Keeping FIGO’s vision andmission on track in new era of Sustainable Development Goals

In ternat iona l Federat ion of Gynecology and Obstet r ics | May 2015 1

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communications@figo.orgwww.figo.org May 2015

Introducing the SDGsThere are 17 SDGs that have been proposed bythe UN, which are interdependent on each other(please see: http://www.theguardian.com/global-development/2015/jan/19/sustainable-development-goals-united-nations).What is of direct impact to us has been definedin goals 3 and 5. Several sub sections of eachare summarised below (source: https://sustainabledevelopment.un.org/cont):3.1 By 2030, reduce the global maternal

mortality ratio to less than 70 per 100,000live births

3.2 By 2030, end preventable deaths ofnewborns and children under five years ofage

3.3 By 2030, end the epidemics of AIDS,tuberculosis, malaria and neglected tropicaldiseases and combat hepatitis, water-bornediseases and other communicable diseases

3.4 By 2030, reduce by one third prematuremortality from non-communicable diseasesthrough prevention and treatment andpromote mental health and wellbeing

5.1 End all forms of discrimination against allwomen and girls everywhere

(AFOG-KOGS Congress, February 2015, Kenya)L–R: Professor Abdel Latif Ashmaig (AFOG Honorary Secretary); Professor Sir Sabaratnam Arulkumaran (FIGO President); Dr Yirgu Gebrehiwot (AFOG President); Mrs Margaret Kenyatta(Honorable First Lady of Kenya); Dr Anne Kihara (KOGS President); Professor Oladapo Ladipo (AFOG President Elect); Professor Eusèbe Alihonou (AFOG Vice President)

Dear ColleaguesHave we satisfactorily achieved MDG goals 4, 5and 6 in order that we can venture into the era ofthe new Sustainable Development Goals (SDGs)?In my view, the ‘sell-by’ date for the MDGs hascome, and global leaders have now expandedthe goals for human society’s development,within which the old MDGs are buried. What isthe position with regard to women’s health?What should FIGO, National Societies andindividual obstetricians and gynecologists do inthe next few years, as women’s healthadvocates? continued on page 2

(courtesy of the organisers)

Keeping FIGO’s vision and mission on track in new era of SustainableDevelopment Goalscontinued from page 1

In ternat iona l Federat ion of Gynecology and Obstet r ics | May 20152

5.2 Eliminate all forms of violence against allwomen and girls in the public and privatespheres, including trafficking and sexual andother types of exploitation

5.3 Eliminate all harmful practices, such as child,early and forced marriage and female genitalmutilation

One could say that the global community hasunfinished business in relation to MDGs; ourattention not deviated but rather subsumed in theexpanded number of goals. Our themes have notchanged: we have to increase antenatal care andthe provision of skilled birth attendants in labourand delivery, and close the gap of unmet needsof contraception etc. It sounds like ‘business asusual’, but we must make renewed efforts if weare to realise the global community’s ambition inachieving these goals. FIGO is proud that it hasalready taken action with its national andinternational communities.

The importance of contraception tohelp achieve SDG 3.1Providing adequate and appropriatecontraception is fundamental to improving sexualand reproductive health. It reduces maternalmortality by up to 30 per cent and child mortalityby up to 10 per cent through the impact ofspacing. Indirectly, contraception helps toalleviate poverty and improve climate change bythe reduction of population. The FIGO ExecutiveBoard has mandated the formation of a newFIGO Working Group on Contraception, cominginto effect later this year, involving IPPF, WHO,UNFPA, the Population Council, organisationsinterested in women’s health – such as WomenDeliver – and the donor community.

FIGO’s PPIUD project (see report on page six) isnow in fruition. The successful pilot phase in SriLanka has resulted in new activities in India,Nepal, Bangladesh, Tanzania and Kenya, now inprogress. I would like to place on record mysincere thanks to the anonymous donor who hasmade all of this possible. Due to the largenumber of institutions involved (48 hospitals in sixcountries), we have national co-ordinators andmanagers helping us in the individual countries,in addition to our own Project Manager, Ms LauraBanks, and Project Co-ordinator, Ms Maya Sethi.We hope to extend the programme to othercountries as we gain further experience.

In addition, FIGO is working in Kenya andTanzania, with the help of funding from theLaerdal Foundation, on an ambitious project:‘Helping Mothers Survive’, the main focus ofwhich is preventing mothers dying of post-partum haemorrhage. Unsafe abortion is also amajor contributor to maternal deaths andmorbidity, and Professor Anibal Faúndes isworking with FIGO colleagues in over 40countries on the issue of safe abortion care.

SDG 3.2 deals with preventable deaths innewborns and children under five. A significantproportion of these deaths is due to prematurity.FIGO is doing excellent work with March of Dimes(MOD) on preterm birth (see page four), withregular teleconferences on strategy and research.Together with MOD’s President, Dr JenniferHowse, and Senior Vice President for Researchand Global Programs, Dr Joe Leigh Simpson, Irecently visited Cyprus to attend a symposium tosee how best we can help to reduce its highpreterm birth rate of 14 per cent (caused by latepreterm births). The Cyprus Minister of Health andthe US Ambassador to Cyprus attended themeeting; robust action plans are underconsideration to try to reduce the rates. FIGO isgrateful to MOD for its continuous support,encouragement and collaborative efforts.

