Despite the United State's recent increase in family planning funding, a dramatic decrease in international donor funding is taking place, which threatens to unravel other humanitarian gains made in regards to issues such as poverty, hunger, and efforts to counter global warming.
In 1994 the International Conference on Population and Development took place in Cairo and alerted the world to issues of population and development, and the severe consequences for inaction. Following this highly publicized conference, countries worldwide were eager to commit funding, but after reaching a peak in 1995 with U.S.$723 million allotted, a drastic decline has occurred worldwide. The latest estimate, for 2007, shows contributions totaling only about $338 million, which according to UNFPA senior demographer Stan Bernstein, is "a hell of a decline." Furthermore, if one takes inflation into account the decrease appears even more severe.
The recent decline in funding not only hurts family planning services, but also threatens to undermine other humanitarian achievements such as advents made in the arenas of poverty and hunger. Unless their is renewed attention to issues of population and development, as well as an increase in funding for family planning, high fertility, especially in sub-Saharan Africa will simply exacerbate related humanitarian problems such as poverty. UNFPA Executive Director Thoraya A Obaid explains how "We have to protect the gains made and ensure that these gains do not slip back" in order to make any sustainable progress.
In an effort to prioritize issues of population and development, UNFPA convened 30 family planning experts in New York late this June including representatives from Bangladesh, Colombia, Guatemala, Kenya, India, Senegal, Tanzania, Uganda, the U.K. and the U.S. What they found was that countries who felt that they had made significant strides in reproductive health and effective family planning, were compelled to shift funding to other problems that seemed to require more attention. What they failed to realize however, is that such a monetary commitment must be continued if any lasting progress is to be made. Furthermore, many prior efforts were aimed at a specific age group of sexually active young men and women. Now that funding has been decreased, international programmes are having to choose what areas to focus on. This means that someone who was a child during the initial wave of family planning funding, will now find that resources and services are more limited as they become sexually active, and that the only information they will receive is that which funding will allow. One prominent example is in sub-Saharan Africa, where the limited funding has been focused almost entirely on HIV and AIDS, and has failed to address other important issues such as abortion and contraception.
Without an increase in funding, not only will family planning and reproductive health services be diminished, but an endless cycle connecting population with other humanitarian issues will relentlessly continue. If we are to make any strides regarding other issues, such as global warming or hunger, we must continue to address the core of every problem, namely , population. It is PPD's hope that a recommitment to the original goals of the ICPD will occur, and that the United State's recent increase in funding to family planning will emphasize the necessity of such a financial commitment.
Showing posts with label reproductive health. Show all posts
Showing posts with label reproductive health. Show all posts
Thursday, July 16, 2009
Sunday, July 12, 2009
Dr. Musinguzi on World Population Day 2009
Fulfilling Our Promises to Women
Saturday, 11 July 2009
In these times of global economic crisis, our families, communities and nation face increasingly difficult decisions about how to spend scarce financial resources. We hear dismal statistics repeated in the newspapers and online: the economy of developed countries (measured by GDP) is predicted to fall 4.5% in 2009 and world trade will fall nearly 10% (The World Bank’s annual Global Development Finance (GDF) report: http://www.worldbank.org/gdf2009).
For example, in Uganda, remittances are down 47%, from $504.04 million to $267.32 million (http://news.id.msn.com/business/article.aspx?cp-documentid=3398635 and http://af.reuters.com/article/ugandaNews/idAFLM14443220090622?feedType=RSS&feedName=ugandaNews). USh2.5trn of Uganda’s budget this year (33%) is to come from donor support. Yet it is widely known that donor countries’ official development aid (ODA) is reduced when their economies face turmoil (http://ideas.repec.org/p/frd/wpaper/dp2009-01.html and Roodam, D. (2008). ‘History says Financial Crisis Will Suppress Aid’. Centre for Global Development Website, http://blogs.cgdev.org/globaldevelopment/2008/10/history_says_financial_crisis.php).
What started as a financial issue of the US and Europe is now clearly a global crisis that is hitting Africa hard. It is already affecting our progress toward reducing poverty. Uganda and other developing countries are negatively impacted in the economic crisis because of our reliance on remittances from family overseas and official development aid (ODA) for national budget support.
We know that women and children in developing countries will bear the brunt of the impact of the global financial crisis. Yet we must face this harsh reality with the knowledge we have on what works in development. We must invest in critical services to mitigate the impact on women and allow them to contribute to the economic productivity of their families, communities, and our country.
Funding for reproductive health, prevention of HIV, and preventative health care in general can be viewed by both families and policy makers as non-essential services. Yet dropping these critical services leads to increases in maternal and infant death and disability.
Investing in family planning and reproductive health services not only is good for women’s health and rights (UN resolution on "Preventable maternal mortality and morbidity and human rights", June 17, 2009), it makes economic sense—each $1 invested in contraceptive services will avoid between $1.7 and $4 in expenditures on maternal and newborn health, in addition to cost-savings in education, water sanitation, and immunization. Investing in family planning services reduces maternal mortality, improves child survival, promotes women's empowerment and contributes to poverty reduction.
On 11 July 2009, people around the world will observe the 20th World Population Day. Over the past 20 years, we have seen investments in health and education for women and girls leading to increases in productivity, agricultural yields, and national incomes in developing countries.
Yet, there is still much to be achieved. For example, at the 2009 Commission on Population and Development, the Government of Uganda recognized the high population growth rate of 3.2%, “unacceptably high levels of illiteracy (30%), high infant mortality rate (76/1000 live births), high maternal mortality ratio (435/100,000 live births); low life expectancy (average of 51 years); and a high rate of HIV/AIDS (6.4%).” Yet while a number of these indices have improved over the last 10 years, Uganda has not made a significant positive step in terms of the population growth rate, fertility rate and contraceptive usage (http://www.un.org/esa/population/cpd/cpd2009/comm2009.htm.
Every year, 265,000 mothers in sub-Saharan Africa die in childbirth from preventable causes. In Uganda alone, approximately 6,000 women die every year due to pregnancy complications. Women bleed to death, they do not have access to antibiotics to prevent simple infections; they often do not have the option of a caesarean section when it is necessary. We can prevent these tragedies by providing women with prenatal care, skilled attendance at births, and emergency obstetric care.
Maternal mortality has significant impact on women, families and our country--in terms of lost lives, rights, and national productivity (GDP) (Maternal mortality has a statistically significant negative effect on GDP http://ajol.info/index.php/ajhs/article/viewFile/30801/23132).
We have a blueprint for what we need to do, in Africa and globally—we must fund and implement the 2006 Maputo Plan of Action of the African Union Conference of Ministers of Health (later ratified by African Heads of State). This plan of action aligns with global frameworks and agreements such as the global commitment to universal access to reproductive health services by 2015 of the International Conference on Population and Development Programme of Action (ICPD PoA) agreed to by 179 countries in 1994 and the Millennium Development Goals (MDGs).
In order to fulfill our commitments, we must use our resources wisely. This can best be done in developing countries by sharing our experiences and good practices through South-South cooperation and learning from the successes of our brothers and sisters in other developing countries. We need to look to the example set by other countries like Egypt, Malaysia, Thailand, South Africa and Sri Lanka, who have successfully lowered their rates of maternal ill-health through sustained financial and political commitment. Between 1992-93 and 2000, Egypt reduced its maternal mortality ratio (MMR) over 50% due to the focused efforts of the Ministry of Health and Population to improve access to, and quality of maternal and reproductive health services, reduce fertility rates, and improve antenatal care utilization and skilled attendance at delivery (http://www.jsi.com/JSIInternet/Projects/ListProjects.cfm?Select=Region&ID=2&ProjectStatus=Active). With concentrated efforts, significant improvements in reducing maternal mortality are achievable.
South-South cooperation is a tool that we must take advantage of to both share our knowledge with other developing countries and to learn from their experiences, as well. Developed countries will be increasingly focused on their own problems, leaving us as developing countries to partner and learn from each other as we all strive towards the attainment of the common ICPD goals and MDGs. We must take advantage of our knowledge of local conditions and solutions.
We have the shared knowledge to implement effective, low-cost strategies to improve the health of mothers and children. What we now need is the commitment of community and political leaders to support health progammes that work and to fund the policies and commitments they have made.
We must commit ourselves to ending the tragedy of maternal mortality. No woman should lose her life while giving life.
by Dr. Jotham Musinguzi, M.D., M.P.H.
The writer is the Regional Director of Partners in Population and Development Africa Regional Office (www.ppdafrica.org).
Saturday, 11 July 2009
In these times of global economic crisis, our families, communities and nation face increasingly difficult decisions about how to spend scarce financial resources. We hear dismal statistics repeated in the newspapers and online: the economy of developed countries (measured by GDP) is predicted to fall 4.5% in 2009 and world trade will fall nearly 10% (The World Bank’s annual Global Development Finance (GDF) report: http://www.worldbank.org/gdf2009).
For example, in Uganda, remittances are down 47%, from $504.04 million to $267.32 million (http://news.id.msn.com/business/article.aspx?cp-documentid=3398635 and http://af.reuters.com/article/ugandaNews/idAFLM14443220090622?feedType=RSS&feedName=ugandaNews). USh2.5trn of Uganda’s budget this year (33%) is to come from donor support. Yet it is widely known that donor countries’ official development aid (ODA) is reduced when their economies face turmoil (http://ideas.repec.org/p/frd/wpaper/dp2009-01.html and Roodam, D. (2008). ‘History says Financial Crisis Will Suppress Aid’. Centre for Global Development Website, http://blogs.cgdev.org/globaldevelopment/2008/10/history_says_financial_crisis.php).
