Dr. Ton van der Velden

Dear all,

Please find here some of the RH news from October 2007.

But first, do check out JAMA’s Global Theme Issue on Poverty and Human Development, (volume 298, issue 16, if the link does not work right), and the WHO Bulletin. They join over 230 other journals around the world in publishing papers on poverty and human development this month, as part of an initiative by the Council of Science Editors.

The World Development Report 2008: Agriculture for Development (7 MB!) is out. The Report calls for greater investment in agriculture in developing countries

Please read the draft Human Rights Guidelines for Pharmaceutical Companies in relation to Access to Medicines . Pharmaceutical companies have a profound impact - both positive and negative – on Governments' ability to realise the right to the highest attainable standard of health. It is time to identify what pharmaceutical companies should do to help realize the human right to medicine. How can we expect pharmaceutical companies to respect human rights if we fail to explain what they are expected to do? Comments to the draft guidelines by 31 December 2007 to Địa chỉ email này đã được bảo vệ từ spam bots, bạn cần kích hoạt Javascript để xem nó.

Family planning

The “Future of Male Contraception” conference was held in Seattle. For a detailed summary of conference news, check out the archived researcher version of the Male contraception newsletter.

A Pocket Guide for Health Practitioners, Program Managers, and Community Leaders from the ESD project provides an overview about healthy timing and spacing of pregnancies (which now has its own exiting acronym: HTSP). It discusses key findings from global research on the link between pregnancy spacing and maternal and newborn health outcomes.

Required reading: A new Population Reports, Implants: The Next Generation is out. The new one-rod system Implanon, the two-rod system Jadelle, and Sino-Implant (II), another two-rod system available in some countries, will replace Norplant, that will be unavailable after 2008. Sino-Implant is particularly interesting as it cost only $4.50 whole sale. See also the INFO report companion and the powerpoint slideshow.

Powerful Partners: Adolescent Girls’ Education and Delayed Childbearing by the PBR describes how many successful programs are keeping adolescent girls in school and many programs offer reproductive health information and services out of school, including family planning. Combining such programs may yield more benefits than either one alone.

Some science?

Comparison of Cycle Control and Side Effects between Transdermal Contraceptive Patch and an Oral Contraceptive in Women Older than 35 Years

Changes in Contraceptive Method Mix In Developing Countries

Oral Contraceptives and the Risk of Death From Breast Cancer

A comparative study of Cyclofem® and depot medroxyprogesterone acetate (DMPA) effects on endometrial vasculature

Association of Oral Contraceptive Use, Other Contraceptive Methods, and Infertility with Ovarian Cancer Risk This study shows that for women using oral contraceptives for >5 years, the rate ratio for ovarian cancer for 20 years since last use was 0.58 (95% confidence interval (CI): 0.39, 0.87). Tubal ligation (RR = 0.66, 95% CI: 0.50, 0.87) was associated with decreased ovarian cancer risk, whereas intrauterine device use (RR = 1.76, 95% CI: 1.08, 2.85) and infertility (RR = 1.36, 95% CI: 1.07, 1.75) were associated with an increased risk.

Other new FP research is here, here, and here. (If you really do not want to miss anything…)

MCH

Big topic last month was the Women Deliver Conference in London. It was full of commitments. Ministers of Health and Finance turned up. They made a powerful declaration of support, and concrete suggestions for how to improve the status of maternal health on the international development agenda. The U.K. government announced a $200 million grant to the UNFPA for contraceptive commodities, and the Japanese government vowed to make global health a priority at the Group of Eight Summit meeting next year in Japan. Not just promises: The John D. and Catherine T. Mac Arthur Foundation donated a large amount-$11 million- to Pathfinder Int, on a four-part intervention strategy to dramatically reduce maternal mortality. Meanwhile new global figures released by WHO, UNICEF, UNFPA and The World Bank in “Maternal mortality in 2005” show that the world's maternal mortality ratio  is declining too slowly to meet Millennium Development Goal 5, which aims to improve maternal health and prevent women from dying in pregnancy and childbirth. See also the Lancet. (BTW there is now a Global Campaign for the Health Millennium Development Goals 4-5-6 Does anyone else find it odd that there is a campaign to help the campaign?)

