Women & Gender

A common challenge in advancing family planning is overcoming the misconceptions religious leaders have about the use of contraceptives.

Concerns from religious leaders are often based on misconceptions about family planning methods rather than their religious beliefs. The fear that hormonal methods will cause infertility or are dangerous, are commonly expressed as concerns from religious leaders.

These methods are 300 times safer than becoming pregnant in Afghanistan and about 100 times safer than pregnancy in Yemen, Malawi, and Tanzania is an appropriate way to look at the risks versus benefits.  My experience in these four countries has been that this message was well received by both Muslims and Christians, along with the sound evidence for improved child and maternal health outcomes with healthy timing and spacing of pregnancy (HTSP). 

Pick up any American newspaper these days, and all of the stories coming out of Haiti are negative: earthquake relief work is going slow, displaced people are still living in tented camps, men and women are still struggling to find work.  And while these facts can’t be disputed, there are many other stories that are being left untold.  Working in Haiti earlier this month, I encountered six women who are on the front lines of the battle against Haiti’s HIV & AIDS epidemic, who shared their stories with me.

Women in Haiti

On July 19, here in Vienna at the XVIIIth International AIDS Conference, positive results were announced from the CAPRISA 004 Phase IIb microbicide trial of 1% tenofovir gel, which was tested in 889 South African women. Overall, there were 39 percent fewer infections among women who received the gel compared to women who received the placebo –and the results showed 51% efficacy of the gel against transmission of herpes simplex virusto women.  Of note, recent vaccine trials and microbicide trials have set as a limit of efficacy 30% in order to be considered “effective”, which generally means that the FDA will approve them.  

With sometimes impenetrable terrain and limited infrastructure, Yemen presents a very challenging environment for delivering health services to rural areas. Basic health services do not reach most women; rural areas lack health facilities; and Yemen’s conservative cultures do not allow women to receive health services from men, or to freely come and go from their home.

In Yemen, through a pilot program, the Extending Service Delivery (ESD) Project supported the Basic Health Services (BHS) Project to assist midwives with setting up private practices in rural communities where facilities did not exist or were too far away. Midwives are generally respected in Yemen communities and, most husbands allow their wives to visit the midwives in their homes.

The Group of Eight (G-8), holding their annual summit last weekend in Muskoka,Canada, announced a Canadian-led Muskoka Initiative on Maternal, Newborn and Under-Five Child Health (Muskoka Initiative). The Group of 20 (G-20) summit held immediately after in Toronto, resulted in no additional commitments to maternal and child health. MSH believes the G-20 missed an opportunity to support global health when the group did not endorse the G-8’s maternal and child health initiative announced the day before. The G-20 is a group of key finance ministers and central bank governors that meets semi-annually on matters relating to the international financial system.

One of the most striking admissions I heard during the Women Deliver 2010 conference in Washington DC (June 7-9) was that the major challenge facing maternal health improvement is a lack of political will. Kathleen Sebelius, the US Secretary for Health and Human Services, suggested that the problem with improving maternal mortality lay not with the lack of knowledge or interventions, but the political will to put that knowledge to action, the will to make maternal mortality a priority of governments, the will to stand up and say that the lives of women matter, and we MUST do something about it.

UNAIDS’s new campaign aims to eliminate mother to child transmission (MTCT) of HIV by the 2012 World Cup in Brazil. It is fantastic to see that UNAIDS is using the enthusiasm and media coverage of World Cup to draw attention to one of Africa’s most pressing health issues, perinatal transmission of HIV.

My colleague Jude Nwokikie, program manager of the Strengthening Pharmaceutical Systems (SPS) project in South Africa and Namibia declared, “The world is no longer in the mood to tolerate MTCT.”

Last week at the Women Deliver Conference in Washington, DC, Melinda Gates announced that the Gates Foundation is committing $1.5 Billion in new grant money for maternal health. “Women and children have moved up on the global agenda, and I’m here to tell you that’s where they are going to stay,” said Gates.

In most developing countries, women and girls are the poorest and most vulnerable parts of the population because of entrenched inequalities. MSH believes that health is a human right; equal access is essential to all aspects of health care.

Global Health TV visits Ethiopia’s capital, Addis Ababa, to see how MSH’s  systems approach at the community level results in better lives for people living with HIV & AIDS. Management Sciences for Health, an international nonprofit organization, uses proven approaches developed over four decades to help leaders, health managers, and communities in over 60 countries build stronger health systems for greater health impact.

Watch the video.

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