The Center for Global Health Policy’s “Science Speaks” blog examines a recent study that found only slightly more than 44 percent of women in the Nyanza province of Kenya deliver their infants in a health care facility, with many women citing fear of stigma and discrimination as a reason for not attending clinics for prenatal care. Janet Turan of the University of Alabama led the study, published in the August edition of PLoS Medicine, as well as a literature review showing the impact of stigma and discrimination on efforts to prevent mother-to-child HIV transmission, according to the blog. The researchers “conclude that efforts to address HIV-related stigma in and out of health settings are needed, if efforts targeting maternal mortality and parent to child HIV transmission are to succeed,” the blog writes (Barton, 8/29).
Study Finds 'Inconclusive' Evidence To Support Use Of WHO-Backed Drug To Prevent Hemorrhage During Labor
According to a study published Monday in the Journal of the Royal Society of Medicine, “[t]he World Health Organization [WHO] should review its approval of a drug used to prevent life-threatening bleeding in women in childbirth because there is not enough evidence that it is effective,” Reuters reports. The study finds that “the evidence to support the use of misoprostol is ‘at best inconclusive,’ yet it is increasingly used in poorer countries to prevent postpartum hemorrhage (PPH),” the news service writes, noting “researchers analyzed 172 previous studies on the use of misoprostol during labor and found that only six had enough information to say whether or not the drug was effective in preventing PPH in rural and community settings in poor countries” (Kelland, 8/20).
“Women in developing countries could play a major role in remedying the situation, if given the chance,” Jeanette Brown, a scientist with the University of Connecticut in Storrs, said on Monday at the 244th National Meeting & Exposition of the American Chemical Society (ACS), an American Chemical Society press release reports. “A study by the International Water and Sanitation Centre (IRC) of community water and sanitation projects in 88 communities found that projects designed and run with the full participation of women are more sustainable and effective than those that do not,” Brown said in a speech on the global crisis in availability of clean water and basic sanitation, the press release states. “However, she said that women often do not have the opportunity to work on such projects because they lack education, or local cultural rules prevent education for women and even prohibit their using local toilet facilities,” the press release adds (8/20).
In this post in Management Sciences for Health’s (MSH) “Global Health Impact” blog, Belkis Giorgis, senior technical advisor for the Leadership Management and Governance Project at MSH, reports on the International Protecting Girls by Preventing Child Marriage Act (House Resolution 6087), which “establishes a strategy to prevent child marriage and promote the empowerment of girls.” She writes, “If passed into law, the International Protecting Girls by Preventing Child Marriage Act must be implemented in a matter that views the long-term resolution of child marriage as ensuring that young girls are kept in school,” adding, “Most importantly, the legislation must provide effective means to enforce it, to ensure long-term health impact for young women and girls” (8/16).
Highlighting a recent report by the Journal of the Royal Society of Medicine about the use of the drug misoprostol to prevent postpartum hemorrhage and the WHO’s inclusion of the drug on its Essential Medicine List, Guardian health editor Sarah Boseley writes in this post in her “Global Health Blog,” “Seldom has there been a drug that has excited as much controversy as misoprostol.” She continues, “Misoprostol causes the uterus to contract, which is why it can stop postpartum hemorrhage, the cause of around a quarter of maternal deaths,” but “there has been a huge fight over whether and how well it works, which in some quarters has been ideologically motivated, because misoprostol can also bring about an abortion.”
“The United Nations has urged the Philippines to pass a bill that will allow the government to provide free contraceptives,” BBC News reports (8/5). “UNFPA country coordinator Ugochi Florence Daniels said the [reproductive health (RH)] bill is important for the Philippines to achieve its health-related targets in the Millennium Development Goals (MDGs),” including maternal health, HIV/AIDS and infant mortality, the Philippine Star writes (Crisostomo, 8/4). “The House of Representatives plans to decide Tuesday whether to end debate on the bill and put it to a vote,” the Associated Press/Seattle Times notes (Gomez, 8/5).
Inter Press Service reports on the successful efforts of Tanzania’s Kigoma Region “to train assistant medical officers to conduct life-saving c-sections at its rural health centers,” allowing pregnant women with complications to deliver at more local facilities instead of having to travel to regional or district hospitals. Tanzania’s maternal mortality rate is high, at 578 deaths for every 100,000 live births, IPS notes. “[A]t one point the Kigoma Region had the highest rate in the country, at 933 per 100,000 live births in the early 1980s,” but “maternal mortality in this region [now] is considered to be lower than in the rest of the country,” according to the news service.
As part of its monthly series Stories Behind the Statistics, “guest edited by FHI 360 on behalf of USAID’S IYWG, which provides technical leadership to improve the reproductive and sexual health of young people,” the Bill & Melinda Gates Foundation’s “Impatient Optimists” blog features a story by Gaj Bahadur Gurung, program coordinator for the National Federation of Women Living with HIV and AIDS in Nepal, who discusses the impact of adolescent pregnancy on girls and young women in South Asia. He writes, “Policies and programs must both help prevent early and unintended pregnancy (for married and unmarried women) and mitigate the negative consequences for girls who do become pregnant. Programs should provide young women access to, control over, and informed choice of their sexual and maternal health services” (8/3).
On the first stop of a 10-day tour of Africa, Secretary of State Hillary Clinton stopped at the Phillipe Maguilen Senghor Health Center in Dakar, Senegal, where Awa Marie Coll-Seck, the country’s minister of health, “explained to Secretary Clinton how these operational centers dramatically improve maternal and child health,” according to a post in USAID’s “IMPACTblog.” Coll-Seck “also noted that USAID-supported distribution of insecticide impregnated mosquito nets across the country had drastically reduced the incidence of malaria,” according to the blog, which adds that Clinton “was pleased to hear that the United States is playing a key role in helping meet one of its biggest challenges: decentralizing services so they are available at the village level throughout the country.” In an address several hours later, “Clinton invoked the Senghor center … saying she was highly impressed by the integrated nature of the facility” and that “[i]t was a successful model she hoped could be duplicated throughout Senegal and the entire West African region” (Taylor, 8/1).
“Women who are living with HIV remain particularly vulnerable to human rights abuses, including unlawful breaches of confidentiality, denial of health services, compulsory HIV testing and in some cases forced sterilization,” a UNAIDS feature story reports, highlighting a study from January 2008 by the International Community of Women living with HIV (ICW), which found that “[o]f the 230 women interviewed, most reported some form of discrimination in health services and nearly 20 percent stated that they had been coerced or forced into sterilization.” The article continues, “All too often, women living with HIV lack the means and support to challenge violation of their human rights,” adding, “However in Namibia, with the help of the Legal Assistance Centre, a local human rights organization, three women living with HIV took legal action for having been sterilized without their informed consent.” According to the article, “The ruling has been hailed as a step forward in recognizing the reproductive health rights of all women regardless of their HIV status” (8/8).