Women's health—what's new worldwide


International guidelines/reports

Making health services adolescent friendly: developing national quality standards for adolescent-friendly health services

This guidance document, published by the World Health Organization, sets out the rationale for allowing young people easier access to the health services that they require including sexual and reproductive health services. Aimed at government public health managers, the guidebook outlines a five-step process for developing quality standards for adolescent-friendly health services and provides guidance on how to assess whether these standards have been achieved. The five-step process involves: (i) developing a shared understanding of adolescent health and strengthening health service provision to adolescents; (ii) establishing the basis for formulating the national quality standards for health service provision to adolescents, in national HIV/AIDS and/or reproductive health policies and strategies; (iii) examining the programmatic implications of applying the national quality standards; (iv) developing the national standards; (v) outlining essential preparatory work at national levels before the quality standards can be applied. Issues discussed include: what are the health problems that adolescents experience? What barriers do adolescents face in obtaining health services? What is already being done to make health services adolescent friendly? What can be done to improve the service delivered to adolescents? Helpful resources that can be used to conduct a workshop to develop appropriate national quality standards are also provided including a set of workshop facilitator slides. (http://www.who.int/entity/maternal_child_adolescent/documents/adolescent_friendly_health_services_2012.ppt).


Health in the post-2015 agenda: report of the Global Thematic Consultation on Health

This report was produced by the Task Team for the Global Thematic Consultation on Health in the post-2015 development agenda and summarises the main findings and messages from an international consultation to gather views on how best to ensure the health of future generations. The consultation, which took place between September 2012 and March 2013 (and in which over 150 000 people from around the world took part) had three main objectives: (i) to stimulate wide-ranging discussion at global, regional and country levels on progress made and lessons learnt from the Millennium Development Goals (MDGs) relating to health; (ii) to discuss and develop a shared understanding among member States, United Nations agencies, civil society and other stakeholders on the positioning of health in the post-2015 development framework; (iii) to propose health goals and related targets and indicators for the post-2015 development agenda, as well as approaches for implementation, measurement and monitoring. An overview of progress towards achieving the MDGs, including MDG3 (promote gender equality and empower women) and MDG5 (improve maternal health), is provided, opportunities and challenges regarding health priorities post-2015 are examined and the accountability framework for women's and children's health is discussed. The report proposes several recommendations for what should be included in a post-2015 agenda including: specifying health-related targets; that a more holistic, life-course approach to people's health with an emphasis on health promotion and disease prevention should be taken; progress should be accelerated in areas where MDG targets have been missed and more ambitious targets for the future should be set; the need to address the growing burden of noncommunicable diseases, mental health issues and other emerging health challenges; the need to ensure sexual and reproductive health and rights are being met. The above recommendations will inform the discussions of the High-Level Panel of Eminent Persons and the UN Secretary-General's report to the General Assembly.


ProPAN: Process for the Promotion of Child Feeding—a tool to improve infant and young child feeding

This tool, developed by the Pan American Health Organization, the World Health Organization and United Nations Children's Fund, provides guidance on how to design, implement and evaluate both programmes and individual interventions to help improve the feeding and diet of infants and young children. The tool outlines a process to identify dietary and feeding problems in specific populations, a method to aid the formulation of dietary and feeding recommendations, examples of forms to be used for data collection, software allowing for the standardisation of the output of the anthropometric, diet and feeding information collected, and detailed guidance on how to convert all the information gathered into a targeted intervention or programme. Information is also provided on logistics and resource requirements including estimated budgets, required staffing levels and an envisaged time frame. The downloadable ProPAN tool consists of an interactive field manual containing step-by-step guidelines regarding quantitative and qualitative research methods and data collection, an Epi Info™ based software program to be used for data entry and analysis and a detailed software user guide. The software is available in Spanish, French and English.


Facts for family planning

This handbook, developed by the US Agency for International Development and Family Health International (FHI 360), is aimed at everyone (including, for example, programme managers, counsellors, social workers, religious leaders and community health workers) who is involved in communicating information about family planning and reproductive health to people in low-resource settings. The handbook provides information, examples and resources to help in the development of training resources, in communicating key messages and in producing advocacy materials. Topics covered by the handbook include: promoting family planning; planning families; delaying first pregnancy; spacing pregnancies; completing the family; understanding fertility; family planning methods; family planning after miscarriage or abortion; unmarried young people and unintended pregnancy; family planning and sexually transmitted infections including HIV. Each chapter contains: an introduction; key facts to share that can be translated into local languages and included in advocacy policies, mass media campaigns, outreach materials, counselling resources and communication tools; and supporting information. A useful resource list with links to further information is also provided.


