‘Access to free and legal abortion is key to gender equality’

2016-09-30

To mark World Contraception Day on September 26, the GUE/NGL members of the European Parliament’s Committee on Women’s Rights and Gender Equality issued the following statement: “Women’s and girls’ rights must be placed at the centre of public health policies. Women’s free and universal access to sexual and reproductive health and education, including the right to free and legal abortion is a key factor to gender equality and must be guaranteed all over the world!”

According to a press release issued by the Group of the European United Left/Nordic Green Left (GUE/NGL), the findings of the recent Barometer of Women’s Access to Modern Contraceptive Choice in 16 EU Countries show a stagnation or decline in policies that support women’s right to contraceptive choice across most EU countries during the past three years.

Since 2007, World Contraception Day has aimed to improve awareness of contraception and to enable young people to make informed choices about their sexual and reproductive health. The annual campaign centres on a vision where every pregnancy is wanted.

By Beata Stur

School-based reproductive health services linked to higher birth weight for teen mothers

2016-08-31

Availability of reproductive health care services at high schools may prevent adverse birth outcomes among adolescent mothers, including low birth weight, according to study findings.

Getting Ahead of the Global Urbanization Curve in Reproductive Health

2016-08-12

According to the United Nations, around 66 percent of the world’s population will live in urban areas by 2050. If those projections hold, that means an additional 2.5 billion people will be living in cities, with 90 percent of them in Asia and Africa. With this predicted expansion of human populations toward cities, funders are feeling the pressure to get ahead in all manner of global health and development challenges.

The Gates Foundation has its eye on meeting the growing need for urban reproductive health programs—a matter in which the foundation and its partners have been looking into since 2009 with its Urban Reproductive Health Initiative (URHI).

Armed with funding from Gates, the URHI pilot program was launched in 2009 in Kenya, Nigeria, Senegal, and India. The overarching principle of the program was to increase women’s access to modern contraception. Implementing partners in each country then expanded on that basic principle. For example, URHI in Senegal worked with project partners to develop cost effective family planning programs, increase awareness for family planning in local communities, and inform policy making related to family planning. The pilot ran from 2009 to 2015.

Now, the Bill & Melinda Gates Institute for Population and Reproductive Health, which is based at the Johns Hopkins Bloomberg School of Public Health, is launching a new urban reproductive health program, called The Challenge Initiative, or TCI.

The Gates Foundation has made a $42 million grant to support TCI which aims to scale the “tools and approaches developed and lessons learned in URHI to more cities and geographies.” TCI will focus its work on cities that demonstrate a high need for modern contraceptives, family planning information, and sexual and reproductive health services.

Given that TCI is taking a demand-driven approach, it asking participating cities to “self-select” and work with in-country partners to develop full proposals that include family planning and reproductive health interventions that are cost effective and accessible. From there, chosen cities will have access to a chunk of Gates’ $42 million.

Family planning and sexual and reproductive health isn’t just about women having increased control over their own sexual and reproductive health choices. Expanding choices, education, and accessibility here can have a significant impact on a variety of global health and development challenges such as economic security, education, poverty alleviation, and women’s empowerment.

The Gates Foundation is a key funder in the global family planning space—last year, it committed nearly $300 million to related programs—but there are a few other big names here, like the Hewlett and Children’s Investment Fund foundations. Of course, also, the Susan Thompson Buffett Foundation is a major player here.

Hewlett is a heavy funder of projects related to reproductive health rights advocacy and research to inform policymaking, rather than those focused on health care delivery services. This funder has been committed to helping women gain autonomy over their bodies, and their sexual and reproductive health choices for decades.

Hewlett’s International Women’s Reproductive Health program aims to decrease unwanted pregnancies, increase access to basic reproductive health services, and ensure that no woman or girl dies from unsafe abortions. Recent grants coming out of Hewlett include a $1.25 million give to Pathfinder International for its work which includes providing sexual and reproductive health services including maternal health, HIV prevention, and safe abortion provision. Pathfinder is also committed to strengthening national and international health systems, advocating for increased policy making in the sexual and reproductive health arena.