Non-communicable diseases (NCDs)in SDG 3.4With changing life styles, increased consumptionand less physical activity, obesity is on theincrease, contributing to premature illness anddeaths due to NCDs. This is further compoundedby the increasing life expectancy of thepopulation brought about by the rapid reductionof communicable diseases with immunisationand antibiotics. The etiology of NCDs isattributed to genetics, epigenetics, and ourlifestyles. Many factors start in utero eg pretermbirth, diabetes in pregnancy, intra uterine growth,nutrition during pregnancy and lactation,environmental toxins and many others that startin foetal life and early childhood. FIGO hasestablished groups to look at hyperglycaemia inpregnancy (under the leadership of ProfessorMoshe Hod), and nutrition in pregnancy andinfancy (chaired by Professor Mark Hanson).Their respective papers are completed and, onceapproved by the Executive Board, will be widelycirculated. Environmental toxins can influence thegrowth and outcome of the foetus and newbornand have an impact on the long-term health andlife of an individual. FIGO is working closely withACOG and other organisations on a paper onthis subject with the help of Professor LindaGiudice. These important papers will form theframework to plan what needs to be done, andto take action towards SDG 3.5, which focuseson strengthening the prevention and treatment ofsubstance and alcohol abuse.

Focus on gender equality andelimination of gender-basedviolence to help achieve SDG 5

The recently formedFIGO Working Group onGender Violence –including representativesfrom WHO, UNAIDS andWAHA, under the ablechairmanship of DrDiana Galimberti fromArgentina – willspearhead someimportant activities thisyear. In October 2015,at the FIGO World

Congress in Vancouver, there are importantsessions dedicated to sex discrimination andgender-based violence. The inaugural MahmoudFathalla Lecture will be delivered by the Tonyaward winner, playwright, activist and author EveEnsler, and will set the scene for continuing thediscussion as to how best our community cantackle the problem.

Gender equality will never prevail as long as wehave cases of avoidable maternal deaths, fistulaefollowing childbirth (see project report on page 7)and the practice of female genital mutilation, all ofwhich have been on the FIGO radar for decades.

Promotion of FIGO at national andregional meetingsI have recently participated in several visitsconnected to the PPIUD programme, in India,Tanzania and Sri Lanka. While in Sri Lanka, I alsoattended the official induction of ProfessorKanishka Karunaratne as the new President ofthe Sri Lankan College of Obstetricians andGynaecologists (SLCOG). He has pledged his fullsupport for FIGO activities – we wish him well forhis term as President.

In January 2015, the All India Congress ofObstetrics and Gynaecology (AICOG), under theFOGSI Presidency of Dr Suchitra Pandit, andchairmanship of Dr Kurian Joseph, was aresounding success with 12,000 participants. Mycongratulations to the team for conducting sucha large and meticulously planned conference inChennai. FIGO is grateful for the kind opportunityit afforded to present two seminars on the use ofmisoprostol.

In mid-February, the African Federation ofObstetrics and Gynecology (AFOG), inpartnership with the Kenya Obstetrical andGynaecological Society (KOGS), held its firstCongress in Nairobi, Kenya where I gave aninaugural address. It was a good opportunity tomeet with the current AFOG and KOGS Officers.The meeting was well attended and theHonorable First Lady Margaret Kenyatta openedthe proceedings.

Congress Countdown – five monthsto go!I urge all colleagues to attend FIGO’s WorldCongress in Vancouver (4–9 October 2015), toenjoy a truly varied and stimulating ‘Science andSocial’ feast! FIGO’s teams in London andVancouver are working exceptionally hard to giveyou the very best Congress experience. Pleasevisit www.figo2015.org and register today atearly bird rates. We are very much lookingforward to greeting our global colleagues, and Ican assure you that you will return home withrenewed energy, ideas and knowledge to helpyou give the very best to women’s health in yourcountry.

It is not an easy world for our community toprovide good services. For example, I am awareof difficult medico-legal terrain faced in somecountries; others are toiling away in ebola-infected or war-torn countries. I would like tothank all our colleagues for their sincere,strenuous work, undertaken daily, to helpimprove women’s health. The human race lives inhope for better times!

My best wishes to each and every one of you;have an energising and productive few monthsuntil the next issue in September.

Kind regards

Professor Sir Sabaratnam ArulkumaranFIGO President

PRESIDENT’S MESSAGE

L–R: Gabriel Kalakoutis (Vice President of the Cyprus Society of Perinatal Medicine); Dr Jennifer Howse (MOD President); Dr Joe Leigh Simpson (MOD Senior Vice President for Research and Global Programs); Dr Christina Karaoli, President of theCyprus Society of Perinatal Medicine) (1st International Seminar of Perinatal Medicine, Cyprus, March 2015)

Dr Diana Galimberti, Chairof the FIGO Working Groupon Gender Violence

(courtesy of the organisers)

CHIEF EXECUTIVE’S OVERVIEW

In ternat iona l Federat ion of Gynecology and Obstet r ics | May 2015 3

Africa regional meeting in Addis Ababa, and heldits first AGM in Khartoum, Sudan, where 30countries were represented and four additionalcountries joined the Federation (February 2014).

