Women's health––what's new worldwide

Authors

  • Shona Kirtley,

  • John Thorp


  • Shona Kirtley, Research Information Specialist, Centre for Statistics in Medicine, University of Oxford, UK and John Thorp, North Carolina Center for Women's Health Research, USA.

International guidelines/reports

UN Commission on life-saving commodities for women and children: Commissioners’ report

This United Nations Population Fund (UNFPA) report outlines recommendations for action developed by experts and a technical working group to improve access to life-saving commodities. The UN Commission on life-saving commodities for women and children is part of the Every Women, Every Child movement and its main goal is to increase access to life-saving commodities in 50 of the poorest countries in the world that account for more than 80% of all maternal and child deaths. Initially 13 commodities were identified by the Commission, and if access to these commodities were improved, it is believed that the lives of more than six million women and children could be saved, including 230 000 maternal deaths being avoided through improved access to family planning services. The commodities identified by the Commission are: for maternal health, oxytocin, misoprostol and magnesium sulphate; for newborn health, injectable antibiotics, antenatal corticosteroids, chlorhexidine and resuscitation devices; for child health, amoxicillin, oral rehydration salts and zinc; for reproductive health, female condoms, contraceptive implants and emergency contraception. Clinicians in the developed world take it as a given that these basic products are readily available and never need worry about having access to them. Key barriers preventing access to these commodities are also highlighted in this report including: under-resourcing of regulatory agencies; issues with product quality; market failures; challenges with user supply and demand. The report highlights the Commission's ten recommendations for improving access to life-saving commodities for women and children: shaping global markets, shaping local delivery markets, innovative financing, quality strengthening, regulatory efficiency, supply and awareness, demand and utilisation, reaching women and children, performance and accountability, and product innovation.

www.unfpa.org/webdav/site/global/shared/images/publications/2012/Final%20UN%20Commission%20Report_14sept2012.pdf

Community discussion guide for maternal and newborn health care

This guide was developed by the UKAid-funded Mobilising Access to Maternal Health Services in Zambia Programme (MAMaZ) in collaboration with the Ministry of Community Development and the Mother and Child Health and District Health Management Teams in six rural districts of Zambia (Chama, Choma, Kaoma, Mkushi, Mongu and Serenje) who support the Ministry of Health's safe motherhood action group (SMAG) initiative. The discussion guide aims to encourage and support a community engagement approach to help make it easier for individual members of the community to adopt healthier practices. It also aims to provide comprehensive, context-specific guidance on how to train large numbers of community health volunteers and community SMAG volunteers to encourage pregnancy planning and newborn care with the aim of reducing maternal and newborn deaths in rural areas. The guide, which consists of two modules, is specially designed to build the knowledge and capacity of SMAG trainers and mentors to encourage and lead discussions in different communities and to encourage participants to share discussion topics and information with their families. Topics covered by the two modules include: needs and rights to good maternal health services; maternal danger signs and care during pregnancy; planning for safe pregnancy and delivery; community systems for increasing access to maternal and newborn health care; immediate newborn care; caring for the newborn in the first 30 days; postnatal care for mother and newborn; gender violence and women's health; reaching the vulnerable and socially excluded; importance of male involvement; establishing community systems that promote maternal and newborn health. The culture within a community is a critical determinant of health, and cultural values and line of authority strongly influence the health and lifestyle decisions of community members. Detailed outlines for what should be covered in each session are provided including information to present, possible questions to ask the group to encourage discussion, instructions and quick references for trainers. It is intended that the modules are completed over seven weekly facilitated discussion sessions lasting between 1.5 and 2 hours.

www.healthpartners-int.co.uk/our_projects/documents/MAMaZ_CDGuide_AW_single_lowres.pdf

A forecasting guide for new and underused methods of family planning: what to do when there are no trend data

This guide, produced by the Institute for Reproductive Health, Georgetown University (IRH/GU), John Snow Inc. (JSI), and Population Services International (PSI) for the Reproductive Health Supplies Coalition (RHSC), aims to help both public sector and private sector programme managers with the challenge of forecasting for new and under-used family planning methods in their country to address high unmet needs. The guide provides a framework to support programme managers when planning the introduction of a new contraceptive method or when planning to scale up access to an under-used method by helping managers to build and increase the accuracy of forecasting for family planning commodities and by recommending strategies to avoid common forecasting pitfalls. The guide is based on experiences and lessons learnt from interviews held with experts from over 25 country programmes including from Ethiopia, Ghana, Guatemala, Kenya, Liberia, Nepal, Rwanda, Tanzania, Malawi, Zambia and Zimbabwe. Data were also analysed from forecasts either done or received by the USAID Deliver Project and the project's Procurement Planning and Monitoring Report from 2006–10 and a review was carried out to assess existing forecasting tools and guides addressing new and under-used family planning methods. The guide outlines a five-step process for new and under-used methods forecasting activity: gather data from secondary sources that can support assumption-building and identify the limitations of the data; build out assumptions based on a contextual framework of factors that potentially influence the uptake of new and under-used methods; host an assumption-building workshop with key stakeholders; forecast and then run a ‘reality check’ on the quantification and distribution strategy; develop and implement a monitoring plan. Section 7 provides a useful list of relevant resources and the authors are keen for users to submit feedback on the guide and to contribute to the ‘Tips from the Experts’ section.