Hewlett, like most funders in this space, connects family planning and reproductive health into broader global health and development goals.

The Children’s Investment Fund Foundation (CIFF) takes a bit of a different funding tack than Hewlett and Gates, focusing squarely on adolescent reproductive health. To date, the UK-based funder has invested $75 million in projects related to HPV vaccinations for adolescent girls in sub-Saharan Africa. HPV is currently the leading cause of cancer-related deaths for women in the region. Other major grant include a $13.5 million to prevent unwanted teen pregnancy in Kenya, and $14.2 million to scale and increase access to the contraceptive, Sayana Press.

Incidentally, earlier this year, CIFF and partnered with the Gates Foundation earlier this year to launch Adolescents 360. The program which was funded by a multi-year, $16.5 million grant from the CIFF and matched by Gates for a total give of $33 million aims to “reinvent sexual and reproductive health services,” with a focus on girls at the center of the program’s development and design.

Upon making the $42 million announcement, Christopher Elias, president of the global development program at the Gates Foundation. “Meeting the growing demand for voluntary family planning, particularly among the urban poor, will allow more women and couples to plan their futures and break the cycle of poverty.” And he’s not wrong.

Multiple reports have found that when women have fewer children or wait longer before having more children, their families are able to invest more in their education, nutrition, and healthcare. Also, women who wait longer to get married or at least have babies, are more likely to continue their educations, which then leads to not only increased economic security, but improved gender equality.

In other words, there’s a lot at stake here.

Diet, Substance Abuse and Male Fertility

2016-07-25

Recently, the American Society for Reproductive Medicine held their annual meeting in Honolulu, Hawaii. The topic of male fertility, in terms of diet and substance use, came up. Recent studies have found conflicts which leave specialists scratching their heads. But endocrinology and andrology experts say observational studies alone are not significant. Though in vitro fertilization (IVF) is better overall for those men who consume more fruits and vegetables, one study showed that eating produce with a high amount of insecticide residue affected sperm quality. But another study showed that vegetarians tended to have poorer sperm concentrations than omnivores. Another paper found that tobacco smokers have a higher risk of erectile dysfunction. But those who drank alcohol were less likely to experience it. Urologists often tell men to stay away from alcohol when trying to conceive. Yet, the final study showed that those men who had a high caffeine intake had more trouble conceiving, while male alcohol consumption seemed to increase chances.

The University of Illinois at Chicago’s Craig S. Niederberger, MD said, “While the results of some studies presented at the meeting seem to be contradictory, it is important to remember that observational studies often can’t tell the whole truth.” He went on, “A more rigorous scientific approach would include randomly assigning people to diets—what scientists call prospective randomization—and seeing what happens.” He added, “So we’re left with a basic rule of thumb: if it’s healthy for other parts of the body, it’s probably good for reproduction, too.” President of the American Society for Reproductive Medicine (ASRM) Rebecca Z. Sokol, MD, MPH said, “The human organism is complex and substances we inhale and imbibe have systemic effects beyond the stimulation the user is seeking.” She went on, “These studies provide new information that can help men make healthy choices for themselves, their partners, and their future children.”

UNFPA puts efforts in curbing girl pregnancies

2016-07-13

THE United Nation Population Fund (UNFPA) announced yesterday it will commit its investments this year to reach millions of marginalised adolescent girls at risk of early and child pregnancy as part of empowering the group to achieve their dreams.

Tanzania demographic health survey released this year shows teenage girls aged between 13 -19 years were still at greater risk of child pregnancy especially if they are not educated.

The figures indicate at least 42per cent of teenagers who had no primary education have had a live birth at the age below 19. Furthermore, 26.8 percent and 7.5 percent of teenagers who had primary and secondary education respectively had also a live birth during the period under review.

