Health

  • Beyond the health benefits, what does family planning have to do with the SDGs?

    A version of this post originally appeared on K4Health. Reposted with permission.

    The international community is abuzz with excitement about the new global development agenda, the Sustainable Development Goals (SDGs). Officially being launched this month, the aims laid out are more ambitious and all encompassing than ever before. As such, they’ve generated an expectedly broad, diverse and loud chorus of suggestions for their implementation. Everyone seems on the hunt for the best new idea or technology to carry the agenda forward. Yet, after decades of work and untold millions of dollars in investments in research and ideas, surely we must know something useful today that could be put to good use? Perhaps while smartly pursuing innovations that keep pace with our changing world, we can also put some real investment behind some of even the simplest things that we already know to be true and which might just need a little more traction before we can finally benefit from their full potential impact.

    For example, right now we have a tool available to us that spans almost every SDG. It’s a relatively inexpensive solution that can simultaneously improve global outcomes in education, health and wealth. It can help preserve our environment and ensure food security for people around the world. You may be wondering why you have not heard of this amazing tool, but it’s far from new. Drumroll … it’s fully meeting the global demand for contraception. That’s right — sound evidence from around the world tells us several things.

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  • Srey Sros: Addressing the needs of transgender populations in Cambodia

    Srey Sros model

    A transgender model promotes the Srey Sros program. Photo: Graphic Roots Studio, Cambodia

    I have three long-haired boys, and wherever we go in Cambodia, people are confused, certain they are girls. We are constantly asked, “Why?” The answer is simple: They like having long hair. My boys’ push against traditional gender expressions is perhaps acceptable only because Cambodians have come to expect odd behavior from foreigners.

    Yet, it is a different matter for a Cambodian transgender individual with long hair. Transgender individuals in this setting face many acute challenges, and their unconventional appearance is only one of them.

    Transgender individuals in Cambodia carry a high burden of HIV. According to a study conducted by FHI 360 in select urban centers of the country, transgender individuals have an HIV prevalence of 4.15 percent (compared to 0.6 percent for the general population). Despite this striking percentage, they have historically been left out of HIV prevention and care programs. When they were included, they were incorrectly targeted as men who have sex with men. This means that there were no distinct behavior change communications or services for this group.

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  • Youth and long-acting, reversible contraception: Confronting the myths with truth

    Youth and contraception: two words that when used together excite visceral responses throughout the world. The response is even more fraught when we consider long-acting, reversible contraceptives (LARCs) for youth. Both intrauterine devices (IUDs) and implants are LARCs, and the challenges for young people who wish to use them — lack of access, myths and misconceptions, provider bias and community stigma — are pervasive. We have to understand more about these challenges in order to overcome them.

    In late May 2015, FHI 360 and partners — U.S. Agency for International Development, PSI, MSI and Pathfinder International’s Evidence to Action project — sponsored a symposium, called “For Youth, a Healthy Option With LARCs” in Washington, DC. The meeting convened more than 100 experts from around the world, including program advisors and implementers, researchers, health providers, donors and advocates, as well as young people themselves. The meeting’s goal was to encourage participants to share experiences, tackle tough questions and advocate for wider access to LARCs for young women.

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  • Final results from two research studies presented at IAS 2015 yesterday demonstrated clear scientific evidence on the benefits of early initiation of antiretroviral therapy (ART). Building on early results of HPTN 052 released in May 2011 that then showed a 96 percent reduction in HIV transmission, the study results presented yesterday provide conclusive evidence that ART should be provided to all HIV-positive people as soon as they are diagnosed for the benefit of both themselves and their sexual partners.

    Jens Lundgren of the University of Copenhagen presented the initial results of the Strategic Timing of AntiRetroviral Treatment (START) study, a randomized trial looking at whether starting ART in people with CD4+ cell counts above 500 cells/mm3, rather than waiting for CD4+ cell counts to drop below 350 cells/mm3, reduces the occurrence of serious morbidity and mortality. START was recently unblinded by the international Data & Safety Monitoring Board (DSMB) 18 months early due to data that showed very clear benefits of immediate treatment versus delayed treatment. Previous studies and guidance from the World Health Organization (WHO) suggested that ART should not be given to patients unless they had symptomatic HIV and/or CD4+ counts that were below 350 cells/mm3. The interim results from START show that ART is safe and effective for all HIV-infected persons regardless of CD4+ count.

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  • Connecting the dots: Advancing contraceptive R&D through partnerships and knowledge sharing

    To optimize opportunities to make groundbreaking advances in contraceptive research and development (R&D), the global health community must help connect the dots to facilitate new partnerships between groups that often work in silos. For example, there is the company in the United States that is developing a promising drug delivery platform but hasn’t yet considered applying the research to contraceptive products. There is the university scientist who has an idea for a new contraceptive product but is unsure whether similar investments are being made in the private sector. There is the small company based in the global South that wants to enter the international market but lacks experience registering its contraceptive products in sub-Saharan Africa.