Welcoming Dr Richard Adanu, the new IJGO EditorThe annual meeting of FIGO’s official journal, theInternational Journal of Gynecology & Obstetrics(IJGO), took place in late February. We aredelighted to formally welcome Dr Richard Adanuto the role of IJGO Editor. Please turn to page 9to meet him, and catch up on the detail of themeeting. IJGO truly goes from strength tostrength, and is a ‘must-see’ publication onwomen’s health in low-resource countries. Forthose who prefer online access, a new version ofthe IJGO app is now available for both iPad andiPhone, with upgraded functionality and newfeatures(www.ijgo.org/content/mobileappinfo).

An expanding SecretariatObservers will doubtless have noticed the recentgrowth of the FIGO Secretariat. In this issue, weare delighted to confirm the new-look accountsdepartment and a new addition to the fistulateam, Gillian Slinger, Project Manager.

FIGO is also pleased to announce that MayaSethi, previously a project assistant, has nowbeen confirmed as a Co-ordinator on FIGO’sProject for ‘Institutionalising Post-Partum IUDServices and Increasing Access to Informationand Education on Contraception and SafeAbortion Services’. We wish our new teams thevery best of luck, and look forward to reportingon the progress of their activities in due course.

Until our next issue (August/September 2015), Iwish you all a productive and enjoyable fewmonths.

With best wishes

Professor Hamid RushwanFIGO Chief Executive

FIGO HouseWaterloo Court, 10 Theed StreetLondon SE1 8ST, UKTel: +44 20 7928 1166Fax: +44 20 7928 7099Email: figo@figo.org

The International Federation of Gynecology andObstetrics is a UK Registered Charity (No 1113263;Company No 5498067) registered in England andWales. The Registered Office is shown above.

Administrative Director:Sean O’Donnell

FIGO Officers:

President:Professor Sir Sabaratnam Arulkumaran (United Kingdom)

President-Elect:Professor Chittaranjan Narahari Purandare (India)

Past-President:Professor Gamal Serour (Egypt)

Vice President:Professor Ernesto Castelazo Morales (Mexico)

Honorary Secretary:Professor Gian Carlo Di Renzo (Italy)

Honorary Treasurer:Professor Wolfgang Holzgreve (Switzerland)

Chief Executive:Professor Hamid Rushwan (Sudan/UK) (Ex-officio)

Readers are invited to refer items for consideration byemail to communications@figo.org no later than Friday 19 June 2015 for the next issue.

The views expressed in articles in the FIGO Newsletterare those of the authors and do not necessarily reflectthe official viewpoint of FIGO.

Produced and edited by Alexandra Gilpin at the FIGOSecretariat © FIGO 2015.

International Federation of Gynecology and Obstetrics

(courtesy of the organisers)

The Officers at FIGO House (January 2015)

Professor Rushwan (centre) with colleagues at the Egyptian Fertility and Sterility Society 20th Annual InternationalConference (Cairo, December 2014)

Dear ColleaguesI trust you are well, and have been enjoying anexciting and productive start to 2015. This year isobviously an exceptionally busy time, due to theFIGO triennial World Congress taking place from4–9 October in Vancouver, Canada. We areabuzz with activity as we enter the final stage ofarrangements. Please visit www.figo2015.orgfor the latest information. We greatly value theparticipation of all our attendees, who will benefitenormously from a truly exceptional ScientificProgramme, as well as the chance to touch basewith friends and colleges from all over the world.

My final commitments of 2014 took me to Cairofor the Egyptian Fertility and Sterility Society 20thAnnual International Conference: ‘New Trendsand Developments in Women’s ReproductiveHealth’ (18–19 December 2014). I also attendedthe ‘Basic & Advanced Clinical and LaboratoryTraining Course in Infertility, including ART, forDeveloping Countries’ that was held at Al-Azharjust prior to this (13–17 December 2014),organised by the International Islamic Center forPopulation Studies and Research (IICPSR) Moredetails on these two events can be found onpage five.

Planning for 2021!During early 2015, I commenced a series of sitevisits to the venues selected for consideration forour World Congress in 2021: Yokahama, (Japan),Seoul (South Korea), Sydney and Melbourne(Australia), Singapore and Hyderabad (India). TheCongress rotates through five continents everythree years – the Africa-Eastern Mediterranean,Asia-Oceania, Europe, Latin America and NorthAmerica regions – and the site is selected sixyears in advance by a majority vote at theGeneral Assembly. Due to the fast paced andtightly scheduled world of internationalconference planning, it is necessary to plan forfuture years well ahead, and in great detail. Allvisits ran smoothly, and our thanks go to all thosewho participated in the extensive organisation.

The FIGO Officers – Professor Sir SabaratnamArulkumaran (President); Professor C N

Purandare (President-Elect); Dr ErnestoCastelazo Morales (Vice President); ProfessorGian Carlo Di Renzo (Honorary Secretary);Professor Wolfgang Holzgreve (HonoraryTreasurer); Professor Gamal Serour (Past-President) – and I officially meet twice yearly todiscuss the Federation’s business. We weredelighted to convene at FIGO House in lateJanuary, where a most productive discussionensued to set the agenda for the year.