Mr Samwel Msoka, UNFPA Programme Manager said the figure means less teenagers participate in production activities–thus have little contribution on the national economy. “This is the challenge and we must tackle it,” he said.

He said the UN agency will put much concentration in the lake zone where cases of female genital mutilation (FGM)–a serious cause of early pregnancies and marriage were still high.

Minister for Health, Community Development, Elders and Children Ummy Mwalimu is expected to preside over the world population day next Monday, where UNFPA said this year’s celebration will be themed by “Investing in teenage girls.”

Speaking to reporters in the city, Dr Babatunde Osotimehin, the Executive Director for UNFPA said the celebration will underscore the relevance of investing in teenage girls in Tanzania.

In Tanzania, the focus is to empower teenage girls through education, protection and information about sexual and reproductive health and rights so that they can be prepared for future employment.

“The new development agenda calls on us to leave no one behind. To reach those furthest behind, leaders and communities must focus on and stand up for the human rights of the most marginalised teenage girls, particularly those who are poor, out of school, exploited, or subjected to harmful traditional practices, including child marriage.” “Marginalised girls are vulnerable to poor reproductive health and more likely to become mothers while still children themselves.

They have a right to understand and control their own bodies and shape their own lives,” she noted. Tanzania ranks 9th globally in terms of adolescent pregnancies.

Teenage girls around the world face more and greater challenges than their male counterparts. Channelling investments to teenage girls responds to their needs and rights. It also corresponds to the sustainable economic growth aims of the nation.

When a teenage girl has the power, the means and the information, she is more likely to make good decisions in life and realise her full potential, the UN official said. Adding: “she becomes a positive force in her home, community and nation.

Policies that lead to investment in education and health and those that create economic conditions that lead to decent jobs are particularly important in countries with large, emerging youth populations like Tanzania.”

Teenage girls, she said, are central to the future development agenda, adding that safeguarding their rights and investing in their future by providing quality education, decent employment, effective livelihood skills, and access to sexual and reproductive health services and comprehensive sexuality education is essential to their development, saying that it also improves the well-being of their families, communities and countries.

“There are more adolescents in Tanzania today than ever before, and their numbers are projected to grow rapidly over the next decade,” she concluded. Dr Natalia Kanem, Country Representative for the United Nations Populations Fund (UNFPA) Tanzania admitted that too many of these girl’s pregnancies has little to do with choice. It is often rooted in ignorance, gender inequality, and forced marriage, lack of education, sexual violence and coercion.

Its consequences reverberate throughout the life of the girl and for generations to come, she said. “Rescuing girls is the right thing to do. It’s also the smart thing to do. Empowering girls through education, protection and information may well be the highest-return investment available in the developing world,” said the UNFPA country representative.

Restrictive laws do not necessarily lower abortion rates

2016-07-01

TRACKING abortion rates is a hard task. Some countries under-report them, and many do not report them at all. A new paper published in the Lancet, led by Gilda Sedgh of the Guttmacher Institute, and the World Health Organisation, is only the fourth such study, and supersedes previous estimates that are considered too conservative. The authors (who also produced the last study four years ago) estimate that the global rate fell slightly from 40 abortions per 1,000 women aged 15-44 in 1990, to 35 in 2014. But this masks a wide variation by income and by region. In the developed world, rates declined dramatically from 46 to 27 as better family planning and education became available to women to prevent unintended pregnancies. The steepest drop was seen in eastern Europe following the break-up of the Soviet Union, as women gained access to family planning and modern contraception. By contrast, the abortion rate has stayed relatively unchanged in developing regions and the share of pregnancies ending in abortion has nudged up from 21% to 24%. This matters: 50m of the 56m abortions every year are in developing countries. In Latin America, which has restrictive abortion laws and the highest abortion rates, one in three pregnancies ended in abortion in 2014, higher than any other region. Restrictive laws do not appear to lower the number of procedures, but do increase the likelihood of health risks to women who must seek unsafe procedures. Around $300m a year is spent treating an estimated 7m women who suffer complications after unsafe abortions.