What started as a financial issue of the US and Europe is now clearly a global crisis that is hitting Africa hard. It is already affecting our progress toward reducing poverty. Uganda and other developing countries are negatively impacted in the economic crisis because of our reliance on remittances from family overseas and official development aid (ODA) for national budget support.
We know that women and children in developing countries will bear the brunt of the impact of the global financial crisis. Yet we must face this harsh reality with the knowledge we have on what works in development. We must invest in critical services to mitigate the impact on women and allow them to contribute to the economic productivity of their families, communities, and our country.
Funding for reproductive health, prevention of HIV, and preventative health care in general can be viewed by both families and policy makers as non-essential services. Yet dropping these critical services leads to increases in maternal and infant death and disability.
Investing in family planning and reproductive health services not only is good for women’s health and rights (UN resolution on "Preventable maternal mortality and morbidity and human rights", June 17, 2009), it makes economic sense—each $1 invested in contraceptive services will avoid between $1.7 and $4 in expenditures on maternal and newborn health, in addition to cost-savings in education, water sanitation, and immunization. Investing in family planning services reduces maternal mortality, improves child survival, promotes women's empowerment and contributes to poverty reduction.
On 11 July 2009, people around the world will observe the 20th World Population Day. Over the past 20 years, we have seen investments in health and education for women and girls leading to increases in productivity, agricultural yields, and national incomes in developing countries.
Yet, there is still much to be achieved. For example, at the 2009 Commission on Population and Development, the Government of Uganda recognized the high population growth rate of 3.2%, “unacceptably high levels of illiteracy (30%), high infant mortality rate (76/1000 live births), high maternal mortality ratio (435/100,000 live births); low life expectancy (average of 51 years); and a high rate of HIV/AIDS (6.4%).” Yet while a number of these indices have improved over the last 10 years, Uganda has not made a significant positive step in terms of the population growth rate, fertility rate and contraceptive usage (http://www.un.org/esa/population/cpd/cpd2009/comm2009.htm.
Every year, 265,000 mothers in sub-Saharan Africa die in childbirth from preventable causes. In Uganda alone, approximately 6,000 women die every year due to pregnancy complications. Women bleed to death, they do not have access to antibiotics to prevent simple infections; they often do not have the option of a caesarean section when it is necessary. We can prevent these tragedies by providing women with prenatal care, skilled attendance at births, and emergency obstetric care.
Maternal mortality has significant impact on women, families and our country--in terms of lost lives, rights, and national productivity (GDP) (Maternal mortality has a statistically significant negative effect on GDP http://ajol.info/index.php/ajhs/article/viewFile/30801/23132).
We have a blueprint for what we need to do, in Africa and globally—we must fund and implement the 2006 Maputo Plan of Action of the African Union Conference of Ministers of Health (later ratified by African Heads of State). This plan of action aligns with global frameworks and agreements such as the global commitment to universal access to reproductive health services by 2015 of the International Conference on Population and Development Programme of Action (ICPD PoA) agreed to by 179 countries in 1994 and the Millennium Development Goals (MDGs).
In order to fulfill our commitments, we must use our resources wisely. This can best be done in developing countries by sharing our experiences and good practices through South-South cooperation and learning from the successes of our brothers and sisters in other developing countries. We need to look to the example set by other countries like Egypt, Malaysia, Thailand, South Africa and Sri Lanka, who have successfully lowered their rates of maternal ill-health through sustained financial and political commitment. Between 1992-93 and 2000, Egypt reduced its maternal mortality ratio (MMR) over 50% due to the focused efforts of the Ministry of Health and Population to improve access to, and quality of maternal and reproductive health services, reduce fertility rates, and improve antenatal care utilization and skilled attendance at delivery (http://www.jsi.com/JSIInternet/Projects/ListProjects.cfm?Select=Region&ID=2&ProjectStatus=Active). With concentrated efforts, significant improvements in reducing maternal mortality are achievable.
South-South cooperation is a tool that we must take advantage of to both share our knowledge with other developing countries and to learn from their experiences, as well. Developed countries will be increasingly focused on their own problems, leaving us as developing countries to partner and learn from each other as we all strive towards the attainment of the common ICPD goals and MDGs. We must take advantage of our knowledge of local conditions and solutions.
We have the shared knowledge to implement effective, low-cost strategies to improve the health of mothers and children. What we now need is the commitment of community and political leaders to support health progammes that work and to fund the policies and commitments they have made.
We must commit ourselves to ending the tragedy of maternal mortality. No woman should lose her life while giving life.
by Dr. Jotham Musinguzi, M.D., M.P.H.
The writer is the Regional Director of Partners in Population and Development Africa Regional Office (www.ppdafrica.org).
Tuesday, June 2, 2009
New Resources for Developing Presentations and Training Opportunities for Reproductive Health
The Association of Reproductive Health Professionals (ARHP) is now offering two free services to students, faculty and professionals interested in reproductive health, The Global Opportunities Tool (GO Tool) and the Curricula Organizer for Reproductive Health Education (CORE).
The Curricula Organizer for Reproductive Health Education is an open access tool for those interested in building scientific presentations on reproductive health topics. All learning materials are clinically accurate, up to date, peer reviewed and presentation-ready. You can choose to search materials using your own keywords or browse the material by category. When searching under the category "contraception" I found more than 430 individual slides, 40 activities and handouts, and 11 full presentations. The site makes it easy to pull an individual slide to contribute to your own presentation, or to download a fully completed, ready to use presentation. New content is added weekly, and you can request to join their mailing list to stay up to date on the latest CORE material.
The Global Opportunities Tool is a comprehensive resource that connects students in health professions to domestic and international reproductive health training opportunities. You can search available openings by clicking on the continent you are interested in working in, and available positions will present themselves. As of now, only a few countries have available opportunities outside of America, but there is also a component of the site which allows users to submit an opportunity, and I expect that this database will soon become much more extensive.
Both the GO Tool and CORE are great resources for health professionals interested in reproductive health, and I would highly recommend that anyone interested check out their site.
The GO Tool: http://www.arhp.org/publications-and-resources/student-and-educator-resources/global-opportunities-tool
Maternal Mortality at the World Health Assembly
The 62nd session of the World Health Assembly took place in Geneva, from 18 May- 22 May. Although the recent flu pandemic dominated the discussions, monitoring the achievements of the health-related Millennium De
velopment Goals was also on the agenda. Secretary General of the United Nations, Ban Ki-moon, and Sarah Brown, the wife of British prime Minister Gordon Brown, delivered passionate speeches that emphasized the necessity of dealing with global progress toward MDG 5, reducing maternal mortality.
velopment Goals was also on the agenda. Secretary General of the United Nations, Ban Ki-moon, and Sarah Brown, the wife of British prime Minister Gordon Brown, delivered passionate speeches that emphasized the necessity of dealing with global progress toward MDG 5, reducing maternal mortality.Ban Ki-moon's speech "slammed the world's progress on lowering the maternal mortality rate" stating that of all the Millennium Development Goals, this is the slowest moving. He continued on to say that "maternal health is a key barometer of a functioning health system," and without making significant strides to reduce maternal mortality, hope for other health related progress, such as fighting HIV/AIDS, is limited. In the final moments of his passionate speech Ki-moon stated that, "In the 21st century, no woman should have to give her life to give life," maternal mortality must be quickly prioritized in order to stop the magnitude of avoidable deaths. Even in the face of one of the worlds worst financial crisis, we cannot scale back or stop our efforts in such an important area of health.
Sarah Brown addressed the World Health Assembly with an equally passionate speech. Speaking not as a researcher or a scientist, but rather as a mother, Sarah Brown was quick to point out that "there is no excuse for the fact that pregnancy and childbirth worldwide kill 529,000 women and leave one million children without a mother each year." With an emphasis on the incredibly high statistics of sub-Saharan Africa, Mrs. Brown made it clear that something must be done to save these women's lives, "We have the science, the technology, the medicine, the knowledge, the cultural understanding, the means to educate and inform and if we are moved to act, then let us show we have not only the compassion but the moral commitment and the political will too." Sarah Brown also pointed out the consequences of not acting for the children of these mothers. "When one mother survives a lot survives with her. A mother’s survival is the key to her baby’s welfare and often her baby’s life." With that in mind, it appears that not addressing maternal mortality hurts not only the 529,000 mothers who die each year, but also their children. By promoting effective reproductive health, a child's life will begin positively, and by having a mother to look to for advice and guidance, it is PPD's belief that combating maternal mortality will lead to a better life, and a better role in society for both mother and child.
In conjunction with the World Health Assembly, IRIN, a humanitarian news and analysis project released updates on maternal health in Chad, Zimbabwe and Ghana. In Chad, one of the world's most dangerous places to give birth, UNICEFS efforts to step up obstetric care are examined, in order to better prepare for emergencies. IRIN's report on Zimbabwe shows an increasing trend of maternal deaths, due to understaffed clinics, equipment shortages, and poverty. In regards to Ghana, attention to family planning, skilled attendance, comprehensive abortion care, as well as adolescent health care are necessary in order to combat the increasing rate of maternal mortality present.
The Millennium Development Goals were instituted in 2000, but without much progress since then, recent meetings and events have seen more passionate speeches and dire requests than ever before. Prominent leaders such as Ban Ki-moon and Sarah Brown are instrumental in raising awareness of MDG 5, but without government cooperation and implementation of effective programmes, the target goals will never be met. We have the means, now we must show we have the political commitment and the compassion for women around the world.