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  • Improving adolescent sexual and reproductive health in Bangladesh through the Sustainable Development Goals

    In mid-June, we had the opportunity to attend a national consultation with members of Parliament in Bangladesh on integrating sexual and reproductive health and rights into the proposed Sustainable Development Goals (SDGs). The consultation was hosted by the Family Planning Association of Bangladesh with support from the International Planned Parenthood Federation.

    Bangladesh has made impressive strides toward achieving the Millennium Development Goals. It has met the gender parity goals for primary and secondary education and is on track to fulfill the tertiary education goals. Bangladesh has also met the under-five mortality-reduction rate goal and is likely to reach the goal of reducing maternal mortality.

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  • Saplings and contraceptives: Results from a population, health and environment project in Kenya

    East African countries like Kenya have made great strides in recent decades in increasing access to modern contraception, leading to marked declines in fertility rates. But disparities remain.

    The 2014 Kenya Demographic and Health Survey showed that rural women have a total fertility rate of 4.5 children per woman versus 3.1 for urban women, and the poorest women have more than twice as many children on average than the wealthiest. Meanwhile, unmet need for contraception among poor and rural Kenyan women is higher than any other groups. Clearly, innovative solutions are needed to support women and couples in poor, remote rural areas in achieving the number and timing of pregnancies they desire.

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  • Advancing a no-missed-opportunities approach through integrating family planning and immunization services

    A no-missed-opportunities approach recognizes that every service contact presents an opportunity to comprehensively address women’s and children's health needs. Credit: Chelsea Cooper, MCHIP

    A no-missed-opportunities approach recognizes that every service contact presents an opportunity to comprehensively address women’s and children’s health needs. Credit: Chelsea Cooper, MCHIP

    When Lorpu*, a mother in Liberia, brought her baby to a clinic to receive routine immunizations, she was also counseled about family planning and offered a contraceptive method. Lorpu expressed relief about having received same-day provision of both family planning and immunization services: “When I go for [my child’s] vaccine, I can also get family planning. I don’t have to leave and come back.”

    Lorpu received these integrated services as part of a pilot program in Liberia implemented by the U.S. Agency for International Development’s (USAID) predecessor flagship Maternal and Child Health Integrated Program (MCHIP) and the Liberian Ministry of Health and Social Welfare. In participating clinics, women who brought their infants for routine immunization services were provided brief messages about family planning by the vaccinator and offered a referral for same-day services. This approach, now used by MCHIP’s successor program, the flagship Maternal and Child Survival Program (MCSP), has led to substantial increases in family planning uptake, and women have expressed positive feedback about the convenience of having access to both family planning and immunization services during the same visit.

    Integrated health care delivery is critical in the year after childbirth, when there are numerous opportunities to reach women and their infants with services — including postnatal care, immunization, growth monitoring and family planning. A no-missed-opportunities approach recognizes that every service contact presents an opportunity to comprehensively address women’s and children’s health needs.

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  • Common cause: Linking menstrual hygiene management and long-acting contraception to improve youth reproductive health

    What do family planning and menstrual hygiene management (MHM) have in common? Beyond a shared purpose to improve the health and well-being of women and girls, some family planning methods can actually improve menstrual hygiene. Menstrual Hygiene Day on May 28 offers an opportunity to explore synergies between the two fields.

    In recent years, the MHM movement has focused on the critical role that good menstrual hygiene management plays in enabling women and girls to achieve their full potential. Reducing the stigma associated with menstruation and ensuring that adolescent girls and women are able to safely manage their menses can eliminate some of the barriers that prevent girls and women in many countries from participating in day-to-day activities, such as attending school.

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  • Envisioning a world in which youth are at the center of their reproductive lives

    Kelly L’EngleImagine the potential if each one of the 600 million adolescent girls in developing countries could have full control over her reproductive life. She would be able to stay in school, delay marriage, postpone pregnancy, and support herself and her community. Yet, approximately 16 million girls between the ages of 15 and 19 give birth each year and one-third of girls give birth before their 20th birthday.

    To advocate for young people’s access to safe, reliable contraceptive information and services, FHI 360 co-hosted a meeting today on youth and long-acting reversible contraceptives (LARCS). With participants including the LARC and Permanent Methods Community of Practice Secretariat, Population Services International, Marie Stopes International and Pathfinder, the meeting highlighted the range of highly effective contraception methods available and provided a platform for tackling tough questions about how to effectively promote LARCs for youth.

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