In February, I attended the second meeting of theFIGO Maternal Nutrition Guidelines project inLondon, where colleagues met to finaliserevisions for this most important, ground-breaking document.

Spotlight on AFOG/KOGS 2015I am pleased to report that in mid-February, theAfrican Federation of Obstetrics and Gynecology(AFOG), in partnership with the Kenya Obstetricaland Gynaecological Society (KOGS), held its firstCongress in Nairobi, Kenya. FIGO was wellrepresented by its President, Professor SirSabaratnam Arulkumaran, who gave an inauguraladdress. Since AFOG’s launch meeting inOctober 2012 at FIGO’s World Congress inRome, it has established a secretariat inKhartoum, actively participated in the first FIGO

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4 In ternat iona l Federat ion of Gynecology and Obstet r ics | May 2015

Dr Jennifer HowseDr Jennifer L Howse has served as President of the March of Dimes Foundation(www.marchofdimes.org) for over twodecades. The March of Dimes mission is toimprove the health of babies by preventing birthdefects, premature birth and infant mortality.

Dr Howse, what is the ethos of The March of Dimes?The March of Dimes was founded in 1938 by theAmerican President Franklin D Roosevelt (FDR).He had contracted polio and could not walk. Thefounding mission of our organisation was to finda way to prevent polio – a mission that wecompleted in 1955 with the development of theSalk and Sabin polio vaccines. Since then theMarch of Dimes has funded research for manylifesaving treatments for newborns at risk. Wehave also launched several preventioncampaigns, including folic acid education forwomen of childbearing age, and a USAPrematurity Prevention Campaign. We seek toembody the qualities of our founder, FDR,including determination, optimism, and the abilityto rally people from all walks of life behind acommon mission.

What attracted you aboutcollaboration with FIGO?More than a decade ago, the March of Dimescreated a global programmes capability, and

After a busy few months, FIGO has nowcompleted the restructuring of its Financedepartment, and is delighted to report thatnew internal systems are up and runningsmoothly. The new team is comprised of:Paul Mudali – Financial Controller; Katarzyna(‘Kasia’) Majak – Finance Administrator; andAtinuke (‘Tinu’) Olanrewaju – ProjectAccountant.

Professor Hamid Rushwan, FIGO ChiefExecutive, said: ‘The Finance department is amost vital part of FIGO – a busy globalorganisation such as ours deals daily withmany international transactions, and we aresure that, with this new team in place, thedepartment will go from strength to strengthand meet its many exciting challengesaccordingly.’

Paul Mudali is a Fellow Chartered CertifiedAccountant, and a post-graduate incomputing. An experienced FinancialConsultant, he has an excellent track record offinancial strategy formulation and management,systems implementation and drivingefficiencies. His work experience includes overfive years in the charity sector, 10 years in themanufacturing sector and six years in auditpractice, working at, among others, the AgaKhan Foundation, Leonard Cheshire Disabilityand Arthur Anderson.

He explained: ‘We are pleased to report thatour system migration went smoothly – the newprocesses being implemented will help us toprovide the very best service to our colleagues,both internationally and here in the Secretariat,with improved control and reporting benefits.’

Katarzyna Majak (‘Kasia’) originally joined FIGOin 2013 from Aramark, subcontractor forPricewaterhouseCoopers, where she workedfor five years, the last two as a FinancialAdministrator. Her role encompassed book-

keeping, financial reporting, liaising with companyaccountants/headquarters, and HR activity.

She said: ‘I am delighted to be working with Pauland Tinu in our newly structured department. Thelast few months have been exceptionally busy,but we are now well settled into our new roles.’

Atinuke (‘Tinu’) Olanrewaju is a charteredaccountant and member of other professionalassociations. She comes to FIGO with over 19years’ finance experience (10 withPricewaterhouseCoopers), including six years’

experience within the UK charity sector. Shehas also worked within finance at Voice 4Change England, IARS (Independent AcademicResearch Studies), Young Minds and VoluntaryAction Camden. Tinu has also served as aWorld Bank Project Accountant.

She said: ‘I’m very excited to have joined theFIGO team. I look forward to working onvarious project finance activities, including theFIGO PPIUD project implementation in sixcountries.’

FIGO welcomes new-look Finance team

received NGO status from the World HealthOrganization (WHO), enabling us to work inpartnership with organisations and governmentsaround the world. We’ve helped women inEcuador get prenatal care and encouragedgovernments throughout South America to addfolic acid to their fortified grains to help reduceneural tube birth defects. Our formal partnershipwith FIGO is a natural extension of our interest inensuring that we learn from countries around theworld and also provide our support and expertisewhere it is most needed, especially in the area ofprematurity prevention.

How will your current relationshipwith FIGO evolve?We hope to learn and contribute much throughcollaboration with our FIGO colleagues. To beginthat process, a survey is underway to look atrates of preterm birth in high income countriesand identify best practices. We know from datathat many countries have rates of preterm birthbelow seven per cent, compared to the UnitedStates’ unacceptable rate of 11.4 per cent. Weare keenly interested in understanding the factorsthat underlie these differences, including publicpolicy, healthcare practice and demographicmakeup. Together, we hope to identify solutionsand best practices that can help all countriesdeliver the most effective maternity care formothers and babies.