To Watch Ban Ki-moons speech, visit: http://video.who.int/streaming/wha62/wha62_unsg_speech.wmv
Or, to read the text version, of his WHA address, visit: http://www.who.int/mediacentre/events/2009/wha62/secretary_general_speech_20090519/en/index.html
To watch Sarah Brown's speech, visit: http://video.who.int/streaming/wha62/wha62_brown_speech.wmv
Or, to read the text version of her WHA address, visit: http://www.who.int/mediacentre/events/2009/wha62/sarah_brown_speech_20090519/en/index.html
Also on the subject of maternal mortality, the NY Times recently published an article focused on maternal mortality. Entitled, "Where Life's Start is a Deadly Risk," the article provides some interesting insights and an even more fascinating image portfolio of childbirth in Tanzania. To check it out, visit: http://www.nytimes.com/2009/05/24/health/24birth.html?_r=1
Wednesday, May 20, 2009
15 and Counting: New Campaign for ICPD +15
15 and Counting is a new campaign developed by the International Planned Parenthood Foundation (IPPF), a federation of non-governmental organizations working in 176 countries worldwide and a global leader in providing and advocating for the right to improved sexual and reproductive health. With a strategic focus to work with and deliver for young people, 15 and Counting aims to break the silence surrounding the issue of sexuality and reproduction, in order to improve the health and well being of the youth, worldwide.
Created in response to the International Conference on Population and Development (ICPD, 1994) 15 and Counting’s aims include:
- Calling on governments to meet their commitments on sexual and reproductive health,
- campaigning to achieve better access to sexual and reproductive health services and education,
- working with young people around the world to highlight their specific needs,
- advocate for change and
- share positive experiences.
The 15 and Counting website is set up as a way to learn more about the International Conference on Population and Development (ICPD) as well as a platform for getting involved and making your voice heard.
There are multiple resources that help readers understand the background and motivation for 15 and Counting, as well as templates for letters to stakeholders and press releases.
Additionally, the website provides a petition, which over 1,216 people have signed thus far, that declares support for sexual rights for all. Eventually the petition will be submitted to the Secretary-General of the United Nations, reinforcing the necessity to help governments promote, protect and fulfill their promises to provide better access to sexual and reproductive health services for all.
To get involved, visit the 15 and Counting website at http://www.15andcounting.org/
Tell your co-workers, affiliated organizations (particularly, youth-serving organizations) about the campaign and refer them to the campaign website.
WHO Adds Misoprostol to Model List of Essential Medicines
After years of clinical trials, the World Health Organization agreed to add misoprostol to its Model List of Essential Medicines in April of this year. This is due to the efforts of numerous advocates and stakeholders, including an initiative of Gynuity Health Projects and Family Care International to evaluate misoprostol as an alternative medicine for prevention and treatment of post-partum hemorrhaging.
As a safe and efficient drug for the treatment of incomplete abortion and miscarriage, misoprostol is a necessity to help prevent the 500,000 deaths that occur each year due to childbirth and pregnancy related complications, and ultimately to reach MDG 5, reducing maternal mortality by 75%.
Excessive bleeding, (also referred to as post-partum hemorrhage or PPH) is the leading cause of maternal mortality, killing more than 150,000 women every year. Women who suffer from PPH can die very quickly, often within 2 hours, if immediate and appropriate medical care is not available. Many women in developing countries often deliver at home, and are unable to recognize the signs of excessive bleeding in time to seek care. Those who do realize the serious repercussions may still find that there is not available transport or sufficient time to reach the nearest hospital, and even if they were to make it there in time, many facilities are often under supplied and unequipped to handle such emergencies.
The standard drug used in recent years to stop PPH has been oxytocin, but after conducting extensive clinical trials, misoprostol has increasingly demonstrated potential in preventing and treating post-partum hemorrhaging, based on its ability to stimulate uterine contractions and stop bleeding. In addition, misoprostol offers many advantages over the standard treatment; it can be given via a variety of routes (oral, rectal, sublingual, vaginal), it does not require refrigeration, it has a long shelf life, is stable at high temperatures, is inexpensive ($1 per dose) and has relatively few side effects (Lancet source: http://www.thelancet.com/journals/lancet/article/PIIS0140673606695226/fulltext). Due to these characteristics, misoprostol is particularly well suited for developing countries, as it can be used by a wide range of health care providers in low resources settings as well as by midwives and traditional birth attendants in remote villages.
In order to reach MDG 5, reducing maternal mortality by 75% by 2015, we must continue to support organizations and initiatives to gain approval for drugs such as misoprostol. Venture Strategies, a nonprofit organization created to improve the health of low income people in resource-poor settings, and a partner of PPD, has been working to get misoprostol registered in a number of African countries. Due to the efforts of Venture Strategies and partners, in January 2006, Nigeria was the first country in the world to register misoprostol for postpartum hemorrhage. In the past few years misoprostol has also been registered or approved for obstetric/gynecologic indications in several countries, including Ghana, Sudan, Ethiopia, Kenya, South Africa, Tanzania, Uganda, and Zambia.
As the World Health Organization (WHO) has now acknowledged this new drug on its essential medicines list, it is the PPD ARO's hope that significant strides toward reducing maternal mortality will soon be made. Each day more than 350 women die due to severe bleeding, and the creation of a drug that is both effective and actually able to be used in most communities is a huge step in preventing the many unnecessary deaths that occur worldwide.
To learn more about Postpartum Hemorrhage and the use of misoprostol you can access information from Family Care International in English and French at http://www.familycareintl.org/en/resources/publications/21
To review WHO information on misoprostol, including letters of support from various interest groups, please visit
http://www.who.int/selection_medicines/committees/expert/17/application/misoprostol/en/index.html
Medical guidelines and research reports are available at: http://www.misoprostol.org/
And read a recent (April 2009) article on global availability (including details on licensing and distribution in each country) from the International Journal of Gynecology and Obstetrics: http://tinyurl.com/misoavail
As a safe and efficient drug for the treatment of incomplete abortion and miscarriage, misoprostol is a necessity to help prevent the 500,000 deaths that occur each year due to childbirth and pregnancy related complications, and ultimately to reach MDG 5, reducing maternal mortality by 75%.
Excessive bleeding, (also referred to as post-partum hemorrhage or PPH) is the leading cause of maternal mortality, killing more than 150,000 women every year. Women who suffer from PPH can die very quickly, often within 2 hours, if immediate and appropriate medical care is not available. Many women in developing countries often deliver at home, and are unable to recognize the signs of excessive bleeding in time to seek care. Those who do realize the serious repercussions may still find that there is not available transport or sufficient time to reach the nearest hospital, and even if they were to make it there in time, many facilities are often under supplied and unequipped to handle such emergencies.
The standard drug used in recent years to stop PPH has been oxytocin, but after conducting extensive clinical trials, misoprostol has increasingly demonstrated potential in preventing and treating post-partum hemorrhaging, based on its ability to stimulate uterine contractions and stop bleeding. In addition, misoprostol offers many advantages over the standard treatment; it can be given via a variety of routes (oral, rectal, sublingual, vaginal), it does not require refrigeration, it has a long shelf life, is stable at high temperatures, is inexpensive ($1 per dose) and has relatively few side effects (Lancet source: http://www.thelancet.com/journals/lancet/article/PIIS0140673606695226/fulltext). Due to these characteristics, misoprostol is particularly well suited for developing countries, as it can be used by a wide range of health care providers in low resources settings as well as by midwives and traditional birth attendants in remote villages.
In order to reach MDG 5, reducing maternal mortality by 75% by 2015, we must continue to support organizations and initiatives to gain approval for drugs such as misoprostol. Venture Strategies, a nonprofit organization created to improve the health of low income people in resource-poor settings, and a partner of PPD, has been working to get misoprostol registered in a number of African countries. Due to the efforts of Venture Strategies and partners, in January 2006, Nigeria was the first country in the world to register misoprostol for postpartum hemorrhage. In the past few years misoprostol has also been registered or approved for obstetric/gynecologic indications in several countries, including Ghana, Sudan, Ethiopia, Kenya, South Africa, Tanzania, Uganda, and Zambia.
As the World Health Organization (WHO) has now acknowledged this new drug on its essential medicines list, it is the PPD ARO's hope that significant strides toward reducing maternal mortality will soon be made. Each day more than 350 women die due to severe bleeding, and the creation of a drug that is both effective and actually able to be used in most communities is a huge step in preventing the many unnecessary deaths that occur worldwide.
To learn more about Postpartum Hemorrhage and the use of misoprostol you can access information from Family Care International in English and French at http://www.familycareintl.org/en/resources/publications/21
To review WHO information on misoprostol, including letters of support from various interest groups, please visit
http://www.who.int/selection_medicines/committees/expert/17/application/misoprostol/en/index.html
Medical guidelines and research reports are available at: http://www.misoprostol.org/
And read a recent (April 2009) article on global availability (including details on licensing and distribution in each country) from the International Journal of Gynecology and Obstetrics: http://tinyurl.com/misoavail
Thursday, May 14, 2009
International Conference on Family Planning Research and Best Practices
Kampala, Uganda, 15-19 November 2009
The Bill and Melinda Gates Institute for Population and Reproductive Health, Makerere University's School of Public Health, and other international and national partners are organizing a conference on “Family Planning Research and Best Practices.” The conference program will include an opening plenary, multiple concurrent oral sessions, an exhibit area, poster sessions, lunchtime roundtables, a policymaker forum, and special panel presentations. More information is available at: http://www.fpconference2009.org/
The dates for the conference are November 15 (evening opening) and November 16-17 (full days) with November 18 as an optional day for third-party sponsored meetings.