www.k4health.org/sites/default/files/A%20Forecasting%20Guide%20for%20New%20and%20Underused%20Methods%201st%20Edition%202012.pdf

Prevention and recognition of obstetric fistula training package

This training package has been developed by Fistula Care's implementing partner in Ethiopia, IntraHealth. The training package, designed for health workers, aims to improve knowledge of obstetric fistula prevention, identification and pre-repair care and to help health workers to provide health education to women and their communities about safe motherhood, the importance of antenatal care and skilled attendance at birth. Consisting of ten individual modules (freely available to download as pdf slides) the course begins by providing general health information about the female reproductive system, safe motherhood, antenatal and emergency obstetric care and prolonged/obstructed labour. Modules six to ten provide obstetric fistula-specific training including the causes, contributing factors and impact on affected women, identification and diagnosis, pre-repair care and referral, principles of postoperative care and reintegration of women after surgical repair and the role of families, the community and the healthcare system in the prevention of fistulae and the care of women with obstetric fistulae. A facilitator's manual, participant handbook, visual aids and supplementary hand-outs are also freely available to download. It is anticipated that the course would be run over three days and a detailed schedule for each day is provided to help training course facilitators with local planning.

www.fistulacare.org/pages/newsletters/training-materials-announcement.php

Patent news

Granted patents

US 8283451 Kit for prediction of pre-eclampsia. Poston, L., Seed, P.T., Hunt, B.V., Chappell, L.C. 9 October 2012

This granted patent outlines the invention of a method and diagnostic kit for predicting pre-eclampsia. Specifically, this method involves identifying and determining from a maternal sample (preferably taken between 12 and 38 weeks of gestation) the level of two or more markers for pre-eclampsia selected from placenta growth factor, plasminogen activator inhibitor-1, plasminogen activator inhibitor-2 and leptin.

www.patentlens.net/patentlens/patents.html?patnums=US_8283451

US 8277379 Methods and apparatus for the treatment of menometrorrhagia, endometrial pathology, and cervical neoplasia using high intensity focused ultrasound energy. Lau, M.P.H., Teng, N., Vaezy, S., Lebedev, A., Lau, M.W., Connolly, M.J. 2 October 2012

This granted patent discusses the invention of methods and apparatus that use high-intensity focused ultrasound energy to treat internal pathological conditions. Specifically, this invention consists of a probe containing a high-intensity focused ultrasound (HIFU) conducer that can be inserted into the vagina of a woman and that can direct HIFU energy to a specific site within the uterus to initiate necrosis of the tissue. An imaging device is also outlined which is used to help guide the delivery of the HIFU to the correct treatment site.

www.patentlens.net/patentlens/patents.html?patnums=US_8277379

Patent applications

US 2012/0255556 A1 Fallopian tube filter. Renfrow, J.D. 11 October 2012

This US patent application outlines methods and apparatus for a fallopian tube filter which acts as a removable, nonpermanent indwelling contraceptive device. The device is designed to prevent pregnancy without the use of drugs, hormones or altering the anatomy.

www.patentlens.net/patentlens/patents.html?patnums=US_2012_0255556_A1

Legal matters

Polish Parliament deliberates ground breaking sexual and reproductive health bill

The Polish Parliament has recently begun reviewing a draft bill entitled Conscious Parenthood which addresses sexual and reproductive rights. The bill, if passed, would legalise termination of pregnancy up to 12 weeks of gestation in all circumstances, would guarantee all women access to contraceptives and introduce mandatory and comprehensive sex education in schools. At present Poland is reported to have one of the lowest rates of contraceptive use in Europe and has restrictive termination of pregnancy laws.

http://reproductiverights.org/en/press-room/polish-parliament-deliberates-groundbreaking-sexual-and-reproductive-health-bill

Clinical study recruitment

Clinicians keen to keep up-to-date regarding clinical studies that are currently recruiting may find the following informative.

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Ancillary