Abortion ruling reactions are strong, divided on the front lines in Texas

2016-06-28

Three-person babies IVF technique ‘safe’

2016-06-20

The use of an IVF technique involving DNA from three people to create a baby has moved a step closer with a study that shows it is safe.

Scientists at Newcastle University are trying to help women who are at risk of passing on serious genetic disorders to have a healthy child.

Last year the UK approved laws to permit the procedure, which involves using donor DNA from a second woman.

The study in Nature found the technique will lead to normal pregnancies.

The process, known as “early pronuclear transfer” involves removing the parents’ key genetic material from an embryo within hours of fertilisation, leaving behind the woman’s faulty mitochondria.

The parental DNA, which contains all the key genes responsible for character and appearance, is then transferred into a donor woman’s embryo, which has its nucleus removed but contains healthy mitochondria.

Last year the UK became the first country to approve laws to permit the procedure.

A study involving more than 500 eggs from 64 donor women found that the new procedure did not adversely affect embryo development and significantly reduced the amount of faulty mitochondria being passed on.

Prof Doug Turnbull, director of the Wellcome Trust Centre for Mitochondrial Disease at Newcastle University and a co-author of the study, said: “This study using normal human eggs is a major advance in our work towards preventing transmission of mitochondrial DNA disease.”

Prof Mary Herbert, also from the centre, added: “We are optimistic that the technique we have developed will offer affected women the possibility of reducing the risk of transmitting mitochondrial DNA to their children”.

But the studies showed the technique was not always successful. The amount of faulty mitochondrial DNA transferred during the procedure was less than 2%.

However, one in five of the stem cell lines created from the embryos showed an increase in carryover of defective DNA from the original embryo.

Prof Turnbull said: “Our studies on stem cells does express a cautionary note that it might not be 100% efficient in preventing transmission, but for many women who carry these mutations the risk is far less than conceiving naturally.”

Mother to child

Mitochondria are tiny structures which sit outside the nucleus of the cell and convert food into useable energy.

Genetic faults in the mitochondrial DNA mean the body has insufficient energy for key functions. This can cause a huge range of serious illnesses including muscle weakness, hearing loss and multiple organ failure.

The structures are always passed on from mother to child and have their own small amount of DNA, but it does not affect appearance or personality.

Clare Exton, aged 36, from south Derbyshire, who carries faulty mitochondria, is hopeful that the Newcastle team may be able to help her have a healthy baby.

Her mother Norma had multiple health problems due to mitochondrial disease and died aged 58.

Clare told me: “Mum got increasingly weaker over the years. She suffered epilepsy, deafness, heart and breathing problems and was very unsteady on her feet.”

Clare is partially deaf and wears hearing aids due to the faulty mitochondria she inherited. Her health is regularly monitored at the Centre for Mitochondrial Research in Newcastle.

She said: “Everyone wants to have a healthy child, but how my mum suffered it makes me even more determined that any baby I have is not affected by this terrible disorder.

“Knowing that the treatment would prevent the condition passing down future generations would be wonderful.”

Marie Austin is another patient at the Newcastle clinic. She is partially deaf due to due to faulty mitochondria and also suffers fatigue and mobility problems. Marie’s son Adam died aged 12 from organ failure due to severe mitochondrial disease

Marie said: “Adam was a very positive smiling boy but he had very serious health problems from the aged of eight which got progressively worse. I have a daughter, Kaitlyn, who’s 11 and she seems to be healthy for now. I really want her to benefit from this new treatment so in years to come she can have a child who is unaffected and I can have a healthy grandchild.”

The technique used in Newcastle would mean that the healthy mitochondria of a donor woman would combine with the DNA of the parents.