The PPD ARO will be involved with this conference and is encouraging all PCCs to submit abstracts for oral sessions and poster sessions. The deadline for submission of abstracts is 1 June 2009. Information and guidelines on how to submit an abstract is at: http://www.fpconference2009.org/16701.html
Limited travel support from the conference organizers may be available to participants whose abstracts are selected for oral presentation. The conference organizers will provide you with travel support application forms with notification letters if you are selected for oral presentation.
As the PPD ARO does not currently have funding to support PCC travel to this conference, we are currently seeking funding from donors to help PCCs attend the conference. Thus, the PPD ARO would be willing to write letters of support to donors in your country (UNFPA country office, etc.) if you request. We will be happy to provide you with more information on the conference as the date nears, and would, of course, be happy to assist you with planning your logistics to the best of our abilities.
The PPD ARO contact for this conference is Mr. Abdelylah Lakssir, Programme Officer. You can reach him by email (E-mail: alakssir at ppdsec.org) or by phone (+256-772-779-714) or the general office contact: http://ppdafrica.org/contact.html
Conference website: http://www.fpconference2009.org/
Contact information: info@fpconference2009.org
The Bill and Melinda Gates Institute for Population and Reproductive Health, Makerere University's School of Public Health, and other international and national partners are organizing a conference on “Family Planning Research and Best Practices.” The conference program will include an opening plenary, multiple concurrent oral sessions, an exhibit area, poster sessions, lunchtime roundtables, a policymaker forum, and special panel presentations. More information is available at: http://www.fpconference2009.org/
The dates for the conference are November 15 (evening opening) and November 16-17 (full days) with November 18 as an optional day for third-party sponsored meetings.
The PPD ARO will be involved with this conference and is encouraging all PCCs to submit abstracts for oral sessions and poster sessions. The deadline for submission of abstracts is 1 June 2009. Information and guidelines on how to submit an abstract is at: http://www.fpconference2009.org/16701.html
Limited travel support from the conference organizers may be available to participants whose abstracts are selected for oral presentation. The conference organizers will provide you with travel support application forms with notification letters if you are selected for oral presentation.
As the PPD ARO does not currently have funding to support PCC travel to this conference, we are currently seeking funding from donors to help PCCs attend the conference. Thus, the PPD ARO would be willing to write letters of support to donors in your country (UNFPA country office, etc.) if you request. We will be happy to provide you with more information on the conference as the date nears, and would, of course, be happy to assist you with planning your logistics to the best of our abilities.
The PPD ARO contact for this conference is Mr. Abdelylah Lakssir, Programme Officer. You can reach him by email (E-mail: alakssir at ppdsec.org) or by phone (+256-772-779-714) or the general office contact: http://ppdafrica.org/contact.html
Conference website: http://www.fpconference2009.org/
Contact information: info@fpconference2009.org
Tuesday, May 12, 2009
September 2009 NGO Forum on Sexual and Reproductive Health and Development
Global Partners in Action: "NGO Forum on Sexual and Reproductive Health and Development: Invest in Health, Rights and the Future" in Berlin, Germany; 2-4 September 2009
In recognition of the 15 yesr anniversary of the International Conference on Population and Development (ICPD), Global Partners in Action: NGO Forum for Sexual and Reproductive Health and Development aims to strengthen NGOs working in partnership to advance sexual and reproductive health and rights for sustainable development in an uncertain and interdependent world.
The Government of Germany and the United Nations Population Fund (UNFPA) are the co-hosts of this forum. A website with more information on the Forum is at: http://www.globalngoforum.org
Global Partners in Action is led by NGOs and is for NGOs, with considerable emphasis placed on ensuring significant participation from the Global South and of young people. Global Partners in Action will be a highly interactive working meeting, where participants will be able to contribute to approximately 30 breakout sessions, as participants, facilitators, resource persons or rapporteurs. In addition, orientation sessions and regional meetings are being planned for the first day. Participants will furthermore have the opportunity to network and share their work and experiences in a marketplace and at a global café. Plenaries featuring high level speakers will also inspire Global Partners in Action. Finally, all participants will be welcome to assist in the drafting process for the Call to Action throughout the duration of the Forum and outcomes from discussions in various sessions will feed into the Call to Action and an NGO Action Plan.
The Call to Action is envisioned as an advocacy tool for NGOs to share with government and parliamentarians immediately following Global Partners in Action. The NGO Action Plan is foreseen as a medium term road map to ensure that Global Partners in Action charts a way forward for enhanced efforts toward the achievement of the ICPD Programme of Action in synergy with the MDGs by 2015 and beyond.
There will be 400 participants at Global Partners in Action. Out of these, 225 will come from the Global South and will, as far as possible, be fully funded to attend. There are 100 spots for Northern NGOs, these will not generally be funded to attend. However, there will be no registration fee.
The forum steering group aims to ensure diverse representation from as many countries, regions and NGO's working in different fields of health and development as possible. Youth participation is also a priority and a commitment has been made to have at least 25% of participants under the age of 30.
The Global Partners in Action NGO Forum is inviting applications from individuals representing NGO's around the world that:
The deadline for applications is Monday May 25, 2009. Applications will be reviewed by a Selection Committee, which has established several measures to ensure a transparent and objective process. For example, an external consultant will remove all personal and organizational information from initial applications to make them anonymous. They will also be assigned a code that identifies their region, country and age group. The anonymous applications which fill all of the selection criteria will then be analyzed for content and relevance to the ICPD agenda and the objectives of the forum.
Finally, national discussions leading up to the Forum are being planned where possible. The objective is to promote discussion among NGOs on key questions related to the assessment of ongoing progress and needs, successful approaches, remaining barriers, ways forward and additional needs realting to the ICPD agenda. These discussions aspire to have broad participation and to inform the Forum and any subsequent follow-up efforts and to promote intensified discussion of how to implement the ICPD Programme of Action.
Global Partners in Action thanks you for your interest and invites you to visit the web site at: http://www.globalngoforum.org/
In recognition of the 15 yesr anniversary of the International Conference on Population and Development (ICPD), Global Partners in Action: NGO Forum for Sexual and Reproductive Health and Development aims to strengthen NGOs working in partnership to advance sexual and reproductive health and rights for sustainable development in an uncertain and interdependent world.
The Government of Germany and the United Nations Population Fund (UNFPA) are the co-hosts of this forum. A website with more information on the Forum is at: http://www.globalngoforum.org
Global Partners in Action is led by NGOs and is for NGOs, with considerable emphasis placed on ensuring significant participation from the Global South and of young people. Global Partners in Action will be a highly interactive working meeting, where participants will be able to contribute to approximately 30 breakout sessions, as participants, facilitators, resource persons or rapporteurs. In addition, orientation sessions and regional meetings are being planned for the first day. Participants will furthermore have the opportunity to network and share their work and experiences in a marketplace and at a global café. Plenaries featuring high level speakers will also inspire Global Partners in Action. Finally, all participants will be welcome to assist in the drafting process for the Call to Action throughout the duration of the Forum and outcomes from discussions in various sessions will feed into the Call to Action and an NGO Action Plan.
The Call to Action is envisioned as an advocacy tool for NGOs to share with government and parliamentarians immediately following Global Partners in Action. The NGO Action Plan is foreseen as a medium term road map to ensure that Global Partners in Action charts a way forward for enhanced efforts toward the achievement of the ICPD Programme of Action in synergy with the MDGs by 2015 and beyond.
There will be 400 participants at Global Partners in Action. Out of these, 225 will come from the Global South and will, as far as possible, be fully funded to attend. There are 100 spots for Northern NGOs, these will not generally be funded to attend. However, there will be no registration fee.
The forum steering group aims to ensure diverse representation from as many countries, regions and NGO's working in different fields of health and development as possible. Youth participation is also a priority and a commitment has been made to have at least 25% of participants under the age of 30.
The Global Partners in Action NGO Forum is inviting applications from individuals representing NGO's around the world that:
- Are committed to the principles of the ICPD Programme of Action;
- Focus on activities that address key aspects of the ICPD Programme of Action (for example: sexual and reproductive health and rights, women's rights, HIV and AIDS, youth participation, gender equity, etc.);
- Work at either a local, national, regional or international level;
- Are interested and able to share best practices, lessons learned and areas for capacity building;
- Can commit to collaborative follow-up to the Global Partners in Action NGO Forum, guided by the NGO Action Plan and Call to Action that will be produced during the Forum.
The deadline for applications is Monday May 25, 2009. Applications will be reviewed by a Selection Committee, which has established several measures to ensure a transparent and objective process. For example, an external consultant will remove all personal and organizational information from initial applications to make them anonymous. They will also be assigned a code that identifies their region, country and age group. The anonymous applications which fill all of the selection criteria will then be analyzed for content and relevance to the ICPD agenda and the objectives of the forum.
Finally, national discussions leading up to the Forum are being planned where possible. The objective is to promote discussion among NGOs on key questions related to the assessment of ongoing progress and needs, successful approaches, remaining barriers, ways forward and additional needs realting to the ICPD agenda. These discussions aspire to have broad participation and to inform the Forum and any subsequent follow-up efforts and to promote intensified discussion of how to implement the ICPD Programme of Action.
Global Partners in Action thanks you for your interest and invites you to visit the web site at: http://www.globalngoforum.org/
Wednesday, May 6, 2009
Evaluation of World Bank Support for Health, Nutrition, and Population
Between 1997 and mid-2008 the World Bank Group's support for health, nutrition, and population (HNP) provided $17 billion for government-run projects in the fields of nutrition, health, and family planning. An additional $873 million was invested in private health and pharmaceutical investments. Although these numbers may seem high, a report issued last week by the bank's Independent Evaluation Group revealed that one third of the 220 projects undertaken by the World Bank HNP had failed to achieve their goals. Furthermore, the emphasis on HIV/AIDS related projects has resulted in unsatisfactory outcomes, and progress in the nutrition and family planning sectors have greatly been inhibited by such unequivocal funding measures.