Also in London was the landmark Global Safe Abortion Conference, sponsored by Marie Stopes International, in association with Ipas and Abortion Rights. New dataWorld Health Organization (WHO) and the Guttmacher Institute ( published in the Lancet and available as slideshow and pdf)  show that while the number of abortions performed globally has fallen slightly in recent years, the number of unsafe abortions has actually increased slightly. In Africa--where restrictive laws are still on the books and women's access to contraception is most limited--the number of deaths from unsafe abortion rose significantly from 29,800 in 2000 to 36,000 in 2003. And the Brits debate late abortion. from the

BTW, look at Needless death and injury: Unsafe abortion as a critical global health issue, a two-page Congressional briefing that discusses the global problem of unsafe abortion as well as how the Global Gag Rule (GGR) encourages this practice. This briefing also offers policy suggestions for the United States to prevent unsafe abortion worldwide.

Onwards: have you heard of Jeffrey Sachs Millenium villages?  Poverty And Hunger Special Feature: The African Millennium Villages explains what they are and the preliminary results. Required reading, if only to be able to join the discussions….

Enemas during labour shows that enemas do not have a significant effect on infection rates such as perineal wound infection or other neonatal infections and women's satisfaction. This evidence does not support the routine use of enemas during labor; therefore, such practice should be discouraged. So stop already.

Amniotomy for shortening spontaneous labour shows no evidence of any statistical difference in length of first stage of labor,  maternal satisfaction with childbirth experience or low Apgar score less than seven at five minutes. Authors do not recommend it as routine part of labor and delivery. So stop already.

Malaria now: the GSK vaccine trial is going well. The trial was designed to test the safety of the candidate vaccine, and showed that the babies tolerated the three doses with no serious side-effects over six months of follow-up monitoring. The vaccine stimulated the production of antibodies and was 65 per cent effective against new infection after three months of follow-up. Varying efficacy of intermittent preventive treatment for malaria in infants in two similar trials: public health implications shows that intermittent preventive treatment (IPTi) with sulphadoxine-pyrimethamine in infants resulted in different estimates of clinical malaria protection in two trials that used the same protocol in Ifakara, Tanzania, and Manhica, Mozambique. Impact of home-based management of malaria on health outcomes in Africa: a systematic review of the evidence HMM involves presumptively treating febrile children with pre-packaged antimalarial drugs distributed by members of the community.

Effects of trimethoprim-sulfamethoxazole and insecticide-treated bednets on malaria among HIV-infected Ugandan children shows that the combined use of Trimethoprim-sulfamethoxazole (TMP/SMX) prophylaxis and insecticide treated bednets was associated with a dramatic reduction in malaria incidence among HIV-infected children.

Mannitol as adjunct therapy for childhood cerebral malaria in Uganda: a randomized clinical trial

And if you want to make sure you are up to date: Africa Malaria Day 2007 - Bibliography on severe malaria is a summary of publications dealing with management of severe malaria in hospitals and at home from Médecins Sans Frontières Suisse (MSF-CH)

For lab diagnosis you will need Atlas of Human Malaria - Atlante della Malaria Umana, an illustrated Atlas of malaria parasites in English and Italian, with more than 400 pictures.

Comparison of the therapeutic efficacy of chloroquine and sulphadoxine-pyremethamine in children and pregnant women

Postpartum Care: Levels and Determinants in Developing Countries This study was undertaken to analyze the variables (occurrence, timing, and back-ground characteristics) associated with receipt of postpartum care in 30 developing countries representing the major regions of the world. Results show that about seven out of ten births mothers do not receive any postpartum care.

Epilepsy in Pregnancy is a nice overview article and Seasonal variation in the incidence of preeclampsia and eclampsia in tropical climatic conditions is interesting.

HIV/AIDS

What are you planning for World AIDS day?

Potential Impact of Antiretroviral Chemoprophylaxis on HIV-1 Transmission in Resource-Limited Settings describes the potential impact of pre-exposure chemoprophylaxis (PrEP) on heterosexual transmission of HIV-1 infection in resource-limited setting. Approximately 2.7 to 3.2 million new HIV-1 infections could be averted in southern sub-Saharan Africa over 10 years by targeting PrEP (having 90% effectiveness) to those at highest behavioral risk and by preventing sexual dis-inhibition.

Tools for Planning and Implementing a Successful HIV and AIDS Treatment Advocacy Campaign This advocacy toolkit is intended for treatment access advocates and activists acting as individuals or groups. The toolkit aims to offer an understanding of what advocacy is and how it can support the work of other networks or coalitions engaged in advocacy. It is intended to be used as both an information resource and as a training manual.