Dr Jennifer Howse, President, March of Dimes

(courtesy of March of Dimes)

(courtesy of March of Dimes)

L–R: Tinu, Paul and Kasia

5

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oocyte pick-up, embryo transfer, testicularbiopsy, semen processing and oocyte andembryo handling.

The overall evaluation of the Workshop was‘excellent’, as revealed from analysis of theconfidential evaluation forms completed by thecandidates. Many of them required further handson-training in the clinical and laboratoryelements, and were scheduled in small groups toreceive this during the next six months.

Shortly after, the Egyptian Fertility and SterilitySociety (EFSS) held its 20th Annual InternationalConference: ‘New Trends and Developments inWomen’s Reproductive Health’ (18–19December 2014).

The topics discussed included: IVF,micromanipulation, endoscopic surgery, othermodern diagnostic and therapeutic techniques ininfertility management, male infertility, bioethics ininfertility and modern advances in contraception.

Professors and consultants of obstetrics andgynecology in Egypt were invited to participate inthis important Annual Scientific Meeting, inaddition to many participants from neighbouringcountries. Several national and internationalexperts, including FIGO’s Professor DavidAdamson, were also in attendance.

In ternat iona l Federat ion of Gynecology and Obstet r ics | May 2015

The 7th Workshop of the popular ‘A Basicand Advanced Clinical and LaboratoryTraining course in Infertility, including ART, forDeveloping Countries’ – organised by theInternational Islamic Center for PopulationStudies and Research (IICPSR), Al-AzharUniversity, in collaboration with the FIGOCommittee for Reproductive Medicine – tookplace from 13-17 December 2014.

The rich programme of the Workshop wasorganised by Professor Gamal Serour, Past-President of FIGO and Director of IICPSR, incollaboration with Professor David Adamson,Chair of the FIGO Committee for ReproductiveMedicine. It was held at the IVF unit at Al-AzharUniversity, with 51 candidates in attendancefrom Egypt, Yemen, Uganda, Zambia, Nigeriaand Sudan.

The Faculty of the course included ProfessorGamal Serour, Egypt; Professor Dominique deZiegler, France; Professor Klaus Diedrich,Germany; Professor Pier Giorgio Crosignani,Italy; and Professor Christopher Barratt, UK, inaddition to staff from the ART Unit at theUniversity.

The programme included a didactic element, apanel discussion, case presentations andhands-on training in counselling, monitoring,

Cairo plays host to 7th Infertility Workshop and EFFSAnnual Conference

(courtesy of the organisers)

Chennai celebrates 58th All India Congress ofObstetrics and GynaecologyReport by Dr Narendra Malhotra, FOGSI representative to FIGO

‘The high profile 58th All India Congress of Obstetrics and Gynaecology was held in the city ofChennai in January 2015. A one hour FOGSI-FIGO session was organised, overseen bychairpersons Dr C N Purandare, Dr P K Shah, Dr Narendra Malhotra, and Dr P M Gopinath.

‘Professor Sir Sabaratnam Arulkumaran [FIGO President], Dr Gian Carlo Di Renzo [FIGO HonorarySecretary], and Professor Luis Cabero-Roura [Chair of the FIGO Committee for Capacity Building inEducation and Training] spoke on “Knowledge transfer via the Global Library of Women’s Medicine[www.glowm.com – FIGO’s education platform]”, “FIGO Best Practice in Maternal-FetalMedicine”, and “Millennium Goals after 2015” respectively. Over 350 delegates attended the highlyinteractive session, with robust Q and As from the Chair and audience.’

The next AICOG will be held from 13–17 January 2016, in Agra, India.

New ProjectManager forFIGO FistulaInitiative

Gillian Slinger, Project Manager, the FIGO Fistula Initiative

FIGO is delighted to welcome Gillian Slinger toFIGO House as the FIGO Fistula Initiative’sProject Manager.

Gillian is a midwife and holds a BSc in HealthManagement and an MSc in Public Health. Sheworked as a midwife for 10 years in French-speaking Switzerland, then as a Maternal HealthAdvisor for Médecins Sans Frontières (MSF) andSave the Children in countries including Mali,Chad, Somalia, DRC, Sudan, Bangladesh andSierra Leone.

As part of her MSF duties, Gillian had an activerole in developing projects for women withobstetric fistula. Since this time, her involvementin fistula work increased considerably, taking herto New York for four years as Co-ordinator of theglobal Campaign to End Fistula with UNFPA.

Gillian said: ‘I’m delighted to join the FIGO teamto be able to focus 100 per cent on increasingthe number of trained, skilled fistula surgeonsand health teams, in order to extend the reach ofthe Fistula Surgery Training Initiative and providecare for significantly more women with obstetricfistula.’