According to the evaluation, 7 out of 10 AIDS projects financed by the bank had failed to achieve satisfactory outcomes. In Africa, the epicenter of the AIDS pandemic, 8 out of 10 AIDS projects had unsatisfactory outcomes, one of the bank's worst records worldwide. The report insinuated that the failure is not a result of incompetent or ineffective programmes, but rather the inability of inexperienced or weak bureaucracies to carry out such complex projects (ironically, which were encouraged by the donor). Julian Schweitzer, the World Bank’s director of health, nutrition and population, admitted that inexperience and weakness was not just at the country level, but also "sometimes our own".
To improve the effectiveness of such programmes, the report suggested a simplification of projects, a reduction in the number of government ministries involved, and a focus on more modest objectives. Also addressed, was the need to improve programmes in developing nations, with a specific focus on Africa. Middle income countries ranked adequately in their ability to carry out such initiatives, but in Africa, more than three-quarters of the projects were deemed ineffective. The World Bank Group's support for health, nutrition and population needs to make an immediate effort to concentrate resources where they are most crucially needed, and more importantly to ensure that programmes are being carried out appropriately within these regions.
To improve the effectiveness of such programmes, the report suggested a simplification of projects, a reduction in the number of government ministries involved, and a focus on more modest objectives. Also addressed, was the need to improve programmes in developing nations, with a specific focus on Africa. Middle income countries ranked adequately in their ability to carry out such initiatives, but in Africa, more than three-quarters of the projects were deemed ineffective. The World Bank Group's support for health, nutrition and population needs to make an immediate effort to concentrate resources where they are most crucially needed, and more importantly to ensure that programmes are being carried out appropriately within these regions.
Aside from the issue of programme efficiency, the report detailed another important trend in global health, namely, the disproportionate attention and funding allotted to AIDS programmes in the last decade. Since 1997, foreign assistance for global health has increased, with a specific focus on HIV and AIDS. Although it is incredibly important to deal with such a deadly disease, the focus on family planning has greatly declined as a result of this relatively new emphasis on AIDS funding. In reaction to the report, Professor William Easterly of New York University stated that the evaluation of the World Bank confirmed "a fear that many of us have had for some time: that hugely disproportionate attention to AIDS has had a negative effect on aid efforts for all other health problems."
Since 1997, nearly 60% of World Bank HNP projects have focused on AIDS, while efforts aimed at tuberculosis, malaria and leprosy were granted significantly fewer resources (malaria made up only 3% of the projects, and tuberculosis only 2%). Family planning has also been negatively affected by the disproportionality of funds, and leaders of the evaluation group have realized the implications of this. Martha Ainsworth, lead author of the report, reaffirmed the groups commitment to increase funding for family planning by stating, "helping women control the number of children they bear is essential to reducing the high rates at which they die in childbirth in the poorest nations, the fact that no one’s been paying attention to reducing high fertility is critical for Africa."
Mr. Schweitzer, of the World Bank, strongly agreed with the evaluators call for greater efforts in family planning and nutrition, and reaffirmed the necessity of donors and recipient countries working together to coordinate projects and achieve targeted results. In recent years, PPD has advocated against global decrease in population and family planning funding, and it is our hope that such an internal evaluation will be a call to action for the World Bank Group's support for health, nutrition, and population to change their efforts. And as PPD has long recognized, an emphasis on the African region and family planning efforts are crucial to achieving progress worldwide.
To view an executive summary of the report, visit:
Interested in reading more about specific countries project performance assessment reports? Then check out: http://go.worldbank.org/3764K5QNI0
Sunday, May 3, 2009
Experts Call on Obama to Recommit U.S. Funds to Family Planning and Reproductive Health Programmes
From 1978 through 2006, Joseph Speidel, Steven Sinding, Duff Gillespie, Elizabeth Macquire and Margaret Neuse successively directed the U.S. Agency for International Development's (USAID) Population and Reproductive Health program. These five development experts recently issued a report entitled Making the Case for U.S. International Family Planning Assistance, urging President Obama to double U.S. Investments in USAID programmes.
USAID was established in 1961 by President John F. Kennedy, and since then has implemented reproductive health programmes in 50 countries. The programme’s funding peaked in 1995, and has continuously declined thereafter. The five said that this may have resulted from the (mistaken) belief that rapid global population growth has halted; from diversion of resources to other needs. . . and from lack of understanding that family planning is not only essential for women's health, but also a critical part of any successful development strategy." In actuality, donor funds for family planning programmes are more crucial now than ever before as countries around the world work to achieve major progress in the arena of sexual and reproductive health in order to meet approaching international deadlines.
The five development experts suggested that President Obama should move quickly to meet the growing demand for planning services worldwide if the goals of the ICPD and Millennium Development Goals are to be reached. U.S. investment in contraceptive supply and reproductive health programmes run by USAID should be doubled, and the United States should recommit itself as a world leader in family planning. With a new administration and Congress in session, the experts urged a reversal in former funding policies that did not meet the demand for women's reproductive health services, and suggested an increase to $1.2 billion for USAID's population budget by 2010. A future increase to $1.5 billion in 2014 was also predicted, taking into account their imminent plans to expand their work into 17 additional countries with unmet family planning needs. The continuous decline in family planning and reproductive health funding has forced many successful programs to remain stagnant or close. The global fertility decline has slowed and the number of women dying from pregnancy-related complications is unacceptable. The U.S. should take the lead in re-establishing appropriate funding to programmes such as USAID, setting the example for countries worldwide to realize the importance of family planning, and commit themselves to effective programmes.
The report discusses the global unmet need for family planning, family planning as a global success story, family planning as a declining priority, USAID as an effective and capable agency, and the request for more funds. Examples of countries excelling in the fields of family planning and reproductive health are also examined throughout the report, and should be looked to as a resource for South-South cooperation.
The entire report can be found online at http://www.prb.org/pdf09/makingthecase.pdf
An audio clip of the press conference for USAID can be heard at http://www.ccmcfiles.org/population/making_the_case/making_the_case_audio_call_4_21_09.mp3
To read more about what President Obama has accomplished in his first 100 days, regarding women's health, check out http://www.planetwire.org/details/7969
USAID was established in 1961 by President John F. Kennedy, and since then has implemented reproductive health programmes in 50 countries. The programme’s funding peaked in 1995, and has continuously declined thereafter. The five said that this may have resulted from the (mistaken) belief that rapid global population growth has halted; from diversion of resources to other needs. . . and from lack of understanding that family planning is not only essential for women's health, but also a critical part of any successful development strategy." In actuality, donor funds for family planning programmes are more crucial now than ever before as countries around the world work to achieve major progress in the arena of sexual and reproductive health in order to meet approaching international deadlines.
The five development experts suggested that President Obama should move quickly to meet the growing demand for planning services worldwide if the goals of the ICPD and Millennium Development Goals are to be reached. U.S. investment in contraceptive supply and reproductive health programmes run by USAID should be doubled, and the United States should recommit itself as a world leader in family planning. With a new administration and Congress in session, the experts urged a reversal in former funding policies that did not meet the demand for women's reproductive health services, and suggested an increase to $1.2 billion for USAID's population budget by 2010. A future increase to $1.5 billion in 2014 was also predicted, taking into account their imminent plans to expand their work into 17 additional countries with unmet family planning needs. The continuous decline in family planning and reproductive health funding has forced many successful programs to remain stagnant or close. The global fertility decline has slowed and the number of women dying from pregnancy-related complications is unacceptable. The U.S. should take the lead in re-establishing appropriate funding to programmes such as USAID, setting the example for countries worldwide to realize the importance of family planning, and commit themselves to effective programmes.
The report discusses the global unmet need for family planning, family planning as a global success story, family planning as a declining priority, USAID as an effective and capable agency, and the request for more funds. Examples of countries excelling in the fields of family planning and reproductive health are also examined throughout the report, and should be looked to as a resource for South-South cooperation.
The entire report can be found online at http://www.prb.org/pdf09/makingthecase.pdf
An audio clip of the press conference for USAID can be heard at http://www.ccmcfiles.org/population/making_the_case/making_the_case_audio_call_4_21_09.mp3
To read more about what President Obama has accomplished in his first 100 days, regarding women's health, check out http://www.planetwire.org/details/7969
Wednesday, April 29, 2009
Waiting Houses in Mozambique Aim to Decrease Maternal Mortality
Waiting houses, or Casas de Espera, as they are referred to in Mozambique, allow at-risk pregnant women to reside in a home near the local hospital in order to provide immediate care when labor begins. As many of Mozambique's citizens live in rural areas, far from a reliable hospital, these waiting houses are crucial to prevent pregnancy related complications and maternal death from occurring. The Mozambique government has recently decided to revamp its waiting house programme in order to combat maternal mortality and progress toward achieving MDG5.
At the African First Ladies Health Summit last week Maria de Luz Guebuza, the First Lady of Mozambique, explained how 75% of Mozambique's 128 districts now have waiting houses for mothers-to-be. By providing such accommodations, pregnant women are able to travel before their labor begins and remain in the vicinity of well trained professional health care workers, should a complication arise. Women in the community at risk for complicated deliveries, such as pre-eclampsia, history of cesarean section or severe bleeding, malpresentation, or cases of multiple births, are often advised to travel to a casas de espera anywhere from 2 to 4 weeks before their pregnancy. Once there, the women are often able to learn from midwifes on pregnancy-related topics such as development of the fetus, labour and delivery, breast-feeding, immunization and family planning. In some cases the women use their spare time to make crafts and dresses, in order to sell their products to the local community and generate funds for maintenance. Since most of these houses are free of charge, any extra revenue is especially helpful in maintaining the facilities.