Integrating Family Planning Services into Voluntary Counseling and Testing Centers in Kenya aims to determine the effectiveness and costs of adding selected levels of family planning services to Voluntary Counseling and Testing (VCT) centers in Kenya, as well as looking at the effect of adding family planning services on VCT quality of care. The authors found that integrating family planning training improves providers’ knowledge and attitudes toward family planning and increases the likelihood of VCT clients receiving family planning messages.

An while we are on that topic: Linking Sexual and Reproductive Health and HIV/AIDS: An Annotated Inventory is a WHO document that reviews tools that link HIV/AIDS with SRH  programs and those that link SRH with HIV/AIDS programs

Guidelines for the Clinical Management and Treatment of HIV Infected Adults in Europe may be useful.

Human Trafficking and HIV: Exploring vulnerabilities and responses in South Asia shows that people who are trafficked are highly vulnerable to the risk of HIV infection. The report explores the link between trafficking and HIV in six countries of south Asia: Afghanistan, Bangladesh, India, Nepal, Pakistan, and Sri Lanka.

Patient Retention in Antiretroviral Therapy Programs in Sub-Saharan Africa: A Systematic Review

Scaling-up co-trimoxazole prophylaxis in HIV-exposed and HIV-infected children in high HIV-prevalence countries

A follow-up on follow-up: shifting to a community-based response to improve retention in care

Documents on Male Circumcision and Risk of HIV Acquisition is a UNAIDS list of documents about male circumcision. It includes a list of published articles on male circumcision and HIV/STI prevention, including a list of documents on: Biological Plausibility, Impact on HIV transmission and Acceptability.

Randomized Control Trial of Peer-Delivered, Modified Directly Observed Therapy for HAART in Mozambique.

Other RH

Something you should read: The trend of using rape and genital mutilation as a weapon in war now strikes the Congo. The NY times published on it, playwright Eve Ensler provided additional description of the situation in the Congoa piece for Glamour magazine.  UNICEF and V-Day recently partnered to launch a campaign taking on the issue, "Stop Raping our Greatest Resource: Power to Women in the DRC." Yakin   Ertürk, the Special UN Rapporteur on violence against women, its causes and consequences, told the UN that the international community needs to intervene urgently to stem the widespread sexual violence and that it amounts to war crimes. following her visit there in

In that perspective, read Unequal, unfair, ineffective and inefficient, the final Report to the WHO Commission on Social Determinants of Health. The paper draws together evidence that identifies and explains what gender inequality and inequity mean in terms of differential exposures and vulnerabilities for women versus men, and also how health care systems and health research reproduce these inequalities and inequities instead of resolving them.

Also GBV: Asian Son Preference Will Have Severe Social Consequences, New Studies Warn

Predisposing factors for bacterial vaginosis, treatment efficacy and pregnancy outcome among term deliveries; results from a preterm delivery study shows BV is twice as common among smokers…

Denmark and Spain recommend free HPV vaccination for pre-adolescent girls to prevent cervical cancer

Evaluation of adjunctive tests for cervical cancer screening in low resource settings

US interest

President George Bush has appointed Susan Orr to head the Office of Population Affairs at the Department of Health and Human Services. She was widely criticized in the US press because in a 2001 interview with the Washington Post she was quoted as saying that she supported a Bush proposal to stop requiring health plans for federal employees to cover contraception…What a nightmare..

There is also good news: Middle school contraceptive program sets off firestorm

And then, at the last moment: more really bad news: I quote: “[On November 1^st] we learned that the Democratic controlled Labor HHS Appropriations conference committee report includes the full $28 million increase requested by President Bush for failed abstinence-only-until-marriage-programs. The Democrats have now granted the president and his anti-sex education zealots a whopping $141 million dollar budget for abstinence-only programs -- something they could never achieve even under a conservative Republican Congress!