(courtesy of the organisers)

Participants at the 7th Infertility Workshop (Cairo, December 2014)

Subscribe to the latest news and updates:www.figo.org/news/figo-fistula-surgery-training-initiative-spring-newsletter-now-available-0014916

FIGO PROJECTS

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New funding secured for expansion ofPPIUD InitiativeFIGO Project for ‘Institutionalising Post-Partum IUD Services and Increasing Access to Information and Educationon Contraception and Safe Abortion Services’ (Donor: anonymous; 2015–2017)

India training session

Many health facilities in Sri Lanka, India, Kenya,Tanzania, Nepal and Bangladesh haveachieved increasing rates of institutionaldeliveries. However, the proportion of postnatalwomen leaving the facilities without receiving acontraceptive method remains high. In SriLanka, for example, the proportion of womenleaving facilities without receiving acontraceptive method of their choice is around97 per cent. As women delivering in healthfacilities rarely return for contraceptiveservices, the immediate post-partum periodpresents an ideal opportunity to provide amuch needed service. Long-acting reversiblecontraceptive methods such as the IUD enablea woman to plan her family, space herpregnancies, increase her productivity, andimprove the health of both her and her baby.

The initiative, piloted in Sri Lanka from 2013,aims to institutionalise the practice of offering

immediate post-partum Intra-Uterine Deviceservices (IUD) in teaching hospitals. Copper IUDscan be used effectively for over 10 years bywomen who want to limit or space theirpregnancies; they have the lowest rates ofdiscontinuation; are cost effective; and can beprovided by mid-level providers long-term aftersuitable training. The woman does not need toreturn to the clinic for new supplies as she wouldwith other contraceptive types, and the devicecan be removed at any time with an almostimmediate return of fertility.

Laura Banks, Project Manager, said: ‘The pilotphase has been very successful. Training for 260healthcare providers in insertion of PPIUD hasbeen conducted, with training of 1,688 nursemidwives and community midwives incounselling women on the benefits of IUDs.There is strong Governmental commitment, withthe inclusion of PPIUD as part of routine datacollection and training support provided by theFamily Health Bureau. A total of 1,079 womenhave received PPIUD services in Sri Lanka duringthis phase.

‘At the end of 2014, a proposal was approved forproject expansion to five additional countries, aswell as 12 additional facilities in Sri Lanka. India,Kenya, Tanzania, Nepal and Bangladesh have allbeen invited to participate, and the proposal hasbeen developed in close collaboration with thenational societies. ‘We have recently recruited anew Project Co-ordinator, and are currently in theprocess of recruiting a new Deputy Project

Director, to assist with the challenges ofexpansion.

The Project Director has undertaken advocacyvisits to new countries, meeting withGovernments to secure IUD provision, medicalequipment and Ministry support. Meetings havebeen held with the National and FacilityCoordinators and visits undertaken to a selectionof the facilities to see first-hand the patientjourney, available services/capacity andpersonnel. Management and Finance visits havebeen undertaken to Kenya, Tanzania, India andNepal, with a visit to Bangladesh planned shortly.Trainings and service provision continue in SriLanka, and trainings will shortly commence in thenew countries.

The initiative will be complemented by a researchcomponent led by the University of Harvard in SriLanka, Nepal and Tanzania, in collaboration withFIGO and the national societies. Development oftailored data collection tools is nearingcompletion and will facilitate tablet-based datacollection to streamline monitoring processesand allow country teams to advocate withMinistries for continued expansion of services,provide evidence-based arguments and ensurequality of service provision.

Since the launch last year of a dedicated sectionon the importance of Family Planning andPrevention of Unsafe Abortion onwww.glowm.com (FIGO’s educational platform),site use has escalated, with a total of 64 millionhits from over 160 different countries in 2014.

In ternat iona l Federat ion of Gynecology and Obstet r ics | May 2015

FIGO Misoprostol for Post-PartumHaemorrhage in Low-Resource SettingsInitiative (Donor: Gynuity Health Projects;2014–2016)

Post-partum haemorrhage (PPH), the mostsignificant direct cause of maternal mortality inlow-resource countries, accounts forapproximately 30 per cent of maternal deathsworldwide and is highly preventable. The mostcommon cause is a failure of the uterus tocontract adequately after delivery. A key aspectin prevention and treatment is uterotonictherapy and the most widely recommendedagent is oxytocin. However, certain factors canhinder its use in low-resource settings.Misoprostol – available in tablet form, relativelyinexpensive, stable at room temperature – hasincreasingly been adopted as an alternativeintervention strategy, one endorsed by FIGOand other international bodies.

FIGO has a joint project with Gynuity HealthProjects to advocate for the use of misoprostolfor post-partum haemorrhage (PPH) preventionand treatment by acting as a ‘guiding’organisation for advocacy among the medicalcommunity and health professionals. Thisinvolves disseminating information on strongevidence-based results relating to theeffectiveness and greater use of misoprostol,and developing materials for dissemination,including guidelines and protocols, forprofessional groups on the use of misoprostolfor PPH.

Jessica Morris, Project Manager, said: ‘Theproject continues to generate substantial

interest among the ob/gyn community, asevidenced by the fact that, to date, nearly 30expert panel sessions on misoprostol formanagement of PPH have been held at regionaland national conferences. These last few monthsalone we have conducted sessions at the SouthAsian Federation of Obstetrics and Gynecology(SAFOG), All India Congress of Obstetrics andGynecology (AICOG) and the 1st regionalcongress of the African Federation of Obstetricsand Gynecology (AFOG/KOGS), where sessionswere well attended and generated activeaudience participation.’

