Institutionalization of Immediate PostPartum IUD Services 1 FIGO FIGO brings together professional societies of obstetricians and gynecologists on a global basis FIGO currently has Member Societies in 131 countriesterritories projects implemented through the member societies ID: 808898
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Slide1
My Year at FIGO
What can we learn from international public health?
Institutionalization of Immediate Post-Partum IUD Services
1
Slide2FIGO
FIGO brings together professional societies of obstetricians and gynecologists on a global basis.
FIGO currently has Member Societies in 131 countries/territories; projects implemented through the member societiesFIGO's vision is for women of the world to achieve the highest possible standards of physical, mental, reproductive and sexual health and wellbeing throughout their lives.
Slide3FIGO Projects
Projects
Post-Partum Family Planning
Improving fistula surgery around the world
Development of Misoprostol Guidelines for management and prevention of PPH
Evaluation of training for Helping Mothers Survive
Improving Preconceptual, Adolescent and Maternal nutrition
Implementation of essential interventions in maternal and child health
Prevention of unsafe abortionImproving identification and management of hyperglycaemia in pregnancy
Common themes
Low-resource settings
Focus on the most vulnerable women
Potential to impact on health and also to promote gender equality
Capacity-building
Sustainability
Linked to SDGs
Slide4Lifetime risk of maternal death
Developed countries - 1
in 7300
Sweden
-
1 in
17,400
Asia - 1 in
94Sub-Saharan Africa - 1 in 22Chad - 1 in 8
“ Women are not dying because medical science does not know how to save them but because societies do not think these women’s lives are worth saving”
Mahmoud Fathalla (FIGO president 1994-1997)
Slide5Access to contraceptive information is central to achieving gender equality
Empowers women to
determine whether and when to have children;
Enables
women to complete their education
;
Increases
women’s autonomy within their households
;
Boosts
their earning power,
improving
economic security and well-being of women and their
families.
Slide6Birth interval less than 18 months (Reference 24-<60 months)
was associated with:
Institutionalization of Immediate Post-Partum IUD Services
From: Kozuki
et al., BMC Public
Health,
2013
13
(Suppl 3):S3
6
“If all women waited at least 24 months to conceive again, under-five deaths would fall by
13 percent
. The effect of waiting 36 months to conceive again would avoid
25 percent of under-five deaths.
Slide7Institutionalization of Immediate Post-Partum IUD Services as a routine part of antenatal counselling and delivery room services in Sri Lanka, Kenya, India, Tanzania, Nepal and
Bangladesh
“From misconceptions to delayed conceptions”
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Slide8The need for
PPIUD
PPIUD inserted immediately after delivery of placenta, within 48 hours or at Caesarian SectionPPIUD constitutes a effective choice for women delivering in facilities
It is offered at a time when motivation is high
Circumvents need to return to a facility for a FP method
Safe, painless, effective
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Slide9FIGO PPIUD initiative
Being implemented in Sri Lanka, India, Bangladesh, Nepal, Tanzania, Kenya
Providing women with additional information and contraceptive counselling at antenatal clinics
Training providers to counsel women on PPIUD
Training
providers through
a ‘training the trainer’ model
Supplying equipment for training
Research
by Harvard School of Public Health in 3 countries
20/10/2016
Institutionalization of Immediate Post-Partum IUD Services
6 countries will implement the FIGO Institutionalization of Immediate Post-Partum IUD Services initiative
Slide10Family Planning should be approached as a rights issue
Some
women are denied PPIUD on the basis of the stand of health care providers, views of family, inadequate
access to information or services
This
does not promote women’s rights and is a lost
opportunity for a potentially life-saving intervention for the
woman
20/10/2016
Institutionalization of Immediate Post-Partum IUD Services
Slide11Huge influence of
Mothers – in-law
Slide12121 counselling in antenatal clinic and post natal ward in Mumbai
Slide13Queuing up to see the doctor for hours…..a missed opportunity
Slide14Busy postnatal wards in Bangladesh
Slide15Slide16Progress
Master training in all countries completed and facility training progressing
Baseline data completed in intervention facilities in the research
countries
6,500
providers
trained in counselling and/or inserting
17,551
women have had PPIUD inserted since start of initiativeWhere good follow-up, low expulsion rates
20/10/2016
Institutionalization of Immediate Post-Partum IUD Services
Slide17Learning from international public health
Health care professional organisations are an important route to health improvement especially if working together
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Slide18Long term commitment
“If only poverty could be overcome by writing reports”
“I’m always amazed how overnight successes take a helluva long time.”
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Slide19Learning from international public health
Pluralism can be made to work
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Slide20Task sharing
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Slide21Task sharing not task shifting
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Slide22All meetings can be Skype meetings
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Slide23Mobile technology
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Slide24What did I learn?
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Slide25We’re lucky…1.
The NHS
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Slide262. Gender equality
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A woman’s place is….in the audience
Slide27Scale –up is not easy but ownership and participation are key
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Slide28“All
UK doctors, whether they choose to work in the developing world or in Britain, must have an awareness of global issues. It improves their critical thinking, enables them to empathise more with their patients and develops their knowledge of health systems, not least our own
..”
Lord Nigel Crisp, independent crossbench member of the House of Lords
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Slide29Cycling is possible in a UK city
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