Never mind the congressionally-mandated evaluation released in April showing abstinence-only programs have "no impact on adolescent behavior." Never mind the 2006 study by the Society of Adolescent Medicine which stated that these programs "threaten fundamental human rights to health, information and life." Never mind the 2004 report from Congressman Henry Waxman's (D-CA) oversight committee demonstrating that 80% of abstinence-only programs contain "false or misleading information." Never mind the 13 governors who have refused abstinence-only dollars because they see no reason to use precious state dollars to match federal funds for programs that simply do not work. “

Viet Nam interest

Most important: UNFPAs “Population Growth in Vietnam, What the Data from 2006 Can Tell Us”, shows fertility continues to decline in Vietnam. The total fertility rate now stands at 2.09 children per woman, which is just below the level of replacement. However, the sex ratio at birth is becoming imbalanced in Vietnam. Reasons for this include pressure to adhere to the two-child policy coupled with a preference for sons and the ready availability of ultrasound and abortion. The national sex ratio at birth as reported in the 2006 survey was 110 boys to every 100 girls.

Vietnam's medical schools need better training

Woman-centered health care: Improving abortion services in Vietnam. This six-page brochure discusses the growth and successes of comprehensive abortion care (CAC) services in Vietnam. The 18 CAC sites in Vietnam have substantially improved access to safe abortion while reducing barriers to care and providing related services such as counseling and contraception.

Creation of postgraduate training programs for family medicine in Vietnam.

Accessing global value chains? The role of business–state relations in the private clothing industry in Vietnam

Poverty reduction by improving health and social services in Vietnam.

The lives of female sex workers in Vietnam: Findings from a qualitative study.

Risk Factors Associated with Stillbirth in Thai Nguyen Province, Vietnam

Asia's Focus on Sons May Fuel Sexual Violence, UN Report Says

This is hard to believe: A third of high school students recently surveyed don’t know where

babies come from, according to a poll by Ho Chi Minh City university students.

Alumni survey of Masters of Public Health (MPH) training at the Hanoi School of Public Health

Nigeria interest

Spatial Analysis of Risk Factors for Childhood Morbidity in Nigeria

Knowledge of, and attitudes to, acquired immune deficiency syndrome (AIDS) among traditional birth attendants (TBAs) in rural communities in Cross River State, Nigeria.

Pregnancy outcomes in patients with sickle cell disease in Enugu, Nigeria.

Episiotomy and perineal trauma prevalence and obstetric risk factors in Port Harcourt, Nigeria.

Current knowledge and practice of exclusive breastfeeding among mothers in Jos, Nigeria.

Knowledge and behaviour of nurse/midwives in the prevention of vertical transmission of HIV in Owerri, Imo State, Nigeria: a cross- sectional study.

Preventing violence against women: time to uphold an important aspect of the reproductive health needs of women in Nigeria.

HIV/AIDS perception and sexual behaviour among Nigerian University students.

Association of Chlamydia trachomatis serology with tubal infertility in Nigerian women

Cambodia Interest

Ready or Not? A national needs assessment of abortion services in Cambodia

Effectiveness of Highly Active Antiretroviral Therapy in HIV-Positive Children: Evaluation at 12 Months in a Routine Program in Cambodia.

Delivery life support: A preliminary report on the chain of survival for complicated deliveries in rural Cambodia.

Egypt interest

Doaa Oraby points out that FHI published  A Guide for Conducting Behavioral Surveillance Surveys on HIV/AIDS “ in Arabic.

Safe injection practice among health-care workers in Gharbiya Governorate, Egypt.

Egyptian women's attitudes and beliefs about female genital cutting and its association with childhood maltreatment.

Long-term immunity to hepatitis B among a sample of fully vaccinated children in Cairo, Egypt.

Characterization of Pseudomonas aeruginosa isolated from clinical and environmental samples in Minia, Egypt: prevalence, antibiogram and resistance mechanisms

Ethiopia interest

Economic costs of epidemic malaria to households in rural Ethiopia.

Household waste disposal in Mekelle city, Northern Ethiopia.

Gender bias in the food insecurity experience of Ethiopian adolescents.

Women's Empowerment in Ethiopia: New Solutions to Ancient Problems

How to end child marriage: Action strategies for prevention and protection

Program Scan Matrix on Child Marriage

Intra-household Mosquito Net Use in Ethiopia, Ghana, Mali, Nigeria, Senegal, and Zambia: Are Nets Being Used? Who in the Household Uses Them?

Relationship between Trachoma and Chronic and Acute Malnutrition in Children in Rural Ethiopia

And then this:

Pope urges pharmacists to reject abortion pill reports that the pope has said that "Pharmacists must be allowed to refuse to supply drugs that cause abortion or euthanasia” ,

Youth INFONet 38 is out.

Best,

Ton