It’s been twenty-six years since the International Conference on Population and Development affirmed women’s reproductive health as an essential human right. In this episode of A Deeper Look, I sit down with Ann Starrs, Director of Family Planning at the Bill & Melinda Gates Foundation, to hear how new products, policies and practices are disrupting the family planning landscape and offering greater access and better outcomes for users.
Tagged: Reproductive Health
Put a ring on it: Four reasons to make the dapivirine ring an HIV prevention option for women and girlsWritten by
While much progress has been made to end the HIV epidemic, not enough has been done to put the power of prevention directly in women’s hands. The dapivirine ring, a flexible silicone ring inserted monthly into the vagina, can change this. If approved by regulators, the ring would be the first discreet, long-acting HIV prevention tool available specifically for women. The ring would complement daily oral HIV pre-exposure prophylaxis (PrEP) as another biomedical tool in the fight against HIV.
Recent evidence suggests significant acceptability of and demand for vaginal rings as a drug-delivery platform among women who used the dapivirine ring during clinical trials — and also among policymakers and other stakeholders in countries with a high HIV burden. To better understand these perspectives, the OPTIONS Consortium interviewed policymakers, implementers and civil society leaders in seven sub-Saharan African countries about possibilities for introduction and scale-up of the dapivirine ring. An analysis of the interviews shows widespread enthusiasm for the ring as part of comprehensive HIV prevention programming.
Imagine 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.
The numbers are shocking. Each year, 2.8 million babies die during their first 28 days of life, while almost 800 women die every day in pregnancy or childbirth.
A vast majority of these deaths are preventable through simple interventions: providing mothers and their children with access to basic, quality health care, especially during pregnancy and childbirth; encouraging mothers to breastfeed; and treating diarrhea and pneumonia, two of the leading killers of children under 5 years of age.
Despite the impressive progress that has been made in recent years, achieving the Millennium Development Goals (MDGs) on reproductive, maternal, newborn and child health (MDGs 4, 5 and 6) by 2015 will require an all-out global push.
In June, the U.S. Agency for International Development (USAID) announced a major realignment of US$2.9 billion of its resources to “save up to half of a million children from preventable deaths by the end of 2015.” In addition, USAID introduced an ambitious strategy, Acting on the Call: Ending Preventable Child and Maternal Deaths, to dramatically increase progress in 24 countries that account for 70 percent of child and maternal deaths.
This is an important policy shift — one that has the potential to have great impact on development by saving the lives of 15 million children and nearly 600,000 women by 2020. FHI 360, a member of the Advisory Group for Acting on the Call, supports USAID’s commitment. We have seen how evidence-based interventions in maternal, newborn and child health are making a difference in communities around the world.
Today, as we observe International Youth Day, we look back on the past eight years of FHI 360’s involvement with the U.S. Agency for International Development (USAID)’s Interagency Youth Working Group (IYWG), the only source of global information about preventing both unintended pregnancy and HIV among youth. Our work managing the technical content for the IYWG was conducted under USAID’s Preventive Technologies Agreement, which ends this month.
During this time, we have made many contributions. The IYWG tools and resources have been used by thousands — more than 30,000 people from 199 countries have visited our website, over 6,000 have participated in our e-forum discussions, and more than 1,000 have attended our annual technical meetings. Since 2007, we have distributed InfoNet twice monthly to approximately 5,000 individuals and developed 21 issues of YouthLens; 1,219 users follow us on Twitter; and 2,444 people like our IYWG and Answer the Call Facebook pages.
We are grateful to the many dedicated individuals who helped us produce, synthesize and disseminate evidence on youth sexual and reproductive health, and to our partners for sharing their work and supporting ours. To all who have helped us provide practical, evidence-based resources and tools in the service of improving the lives of young people around the world, thank you!
To mark the end of the IYWG, we are featuring a few of our favorites from the IYWG blog, Half the World. Though we will not be providing any new content, the website and blog will continue to exist as a rich resource for information on youth reproductive health and HIV/AIDS.
Greg Louganis, a gold-medal-winning Olympic diver and author, provides an honest, inspiring account of his life with HIV.Read More
Joy Cunningham, a senior technical officer at FHI 360, explains why a 2012 U.S. Agency for International Development policy is critical to young people’s sexual and reproductive health.Read More
Contraceptive technology has come a long way, but there is still much more work that needs to be done to increase women’s access to safe and effective contraceptive choices.
Since Margaret Sanger overturned anti-contraceptive legislation in 1936, making it legal for doctors to provide diaphragms and spermicides to women, researchers have been working to develop improved contraceptive methods. Oral contraceptives were introduced to the public in the 1960s and paved the way for future innovation. Today, contraceptive hormones are delivered in a variety of ways, including through implants, long-acting injections, patches and vaginal rings.
Yet there is still a gap in contraceptive technology that FHI 360 is working to fill – an effective, safe, easy-to-use, and low-cost vaginal contraceptive.
FHI 360 has developed a new vaginal insert, made of soft, non-woven textile materials that can contain different types of vaginal gels. What makes this insert innovative is that it virtually eliminates leakage of the vaginal gel, a critical issue for both effectiveness and acceptability. The insert is packaged as a single-use, ready-to-use product, pre-moistened with medicated gel. Depending upon the type of gel, the device could be used to prevent pregnancy or HIV or to treat vaginal infections.
Currently, the only over-the-counter vaginal contraceptives that are available are detergent-based spermicides containing nonoxynol-9 or similar agents. Detergent-based spermicides are irritating to vaginal tissues and with frequent use can cause ulcerations that could increase the risk of HIV infection.
The insert could be used with new non-irritating spermicides such as BufferGel® (developed by researchers at Johns Hopkins University) or with a ferrous gluconate formulation (developed by researchers at Cornell University). So far, the Hopkins and Cornell researchers have used other delivery methods, including diaphragms and vaginal rings, for their formulations. The FHI 360 insert could also be used to deliver microbicide gels, considered to be one of the most promising interventions to emerge over the past decade to prevent HIV infection in women.
Results of a pivotal study, presented on September 17 at the Reproductive Health 2011 conference, showed that the combination of BufferGel and the new SILCS® diaphragm—a one-size-fits-all device—was as effective as a diaphragm with nonoxynol-9 gel. This is a double dose of innovation—a new, non-irritating spermicidal gel and a new one-size-fits-all diaphragm—and it’s great news for women.
In 2009, we conducted a Phase I study to assess the acceptability of the FHI 360 insert among women and their male partners in Durban, South Africa, using the device saturated with 10 mL of an FDA-approved vaginal lubricant. We recruited 40 women, who first inserted and removed the device at the clinic and then at home. For home use, we asked women to discuss the product with their male partner and—if their partner agreed—to wear it during intercourse.
Participants found the insert easy to place in the vagina and easy to remove with minimal to non-existent leakage. Most men (34) agreed to have intercourse with the device in place. Participants reported that the insert was comfortable during intercourse. Most women said they would be willing to use the insert for contraception or preventing sexually transmitted infections, including HIV, and most men said they would approve of their female partners using it if it became commercially available.
Once again, we have the potential to advance women’s health in the U.S. and around the world. This is what innovation is all about – improving lives.