Mozambique is not alone in providing such waiting houses. Many other countries throughout Africa and Asia have instituted similar programmes and are moving toward achieving MDG5. In 1987, a study was conducted in Zimbabwe that found that women who stayed in these antenatal accommodations experienced better pregnancy outcomes than those women who entered the hospital directly from the community. Since then, improvements have been made and the effectiveness of such a program is remarkable. In addition to maternal mortality decreasing, infant survival rates are also being positively affected.
It is crucial that governments provide funding for such initiatives and that South-South cooperation continues to be emphasized at international conferences, such as the African First Ladies Health Summit. By sharing the effectiveness of such a program with other regional leaders and policy makers, it is PPD's hope that maternal mortality can be significantly reduced in the next few years.
You can read about other country case studies at http://who.int/reproductive-health/publications/MSM_96_21/MSM_96_21.chap4.en.html
Tuesday, April 28, 2009
Bongaarts and Sinding on International Family Planning Programs: Myths v. Facts
Bongaarts and Sinding (a "founding father" of PPD) published "A response to critics of family planning programs" in the recent issue of International Perspectives on Sexual and Reproductive Health.
In this article, the authors argue that funding for international family planning programs in developing countries has declined by 30% since the mid-1990s. Decisions by policymakers and donors to reduce investments in contraceptive services and supplies were based on plausible-sounding—but misguided—arguments. “Donor fatigue” and persistent opposition from conservative governments and institutions, in particular the Bush administration and the Vatican, contributed to this decline. Family planning programs were placed on the back burner as other pressing problems, such as the AIDS epidemic, rose in prominence.
The journal International Perspectives on Sexual and Reproductive Health can be read online for free at: http://www.guttmacher.org/journals/toc/ipsrh3501toc.html
In this article, the authors argue that funding for international family planning programs in developing countries has declined by 30% since the mid-1990s. Decisions by policymakers and donors to reduce investments in contraceptive services and supplies were based on plausible-sounding—but misguided—arguments. “Donor fatigue” and persistent opposition from conservative governments and institutions, in particular the Bush administration and the Vatican, contributed to this decline. Family planning programs were placed on the back burner as other pressing problems, such as the AIDS epidemic, rose in prominence.
Myth: Family planning programs have little or no effect on fertility.
Fact: Decades of research show that comprehensive family planning and reproductive health services lead to sharp rises in contraceptive use that help women avoid unwanted pregnancies. Over a thirty-year period (1960–1990), fertility declined in the developing world from more than six to fewer than four births per woman, and almost half of that decline—43%—is attributable to family planning programs.
Myth: Fertility declines are under way everywhere, so the population problem has largely been solved and family planning programs are no longer needed.
Fact: Population will keep growing even if fertility could immediately be reduced to the replacement level of 2.1 births per woman, because:
- Current birthrates still leave fertility above the level needed to bring about population stabilization.
- People live longer as higher standards of living, better nutrition, expanded health services, and greater investments in public health measures have reduced death rates, and further improvements are likely.
- The large number of young people entering their childbearing years will result in population growth for decades to come. For example, in sub-Saharan Africa, 43% of the total female population was younger than 15 years in 2005.
Myth: The death toll of the AIDS epidemic makes family planning undesirable and unnecessary.
Fact: Despite the substantial mortality from AIDS, UN projections for all developing regions predict further large population increases. Despite a severe epidemic in sub-Saharan Africa, the region’s population is expected to grow by at least one billion between 2005 and 2050. This is because the annual number of AIDS deaths (two million) is equivalent to just 10 days’ growth in the population of the developing world.
Myth: Family planning programs are not cost-effective.
Fact: The World Bank estimates the cost of family planning at $100 per life-year saved. This is of the same order of magnitude as other health interventions, such as basic sanitation for diarrheal disease, a short course of chemotherapy for tuberculosis, and condom distribution for HIV prevention. All these interventions, including those for family planning, are much more cost-effective than antiretroviral treatment of AIDS, which currently receives a large proportion of health-related development aid.
Myth: Family planning programs at best have made women the instruments of population control policies and, at worst, have been coercive.
Fact: Today, nearly all programs around the world respect the right of couples to make informed reproductive choices, free from undue persuasion or coercion. An important exception is China, however, where the one-child policy continues to violate reproductive rights standards.
Population growth and what to do about it has been the subject of controversy since the 1700s. Perhaps because at its most fundamental level the subject deals with sex, it has been a peculiarly incendiary topic of public policy debate. Yet much of today’s discussion about family planning programs, a principal instrument through which population policies have been implemented over the past 50 years, is based on faulty perceptions and misinformation. Large-scale national family planning programs have, for the most part, been remarkably successful.
Why does this matter? Because women and children continue to suffer and die as a consequence of unwanted and unintended childbearing. Beyond that are renewed concerns about a variety of environmental issues and about the security of nations and the stability of governments, as well as deepening worries about food security and pervasive poverty.
“In the face of declining political and financial commitment to family planning programs, we must address head-on the faulty criticisms that have held back efforts to satisfy the unmet demand for family planning services,” say Bongaarts and Sinding. “High fertility and rapid population growth remain real problems that merit our attention and action.”
Read the entire article online at: http://www.popcouncil.org/pdfs/JournalArticles/IPSRH_35_1.pdfThe journal International Perspectives on Sexual and Reproductive Health can be read online for free at: http://www.guttmacher.org/journals/toc/ipsrh3501toc.html
Friday, April 17, 2009
Film on Abortion in Ethiopia: Not Yet Rain
In 2004, Ethiopia enacted one of the most progressive abortion laws in Africa. A woman may now seek an abortion if her life or health is threatened. Abortion is also permitted in cases of rape, incest, fetal impairment, or if the woman is a minor or physically or mentally injured or disabled. Before 2004, abortion abortion was permitted only to save a woman’s life and protect her health and in cases of rape.
However, many women still continue to perform self-induced abortions for multiple reasons: the stigma of sex outside of marriage, the cost of abortion, an inability to travel to safe clinics, and late term abortion restrictions. The new film Not Yet Rain examines the topic of abortion in Ethiopia through the voices of women who have faced the challenge of accessing safe abortion care within their communities.
Each year, 68,000 women around the world die from unsafe abortions. After hearing some of the techniques described in the twenty-three minute documentary Not Yet Rain, this comes as no surprise. One woman describes how a catheter and an umbrella were used to terminate her daughter's pregnancy, ultimately resulting in her death. Others resort to using sticks, plastic objects, and roots to attempt self-induced abortions. Whatever the reason behind being unable to access safe abortion services, the decision to turn to self-remedies is an extremely unsafe option, and it is vital that education is improved in the most remote communities, in order to ensure that women know their options and rights.
As a result of Ethiopia's revised law and 2006 guidelines for safe abortion services, abortion services are some of the safest in all of Africa. At a clinic in the documentary, the midwife/nurse explains that abortion services are now free, allowing women of all economic levels to receive proper care. Furthermore, the use of a manual vacuum aspirator (MVA) to perform the procedure is extremely safe and does not require the use of anesthesia, thus allowing clinics in the poorest and more remote areas of the community to provide such services. Regardless, the system is still full of problems. Due to a lack of education about reproductive health in Ethiopia, late term abortions are still one of the biggest factors leading to self inducement or use of traditional medicines.
Unintended pregnancy is a root cause of induced abortion and maternal mortality. An estimated 108 million married women in developing countries have an unmet need for contraception. Thus, meeting the need for contraception is a critical step toward reducing the incidence of unintended pregnancy.
In light of the mandates of intergovernmental agreements (ICPD, MDGs, Maputo) the prevention of unsafe abortion and death in all countries is an imperative goal for women’s health and rights.
To view the entire film Not Yet Rain online, visit http://www.notyetrain.org/
For useful resources on maternal mortality and MDG 5, check out the Women Deliver Resources at: http://www.womendeliver.org/resources/womendeliver.htm
For more information on the legal status of abortion, read the Center for Reproductive Rights 2007 briefing, “Abortion Worldwide: Twelve Years of Reform” http://reproductiverights.org/sites/default/files/documents/pub_bp_abortionlaws10.pdf
Related articles from The Lancet on global abortion rates and trends are available online at:
However, many women still continue to perform self-induced abortions for multiple reasons: the stigma of sex outside of marriage, the cost of abortion, an inability to travel to safe clinics, and late term abortion restrictions. The new film Not Yet Rain examines the topic of abortion in Ethiopia through the voices of women who have faced the challenge of accessing safe abortion care within their communities.
Each year, 68,000 women around the world die from unsafe abortions. After hearing some of the techniques described in the twenty-three minute documentary Not Yet Rain, this comes as no surprise. One woman describes how a catheter and an umbrella were used to terminate her daughter's pregnancy, ultimately resulting in her death. Others resort to using sticks, plastic objects, and roots to attempt self-induced abortions. Whatever the reason behind being unable to access safe abortion services, the decision to turn to self-remedies is an extremely unsafe option, and it is vital that education is improved in the most remote communities, in order to ensure that women know their options and rights.