Misoprostol information materials weredistributed at all events, either in delegate bagsor at the panel venue, which increaseddissemination reach. Another vital component ofthe project is to continue to reach out to midwifeassociations as well as ob/gyn associations.Continuing FIGO’s collaboration with theInternational Confederation of Midwives (ICM),FIGO will present a session at the ICM 5thRegional Conference of the Americas this July.

Other important news on misoprostol is thatGynuity Health Projects recently submitted anapplication for the inclusion of misoprostol for itstreatment indication in the WHO’s EssentialMedicines List (EML). Currently misoprostol isincluded in the EML for the prevention of PPHbut not for its treatment indication. Thisapplication specifically requests the inclusion ofmisoprostol (800 mcg sublingual) for treatment ofPPH – it was submitted in December 2014 andwill be considered in the upcoming ExpertCommittee meeting.

FIGO submitted a letter of support for thisapplication which included the signatures ofover 150 organisations and individuals fromacross the globe. Other organisations addedtheir letters of support, too: (www.who.int/selection_medicines/committees/expert/20/applications/misoprostol/en/).The EML Committee held meetings in April2015, and we hope to hear its final decisionsoon.

If you are attending the FIGO World Congress,please look out for the following sessions:`Misoprostol and other uterotonics in themanagement of PPH: New evidence to guideclinic practice’ on Wednesday 7 October at15.30, and ‘Misoprostol for PPH management:service delivery strategies to address PPHwhere options are few’ on Friday 9 October at08.00.

Keeping misoprostol on the global agenda

7In ternat iona l Federat ion of Gynecology and Obstet r ics | May 2015

Fighting Fistula – building thecapacity of fistula surgeonsFistula Training Initiative (Donor: The Fistula Foundation; 2014–2016) – Fellowship ProgrammeAn obstetric fistula is a hole between thevagina and rectum or bladder that is caused byprolonged obstructed labor. It most commonlyoccurs among women who live in low-resourcecountries, who give birth without any access tomedical help. The prolonged obstructed labourwhich causes the fistula also results, in nearlyall cases, in the death of the baby and leavesthe woman suffering from a range of healthproblems which include chronic incontinence.This often has severe psychosocial andsocioeconomic consequences that are broughton by social segregation, which in many casesresults in loss of livelihood, isolation andfeelings of shame and despair.

The aim of the project is to build the capacities offistula surgeons in accredited training centres,using the FIGO Global Competency-BasedFistula Surgery Training Manual. This will helpdedicated physicians to acquire the knowledge,skills and professionalism needed to preventobstetric fistula, and provide high quality surgical,medical and psychosocial care to women whohave incurred fistula, whether during childbirth orbecause of inflicted trauma.

The collaborating countries/locations areEthiopia, Nigeria, Tanzania, Uganda, Senegal andNiger.

Gillian Slinger, the Initiative’s new ProjectManager, said: ‘Recent achievements include theexpansion of the Fistula Surgery TrainingProgramme, so that more surgical Fellows arebeing trained and consequently gain skills andcompetence in fistula surgery. This will extend thereach of the Initiative, and will importantly ensurethat many more women with fistula receive life-restoring, quality treatment in the future.’

Recent activities have comprised a new call inSeptember 2014 for the Fistula FellowshipProgramme, which has received approximately

90 applications from 21 countries.Twenty-fournew Fellows have been placed for training inEthiopia, Nigeria, Tanzania, Uganda and Kenya,and more placements are being planned. Teamtraining trials were launched with teams fromGhana and Yemen at Hamlin Fistula, Ethiopia,and the CCBRT Hospital in Tanzania; oneadvanced training started in November in Nigeria;a monitoring/mentoring visit to Nepal has recentlytaken place – Dr Fekade, one of FIGO’saccredited trainers at Hamlin Fistula, Ethiopia,visited three Nepalese Fellows to further developtheir fistula skills and activities.

In addition, a new FIGO Fistula Surgery TrainingInitiative Newsletter was launched in December2014 to provide quarterly updates to the keyprogramme stakeholders, and to share usefulresources on fistula.

Gillian added: ‘Currently, a 12 month trainingschedule is being organised, including Fellowsfrom countries new to the programme, such asthe Gambia, Pakistan and Somaliland; plans arealso being made to provide additional trainingand support to existing Fellows, to increase theirskills to the next level of competency, and todevelop their fistula activities in their ownfacilities.’

FIGO PROJECTSGestational Diabetes –the maternal health linkto defeating diabetesand NCDsGestational Diabetes Initiative (Donor: Novo Nordisk; 2014–2015)

In most parts of the low-, low-middle andupper-middle income countries (whichcontribute to over 85 per cent of the annualglobal deliveries), the majority of women arenot properly screened for diabetes duringpregnancy. Many of the very same countriesalso account for 80 per cent of the globaldiabetes burden, as well as for over 90 percent of all cases of maternal and perinataldeaths and poor pregnancy outcomes. Giventhe interaction between hyperglycemia andpoor pregnancy outcomes – and the role ofin utero imprinting in increasing the risk ofdiabetes and cardio-metabolic disorders inoffspring of mothers with hyperglycemia inpregnancy, as well as increasing maternalvulnerability to future diabetes andcardiovascular disorders – there needs to bea greater global focus on preventing,screening, diagnosing and managinghyperglycemia in pregnancy.

