantly, this year’s WHA considered, and ultimately passed, a resolution to implement the recommendations of the UN Commission on Life-Saving Commodities for Women and Children. The resolution commits countries to improving the quality, supply, and delivery of underutilized and essential commodities for RMNCH, and tasks WHO with reporting back to WHA each year through 2015 on progress in implementing the Commodity Commission recommendations as well as those of Commission on Information and Accountability for Women’s and Children’s Health. The WHA resolution is a clear, global endorsement of the Commodity Commission recommendations, and represents a commitment by the world’s nations to ensure that life-saving medicines and technologies get to the women and children who need them. It is a significant achievement for our community, and it provides an important mechanism for ongoing advocacy, and for holding governments and development partners accountable for keeping their promises.

Notably, the Commodity Commission’s list of 13 priority commodities includes two that are advocacy priorities for FCI: misoprostol, a drug that is highly effective for preventing and treating postpartum hemorrhage (PPH), the leading cause of maternal death; and emergency contraceptives, which help women prevent unintended pregnancy after unprotected sex. (FCI is host organization for the International Consortium for Emergency Contraception—ICEC.)  At a very well-attended side event during the WHA, hosted by the delegations from Nigeria, Norway, and the U.S., along with World Vision International and PATH, speakers focused on the importance of innovation in overcoming barriers to access to essential health commodities. Presentations highlighted the substantial achievements that have already been made, and the important step forward represented by the Commodity Commission’s recommendations. Representatives from various countries also noted the significant challenges that remain, including those related to health commodity distribution systems, manufacturing, and supply. Several countries expressed a preference for purchasing and distributing locally-manufactured commodities, although this approach can sometimes raise concerns about quality assurance; further study, and advocacy, will be needed to address this challenge.

Only a few days later, and half a world away, I was one of a dozen FCI staff members who attended Women Deliver 2013, in Kuala Lumpur, Malaysia. This week was even busier – in fact, much crazier – than the previous week in Geneva; there were meetings and events starting at 7 in the morning, and organized social events went until 8 or 9 pm every night. The conference was amazing, bringing together 4,500 leaders, clinicians, program managers, and advocates representing over 2,200 organizations and 149 countries. I could not take full advantage (or anywhere near it) of everything the conference had to offer; there was an endless variety of stimulating plenary and concurrent sessions (including six sessions presenting the latest findings from Countdown to 2015, in which FCI is a leading advocacy partner), as well as Speaker’s Corner (where FCI and WHO presented new tools for strengthening countries’ policies on adolescent sexual and reproductive health). There was a youth corner and a cinema corner, a busy and bustling exhibition hall, and many, many other activities going on at all times. The cumulative value of all the connections made, facts and ideas conveyed, materials disseminated, and plans and strategies developed was immeasurable but immense.

FCI country directors (Fatimata Kane, Mali; Angela Mutunga, Kenya; Brahima Bassane, Burkina Faso) meet at the FCI booth at Women Deliver 2013

Here, too, essential health commodities were on the agenda. On the Monday morning just before the conference officially started, FCI co-sponsored a side event called “In Our Hands: Successful Strategies to Prioritize Essential Maternal Health Supplies,” at which the Maternal Health Supplies Working Group and the Maternal Health Supplies Caucus of the Reproductive Health Supplies Coalition brought together global and national advocates and program implementers in an interactive forum – including advocacy case studies from Africa, Asia and Latin America – to network, strategize, and exchange ideas for elevating maternal health supplies onto global and national health agendas. At the same time, ICEC co-sponsored a session on “Emergency Contraception: New Research Findings, Programmatic Updates, and Advocacy Strategies,” at which advocates, researchers, pharmaceutical representatives, and other leaders in the field discussed efforts to ensure access to EC globally, with a focus on developing countries.

That afternoon, FIGO and Gynuity Health Projects (our partners in misoprostol advocacy) co-hosted a discussion of misoprostol for PPH: “New Evidence and the Way Forward.” Presenters offered the latest information on ways that the current evidence can help inform and develop effective policies and service delivery programs across varying levels of the health system, and on lessons learned from innovative programs in Afghanistan and Nepal. I concluded the session with a presentation on advocacy opportunities and challenges for “Making Misoprostol an Operational Reality.”

At these and related sessions the level of discussion, the enthusiastic participation by advocates and health workers, and the clear attention that these issues are getting from policy makers, made for an inspiring and energizing two weeks. “Making sure that women and children have the medicines and other supplies they need is critical for our push to achieve the MDGs,” said Secretary-General Ban Ki-moon when he launched the Commodities Commission 15 months ago. Progress is being made, and we, together with our advocacy partners, are working hard to make sure that essential commodities are available to all who need them.