As a result of Ethiopia's revised law and 2006 guidelines for safe abortion services, abortion services are some of the safest in all of Africa. At a clinic in the documentary, the midwife/nurse explains that abortion services are now free, allowing women of all economic levels to receive proper care. Furthermore, the use of a manual vacuum aspirator (MVA) to perform the procedure is extremely safe and does not require the use of anesthesia, thus allowing clinics in the poorest and more remote areas of the community to provide such services. Regardless, the system is still full of problems. Due to a lack of education about reproductive health in Ethiopia, late term abortions are still one of the biggest factors leading to self inducement or use of traditional medicines.
Unintended pregnancy is a root cause of induced abortion and maternal mortality. An estimated 108 million married women in developing countries have an unmet need for contraception. Thus, meeting the need for contraception is a critical step toward reducing the incidence of unintended pregnancy.
In light of the mandates of intergovernmental agreements (ICPD, MDGs, Maputo) the prevention of unsafe abortion and death in all countries is an imperative goal for women’s health and rights.
To view the entire film Not Yet Rain online, visit http://www.notyetrain.org/
For useful resources on maternal mortality and MDG 5, check out the Women Deliver Resources at: http://www.womendeliver.org/resources/womendeliver.htm
For more information on the legal status of abortion, read the Center for Reproductive Rights 2007 briefing, “Abortion Worldwide: Twelve Years of Reform” http://reproductiverights.org/sites/default/files/documents/pub_bp_abortionlaws10.pdf
Related articles from The Lancet on global abortion rates and trends are available online at:
- David A Grimes, Janie Benson, Susheela Singh, Mariana Romero, Bela Ganatra, Friday E Okonofua, Iqbal H Shah. Unsafe abortion: the preventable pandemic. The Lancet Sexual and Reproductive Health Series, October 2006: http://wwwlive.who.ch/reproductive-health/publications/articles/article4.pdf
- Gilda Sedgh, Stanley Henshaw, Susheela Singh, Elisabeth Åhman, Iqbal H Shah. Induced abortion: estimated rates and trends worldwide. The Lancet 2007; 370: 1338–45: http://media.mcclatchydc.com/smedia/2007/10/17/13/Chang-Guttmacher_Institute_abortion_report.source.prod_affiliate.91.pdf
Sunday, March 8, 2009
International Women’s Day: The Status of Women’s Health and Rights
Of the 8 Millennium Development Goals (MDGs), Goal 3 explicitly calls for empowering women and promoting gender equality, specifically setting targets to eliminate gender disparity in all levels of education by 2015, with additional indicators on employment of women and the proportion of women in parliaments. However, gender equality is an essential cross-cutting component for meeting all the targets. According to Kofi Annan, Former Secretary-General of the United Nations, "In our work to reach those objectives, as the Millennium Declaration made clear, gender equality is not only a goal in its own right; it is critical to our ability to reach all the others . . . Study after study has shown that there is no effective development strategy in which women do not play a central role".Gender gaps in access to and control of resources, in economic opportunities and in power and political voices are widespread. To date, only four countries (Sweden, Denmark, Finland, and Norway) have achieved a combination of approximate gender equality in secondary school enrolment, at least a 30 per cent share for women of seats in parliaments or legislatures, and an approximate 50 per cent share of paid employment in non-agricultural activities for women. In most countries, women continue to have less access to social services and productive resources than men. While the last two decades have seen some progress in many parts of the world in gender inequalities in schooling (as of 2006, the world was on track to meet the primary target of MDG 3: Gender Parity in School). Yet, women remain vastly under-represented in national and local assemblies, on average accounting for only 14 per cent of the seats in national parliaments.
And of particular concern to women’s health and rights is maternal mortality, MDG target 5. Pregnancy should be full of hope and joy--yet for so many women in Africa, pregnancy come with unnecessary danger. As a result, women in sub-Saharan Africa have a 1 in 16 chance of dying from complications of pregnancy or childbirth during their lives; comparatively, the lifetime risk to women in developed countries is 1 in 3,800.
Unfortunately, despite global progress on many of the MDGs illustrated in the Figure: Progress Against Targets to Meet the MDGs, less than 1/10th of the distance to be covered to meet the MDG 5 of reducing maternal mortality has been made. The chart shows how far behind the world is on MDG 5. The MDG target for maternal mortality will unlikely be met globally, and particularly in sub-Saharan Africa, without concerted efforts. The Maputo Plan of Action (PoA) for the Operationalisation of the Continental Policy Framework for Sexual and Reproductive Health and Rights 2007- 2010 states that that “African countries are not likely to achieve the Millennium Development Goals (MDGs) without significant improvements in the sexual and reproductive health of the people of Africa.”
On International Women’s Day, PPD encourages its member and collaborating countries to support implementation of MDG 5 by advocating for improved reproductive health services. Universal access to reproductive health (as called for by the ICPD PoA) is essential to achieve gender equality, combat HIV/AIDS, and reduce maternal and child mortality.
Find out more information (including what you can do) by reading PPD ARO’s policy brief on RH in the MDGs:
In English: http://ppdafrica.org/docs/RH-MDGs.pdf
In French: http://ppdafrica.org/docs/RH-MDGsf.pdf
More information on the MDGs is online at:
UN: http://www.un.org/millenniumgoals/
MDG Indicators: http://mdgs.un.org/
Wednesday, February 25, 2009
South-South Cooperation in Maternal Health and HIV/AIDS
“The Tunisia – France – Niger: The Kollo Project for safe motherhood and reproductive health project” was presented by Mr. Fethi Ben Messaoud, PCC for Tunisia and Senetaire General, Office National de la Famille et de la Population at the September 2008 PPD Partner Country Coordinators' Meeting for the Africa Region.
South-South Approaches to Innovative Health Solutions
MediaGlobal: Voice of the Global South
By Lucy-Claire Saunders
22 December 2008 [MEDIAGLOBAL]: At the United Nations Development Programme (UNDP) Special Unit for South-South Cooperation’s first ever Global South-South Development (GSSD) Expo, experts presented four successful projects on HIV prevention and maternal health that exemplify South-South cooperation.
Among the four projects, Campaign to End Fistula was recognized as a model for championing collaboration between countries in the Global South, receiving an award of excellence from the United Nations Development Programme.
“Fistula requires our attention because it is a condition that takes away the dignity and the self-esteem of those who are affected by it,” Bunmi Makinwa, the Africa regional director for the campaign said. “It leaves women incontinent, ashamed and isolated from their communities. Fistula is a stark example of our failure in the public health system in poor countries.”
Fistula is a condition where a woman cannot control the flow of her urine and/or feces due to an injury brought about by prolonged labor. The Campaign to End Fistula, which aims to makes the debilitating condition as rare in developing countries as it is in the industrial world by 2015, is active in more than 45 countries in Africa, Asia and the Arab world.
“We are casting the net wider to incorporate more countries,” Makinwa said. “Recent training sessions in Mali highlight country-level efforts to develop the capacity of fistula service providers though South-South cooperation.”
For example, in Liberia’s surgical wards, they use specialized nurses to assist the surgeon during the operation. This is a service that does not exists in Mali so the program had a Liberian specialist train counterparts in Mali so that hospitals can introduce the new technique in the way they do business.
Three other projects exemplifying South-South cooperations in the health sector were also featured at the afternoon session. Dorcus Phiri, coordinator of the Teacher Capacity Building Project, gave an update on a program that uses live television broadcasts to reach out to teachers and students about HIV/AIDS in Botswana. Using a Brazilian model, the daily television program empowers teachers to break down the silence associated with HIV and AIDS by facilitating an open dialogue in a classroom setting.
“The program increased levels of conversation between teachers, pupils and parents on sexual reproductions health,” Phiri told MediaGlobal. “If we empower teachers with the skills, knowledge and the relevant attitudes for addressing HIV, then they would be better placed to deal with HIV issues in the classroom.”
Named, “Live Talk Back,” the program features a different panel every day who talk about HIV/AIDS and other reproductive health issues. Teachers, students and parents across the country are invited to participate in a live discussion using phone-ins, Short Message Services and e-mails.
Speaking about another project across the world that also deals with AIDS, Mariangela Simao, director of the National STD/AIDS Programme in Brazil, described a multi-country program that address HIV prevention throughout Latin America.
“For us in Brazil, the words of the famous archbishop, Dom Helder Camara, summarize how we think of South-South cooperation: ‘No one is so poor that he has nothing to offer. No one is so rich that he never needs help,’” she said.
The program, which is called, “Lacos –Sul-Sul,” works with partnering countries to ensure universal access to prevention treatment, HIV prevention with adolescents and children, generate demand for services and mobilize participation of those who use the service.
The results have been encouraging, said Simao. In two of the more remote regions in Nicaragua, where LSS support has been provided, HIV testing for pregnant women has increased from 20 per cent to 42 per cent and from 5.3 per cent to 24 per cent. On a side note, Simao mentioned that in regions where LSS is not active, this rate has actually dropped form 3.4 per cent to two per cent.
As well as addressing AIDS, the South-South cooperation projects also addressed maternal and child health. Niger, for example, has one of the lowest life expectancies in the world. The infantile mortality rate is 247 for 1,000 live births while the maternal mortality rate is about 700 for 100,000 live births.
Source: MediaGlobal: Voice of the Global South at http://www.mediaglobal.org/article/2008-12-23/south-south-approaches-to-innovative-health-solutions
South-South Approaches to Innovative Health Solutions
MediaGlobal: Voice of the Global South
By Lucy-Claire Saunders
22 December 2008 [MEDIAGLOBAL]: At the United Nations Development Programme (UNDP) Special Unit for South-South Cooperation’s first ever Global South-South Development (GSSD) Expo, experts presented four successful projects on HIV prevention and maternal health that exemplify South-South cooperation.