Patent news

Patent applications

US2013089574 (A1) Method of preventive on-demand hormonal contraception. This US patent application relates to the invention of a pharmaceutical composition, containing at least one progestogen that can be administered transdermally before intercourse to provide effective contraception. The inventors hope that this method will provide women with higher contraceptive reliability and better tolerability than other currently available postcoital methods.

Schmidt-Gollwitzer K, Stock G. 11 April 2013.


EP2576787 (A1) SNPs associated with polycystic ovary syndrome, chips comprising the same and use thereof. This patent invention relates to the results of a study showing that genetic variants in the THADA, LHCGR and DENNDIA genes are strongly associated with polycystic ovary syndrome in Han Chinese women. The invention provides a kit (comprising a chip) and methods including probes for the THADA, LHCGR and DENNDIA gene SNPs which can be used for scanning, predicting or diagnosing polycystic ovary syndrome.

Chen Z, He L, Shi Y, Ma J, Zhao Y, Zhao H, Shi Y, Geng L, You L. 10 April 2013.


WO2013050383 (A2) In vitro method to determine the risk of a pregnant woman of carrying a fetus with fetal aneuploidy. This world patent application outlines a method to determine whether a pregnant woman has an increased risk of carrying a fetus with fetal aneuploidy by measuring the level of free paraoxonase 1 (PON-1) in a sample of her bodily fluid. The sample is then compared against a predetermined reference value. An increased level PON-1 in the sample compared with the reference threshold indicates an increased risk that the fetus may have fetal aneuploidy.

Demirdjian G, Darbouret B. 11 April 2013.


Legal matters

France: reproductive health care now free

The French government has recently introduced legislation which entitles women to obtain a termination of their pregnancy without incurring any financial cost. Under the new legislation the government will meet the total cost for all terminations of pregnancy carried out in France. The legislation also provides free contraception for all girls aged 15–18 years.


Clinical study recruitment

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

Self-retaining retractor in obese patients undergoing caesarean section (Alexis)
Registration http://clinicaltrials.gov/ct2/show/NCT01826604
Description This randomised study aims to assess the effectiveness of the Alexis O caesarean section retractor in obese women undergoing caesarean section compared with the use of traditional hand-held retractors. Surgical site infection, wound disruption rate, surgery duration, time from skin incision to delivery, change in haemoglobin levels, estimated blood loss, postoperative length of stay, intraoperative or postoperative antiemetic requirements, hospital readmission and any other complications will be assessed.
Outcome measures Primary: wound infection or disruptionSecondary: differences between the two groups
Study site Missouri, USAAnticipated study end date: January 2016
Intraoperative detection of lesions using PET (Positron Emission Tomography) probe during secondary cytoreductive surgery for recurrent ovarian cancer
Registration http://clinicaltrials.gov/ct2/show/NCT01826227
Description This pilot study aims to determine if use of a positron emission tomography probe improves detection of lesions during secondary cytoreductive surgery for recurrent ovarian cancer.
Outcome measures Primary: sensitivity and specificitySecondary: not specified
Study site New York, USAAnticipated study end date: March 2015
Simplified medical abortion in rural India
Registration http://clinicaltrials.gov/ct2/show/NCT01827995
Description This randomised study aims to investigate whether a simplified follow-up regimen for medical abortion (which could be used at primary-level facilities in low-income countries) is as effective as the standard procedure in a low-income setting. The simplified follow-up regimen consists of mifepristone given at the outpatient clinic followed by the administration of misoprostol 24–48 hours later (in the clinic or at home) and instructions are given to each woman regarding how to use a checklist and a low-sensitivity pregnancy test around day 10–14.
Outcome measures Primary: efficacySecondary: safety
Study site Udaipur, IndiaAnticipated study end date: December 2014
Human chorionic gonadotrophin in an antagonist protocol (HCG)
Registration http://clinicaltrials.gov/ct2/show/NCT01833858
Description This study aims to investigate whether luteinising hormone (LH) activity in the form of low-dose human chorionic gonadotrophin in gonadotrophin-releasing hormone antagonist cycles improve the quality of the oocytes, the level of inhibin A or endometrial vascularity.
Outcome measures Primary: number of oocytes; pregnancy rateSecondary: cost of antagonist treatment; spiral artery Doppler indices; percentage of the perifollicular vascularity using power Doppler
Study site Cairo, EgyptAnticipated study end date: January 2014
The use of doppler to diagnose myometrial masses (3D)
Registration http://clinicaltrials.gov/ct2/show/NCT01833871
Description This study aims to investigate whether three-dimensional power Doppler ultrasonography can be used effectively to diagnose and differentiate between uterine adenomyosis and leiomyomas in women presenting with a myometrial mass.
Outcome measures Primary: power Doppler vascular indices; uterine artery Doppler indices in fibroids in relation to adenomyosisSecondary: not specified
Study site Cairo, EgyptAnticipated study end date: December 2013
  • 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.