It would result in babies with 0.1% of their DNA from the second woman, and this genetic material would pass down subsequent generations.

The publication of the safety data was the last piece of scientific data required by the UK regulator, the Human Fertilisation and Embryology Authority (HFEA).

An expert panel appointed by HFEA will now consider the results of the study.

If it supports the findings then the team at Newcastle Fertility Centre will be able to apply for a licence to offer the procedure to women at high risk of passing on inherited mitochondrial diseases.

Women over 50 ‘putting off cervical screening test’

One in three women over 50 has delayed or not attended their cervical screening test, which should take place every five years, according to a survey from a cervical cancer charity.

The average delay was more than two years, but one in 10 put off the test for more than five years.

Jo’s Cervical Cancer Trust surveyed 1,000 women over 50.

It said not attending cervical screening was the biggest risk factor to developing cervical cancer.

The survey found a lack of understanding of cervical cancer and cancer screening among women in that age group.

As a result, by 2040, the charity said cases of cervical cancer were predicted to increase by 16% among 60-64 year-olds and by 85% among 70-74 year-olds if screening uptake stays at the same level.

Preventable

Robert Music, chief executive at Jo’s Cervical Cancer Trust, said diagnoses were on the rise with 3,207 women a year now learning that they are suffering from the condition.

“Cervical cancer is a preventable disease so it is extremely worrying that diagnoses have risen,” he said.

“Women aged 50 to 64 are of particular concern as they are more likely to receive an advanced stage diagnosis, which means more invasive treatment, poorer health outcomes and increased risk of loss of life.”

He said uptake of cervical screening was at an 18-year low of 72%.

In the survey, women over 50 gave a number of reasons for delaying their cervical screening test.

For example, a third found it embarrassing, a quarter found it hard to book an appointment at a convenient time and one in five found it a painful experience.

Nearly 40% said being sent an appointment with their cervical screening invitation would encourage them to go.

Jane Ellison, public health minister, pointed out that cervical screening saved 4,500 lives a year.

“Even as we get older, it is important that we spot any abnormalities early so we have a better chance of preventing cervical cancer,” she said.

Cervical screening information

• Across the whole of the UK, women are invited for cervical screening between the ages of 25 and 64
• Women aged 25-49 are invited every three years
• Women aged 50-64 are invited every five years

New Test Can Detect Infertility Genes

2016-04-25

Around 15% of couples have difficulty conceiving. 50% of the time the problem lies with the man. In many cases, faulty genes are the root cause of the problem. But up until recently, there was no way of knowing what these genetic issues were. Cornell University researchers have now come up with a way to detect mutations in genes affecting fertility. Their findings were published in the Proceedings of the National Academy of Sciences. Common genetic variations are known as single nucleotide polymorphisms (SNPs). Every SNP affects a specific nucleotide or building block of DNA. Researchers say patients struggling with infertility can have their DNA sequenced. If doctors can figure out which SNP is defective, they can provide a genetic diagnosis. This may someday lead to intervention on the genetic level. Fertility specialists could simply detect faulty SNP’s and repair or replace them.

To locate the SNP causing the problem today, the genomes of healthy people are placed side-by-side with those having fertility problems, to locate where differences occur. But this method has been ineffective so far. There are too many genes responsible for fertilization, and the process is too complex. John Schimenti the director of the Center for Vertebrate Genomics along with Priti Singh, a postdoctoral fellow in Schimeti’s department, came up with this new method. These researchers used laboratory mice. They looked at a database of all known mice genes responsible for infertility. These have been arrived upon through testing which is not possible in humans. Then these genes were compared to genetic variation within the human genome. They found SNPs associated within four different genes that are thought to cause fertility problems in our species. Then these SNPs were tested in mice. Through this practice, researchers are beginning to identify those SNPs that cause human infertility. Though this genetic testing is not available yet, couples trying for six months to a year without conceiving should consult a physician. Both partners should be tested. Men should see an urologist or fertility specialist.