Among the four projects, Campaign to End Fistula was recognized as a model for championing collaboration between countries in the Global South, receiving an award of excellence from the United Nations Development Programme.
“Fistula requires our attention because it is a condition that takes away the dignity and the self-esteem of those who are affected by it,” Bunmi Makinwa, the Africa regional director for the campaign said. “It leaves women incontinent, ashamed and isolated from their communities. Fistula is a stark example of our failure in the public health system in poor countries.”
Fistula is a condition where a woman cannot control the flow of her urine and/or feces due to an injury brought about by prolonged labor. The Campaign to End Fistula, which aims to makes the debilitating condition as rare in developing countries as it is in the industrial world by 2015, is active in more than 45 countries in Africa, Asia and the Arab world.
“We are casting the net wider to incorporate more countries,” Makinwa said. “Recent training sessions in Mali highlight country-level efforts to develop the capacity of fistula service providers though South-South cooperation.”
For example, in Liberia’s surgical wards, they use specialized nurses to assist the surgeon during the operation. This is a service that does not exists in Mali so the program had a Liberian specialist train counterparts in Mali so that hospitals can introduce the new technique in the way they do business.
Three other projects exemplifying South-South cooperations in the health sector were also featured at the afternoon session. Dorcus Phiri, coordinator of the Teacher Capacity Building Project, gave an update on a program that uses live television broadcasts to reach out to teachers and students about HIV/AIDS in Botswana. Using a Brazilian model, the daily television program empowers teachers to break down the silence associated with HIV and AIDS by facilitating an open dialogue in a classroom setting.
“The program increased levels of conversation between teachers, pupils and parents on sexual reproductions health,” Phiri told MediaGlobal. “If we empower teachers with the skills, knowledge and the relevant attitudes for addressing HIV, then they would be better placed to deal with HIV issues in the classroom.”
Named, “Live Talk Back,” the program features a different panel every day who talk about HIV/AIDS and other reproductive health issues. Teachers, students and parents across the country are invited to participate in a live discussion using phone-ins, Short Message Services and e-mails.
Speaking about another project across the world that also deals with AIDS, Mariangela Simao, director of the National STD/AIDS Programme in Brazil, described a multi-country program that address HIV prevention throughout Latin America.
“For us in Brazil, the words of the famous archbishop, Dom Helder Camara, summarize how we think of South-South cooperation: ‘No one is so poor that he has nothing to offer. No one is so rich that he never needs help,’” she said.
The program, which is called, “Lacos –Sul-Sul,” works with partnering countries to ensure universal access to prevention treatment, HIV prevention with adolescents and children, generate demand for services and mobilize participation of those who use the service.
The results have been encouraging, said Simao. In two of the more remote regions in Nicaragua, where LSS support has been provided, HIV testing for pregnant women has increased from 20 per cent to 42 per cent and from 5.3 per cent to 24 per cent. On a side note, Simao mentioned that in regions where LSS is not active, this rate has actually dropped form 3.4 per cent to two per cent.
As well as addressing AIDS, the South-South cooperation projects also addressed maternal and child health. Niger, for example, has one of the lowest life expectancies in the world. The infantile mortality rate is 247 for 1,000 live births while the maternal mortality rate is about 700 for 100,000 live births.
Source: MediaGlobal: Voice of the Global South at http://www.mediaglobal.org/article/2008-12-23/south-south-approaches-to-innovative-health-solutions
Tuesday, February 24, 2009
Linking RH and HIV/AIDS: Good Practices in Kenya
Linking sexual and reproductive health and HIV/AIDS policies and services presents many challenges for those on the front line of health care planning and delivery. A case study in Kenya of Family Health Options Kenya (FHOK) details a number of “lessons learned” in integration including:
For more information on linkages between RH and HIV/AIDS policy and programming, a number of tools prepared by IPPF, UNFPA, UNAIDS and WHO offer guidance on how to link sexual and reproductive health with HIV/AIDS.
- FHOK has demonstrated that providing antiretroviral therapy within sexual and reproductive health settings is plausible, possible and practical.
- Providing services for HIV/AIDS at sexual and reproductive health clinics attracts new clients and creates opportunities for promoting sexual and reproductive health to a wider population.
- In order to achieve their core aims, and to maximize the public health impact, sexual and reproductive health and HIV programmes should take specific steps to meet the needs and concerns of men as well as women in providing services.
- The best way to promote sexual and reproductive health among young people and to raise awareness of HIV is to make information and services available as part of a wider programme that addresses their social needs, and helps empower them to make healthy choices.
- By providing space for community groups to meet, or a base for their activities, clinics can strengthen the links with their client population to their mutual benefit.
For more information on linkages between RH and HIV/AIDS policy and programming, a number of tools prepared by IPPF, UNFPA, UNAIDS and WHO offer guidance on how to link sexual and reproductive health with HIV/AIDS.
- Sexual and Reproductive Health and HIV/AIDS: A Framework for Priority Linkages, WHO, UNFPA, UNAIDS & IPPF, 2005.
- Linking Sexual and Reproductive Health and HIV/AIDS. An annotated inventory. WHO, UNFPA, UNAIDS & IPPF, 2005.
- Sexual and Reproductive Health of Women Living with HIV/AIDS, Guidelines on care, treatment and support for women living with HIV/AIDS and their children in resource constrained settings, UNFPA & WHO, 2006.
- Integrating HIV Voluntary Counselling and Testing Services into Reproductive Health Settings, Stepwise guidelines for programme planners, managers and service providers, UNFPA & IPPF, 2004.
- Meeting the Sexual and Reproductive Health Needs of People Living with HIV. Guttmacher Institute, UNAIDS, UNFPA, WHO, Engender Health, IPPF, ICW & GNP+, In Brief, 2006 Series, No. 6.
- Reproductive Choices and Family Planning for People Living with HIV – Counselling Tool, WHO, 2006.
- Rapid Assessment Tool for Sexual and Reproductive Health and HIV Linkages: A Generic Guide, ICW, GNP+, IPPF, UNAIDS, UNFPA, WHO, Young Positives, 2008.
Friday, February 20, 2009
World Day of Social Justice: The Centrality of Reproductive Health and Rights
February 20, 2009 is the first observation of the World Day of Social Justice (UN). The daylong celebration of social justice encourages all UN member states to organize activities on the national level to support the objectives of the 1995 World Summit for Social Development.
As recognized by the World Summit, “social development aims at social justice, solidarity, harmony and equality within and among countries and social justice, equality and equity constitute the fundamental values of all societies.” To achieve “a society for all” governments made a commitment to the creation of a framework for action to promote social justice at national, regional and international levels. Governments also pledged to promote the equitable distribution of income and greater access to resources through equity and equality and opportunity for all. The governments recognized as well that economic growth should promote equity and social justice and that “a society for all” must be based on social justice and respect for all human rights and fundamental freedoms.
Reproductive health and rights are essential components of social justice and development. At the ICPD+5 Forum in 1999, Former WHO Director-General Dr Gro Harlem Brundtland argued that, "Failure to address people's reproductive health needs is a matter of human rights and social justice. People have a right to make free and informed decisions about their reproductive lives. They have a right to information and care that will enable them to protect their health and that of their loved ones. They have a right to benefit from scientific progress in health care. . . . Defining reproductive ill-health as not only a health issue but as a matter of social justice provides a legal and political basis for governments to act.”
For more information:
Statement by Dr Gro Harlem Brundtland, Director-General. ICPD+5 Forum, The Hague, Netherlands, 8–12 February 1999. Geneva, World Health Organization (Document WHO/CHS/RHR/99.8)
UN Reports on the World Day of Social Justice:
Social Justice in an Open World: The Role of the United Nations (2006)
Launch of the World Day of Social Justice New York, 10 February 2009
GA Resolution A/RES/62/10, 19 November 2007 in English and French
UN News Centre, 26 November 2007
GA Draft Resolution A/63/L.29/Rev.1,15 December 2008 in English and French
As recognized by the World Summit, “social development aims at social justice, solidarity, harmony and equality within and among countries and social justice, equality and equity constitute the fundamental values of all societies.” To achieve “a society for all” governments made a commitment to the creation of a framework for action to promote social justice at national, regional and international levels. Governments also pledged to promote the equitable distribution of income and greater access to resources through equity and equality and opportunity for all. The governments recognized as well that economic growth should promote equity and social justice and that “a society for all” must be based on social justice and respect for all human rights and fundamental freedoms.
Reproductive health and rights are essential components of social justice and development. At the ICPD+5 Forum in 1999, Former WHO Director-General Dr Gro Harlem Brundtland argued that, "Failure to address people's reproductive health needs is a matter of human rights and social justice. People have a right to make free and informed decisions about their reproductive lives. They have a right to information and care that will enable them to protect their health and that of their loved ones. They have a right to benefit from scientific progress in health care. . . . Defining reproductive ill-health as not only a health issue but as a matter of social justice provides a legal and political basis for governments to act.”
For more information:
Statement by Dr Gro Harlem Brundtland, Director-General. ICPD+5 Forum, The Hague, Netherlands, 8–12 February 1999. Geneva, World Health Organization (Document WHO/CHS/RHR/99.8)
UN Reports on the World Day of Social Justice:
Social Justice in an Open World: The Role of the United Nations (2006)
Launch of the World Day of Social Justice New York, 10 February 2009
GA Resolution A/RES/62/10, 19 November 2007 in English and French
UN News Centre, 26 November 2007
GA Draft Resolution A/63/L.29/Rev.1,15 December 2008 in English and French
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