In recognition of this, FIGO’s Expert group ongestational diabetes has developed acomprehensive resource providingappropriate evidence-based guidance onscreening, diagnosing and providing care forwomen with gestational diabetes mellitus(GDM). This practical and pragmatic guidepromotes a uniform approach to testing,diagnosis and management of GDM for allcountries and regions based on theirfinancial, human and infrastructureresources.

ProfessorMoshe Hod,Chairpersonof the ExpertGroup, said:‘By providingregionalcase studieswe are ableto suggest atemplate foraction which

is within the resource capabilities of thecountry. In addition, the document provides amodel for countries to assess the costeffectiveness of various gestational diabetesscreening and management choices so theycan make the best decision. We are pleasedto announce that this document has alreadybeen endorsed by the following externalorganisations: the International Association ofDiabetes in Pregnancy Study Groups(IADPSG), the European Diabetic PregnancyStudy Group (DPSG), the Diabetes inPregnancy Study Group India (DIPSI), theEuropean Association of Perinatal Medicine(EAPM) and the Chinese Society of PerinatalMedicine.’

The document will be ready for presentationat the FIGO World Congress. If you areinterested in GDM, consider enrolling on thepost-graduate course on 4 October titled‘New Challenges in Maternal Foetal Health;Facing the Global NCD Epidemic – the FIGOGDM Initiative’, as well as attending asession on 5 October on `Developing anddisseminating evidence-based standards ofcare protocols on caring for women withgestational diabetes’, which will be held at13.45.

Setting the Nutritional Agenda: FIGO Recommendationson Adolescent, Preconception and Maternal NutritionGlobal Maternal Nutrition Guidelines project (Donor: Abbott Nutrition International; 2014–2016)

While there is global consensus on the need for women to have optimal nutrition when planning apregnancy, during a pregnancy and in the post-partum period, a comprehensive resource settingout evidence-based guidance on how to achieve this is not available to healthcare professionals.This project’s aim was to create a comprehensive document comprising evidence-basedrecommendations on maternal nutrition, from pre-conception to the post-partum period. Theheadline for the document is ‘Think Nutrition First.’

Mark Hanson, Chairperson of the Expert Group, said: ‘Poor adolescent, preconception andmaternal nutrition represents a major public health issue that affects not only women’s health butalso that of future generations. The FIGO Recommendations address several issues in this area,including general principles about good nutrition, the needs for micro- and macronutrients duringthe phases of the reproductive cycle, and the issues specifically relevant to low-middle and highincome countries. We anticipate that these recommendations will be useful for a wide audience

including health care providers across arange of specialties, health care deliveryorganizations, policy makers, professionalorganisations, teachers and educators, andwomen and their families.’

If you are planning on attending the FIGOWorld Congress and are interested in thistopic, please consider signing up for theworkshop on the FIGO Recommendationson Adolescent, Preconception and MaternalNutrition which will take place on 4 Octoberfrom 14.00–17.00, as well as a panel sessionon the recommendations on 5 October at13.45.

Participants at the FIGO Maternal Nutrition Guidelinesmeeting (February 2015)

FIGO PROJECTS

8 In ternat iona l Federat ion of Gynecology and Obstet r ics | May 2015

The FIGO Prevention ofUnsafe Abortion InitiativeThe FIGO Prevention of Unsafe Abortion Initiative has as its aim the reduction of unsafe abortionrates and the maternal mortality and morbidity associated with unsafe abortion through twocomponents: encouraging FIGO Member Societies to give proper attention to the problem ofunsafe abortion and adopt the FIGO Initiative for the Prevention of Unsafe Abortion; the other isworking directly with Member Societies in ensuring that they are involved in preparing andimplementing a plan of action that serves the affected women. The Initiative involves 46 countries,and concentrates on 16 priority countries with high unsafe abortion and maternal mortality rates.

There are few objectiveparameters withwhich to measurethe progressachieved by theInitiative for thePrevention ofUnsafe Abortion,but those thatexist areencouraging.

It is broadlyrecognised thatchanges in directindicators such asunsafe abortionrates and abortion-related maternalmortality are veryslow and difficult toidentify in shortperiods of time.Abortion rates are

difficult to measure in countries where abortionlaws are restrictive and health statistics unreliableand it would be unrealistic to depend on such anindicator.

Only one small country (Gabon) included areduction in abortion-related mortality in the mainhospital, which takes care of about one third ofall deliveries and abortion complications in thecountry, in its plan of action. As a result it waspossible to calculate the number of abortion-related deaths year by year since the beginningof this Initiative. The main interventions werewithin the hospital: introduction of manualvacuum aspiration (MVA), and a drastic reductionin the delay in care; also very importantly,misoprostol was introduced in the country, andinformation on its correct use was madeavailable.

While the hospital had 19 abortion-related deathsin the three years from 2005 through 2007(before the start of the Initiative), it did not haveone single death during the last three years(2012–2014). It is impossible to know whichfactor was the most influential, but there is nodoubt that the broader use of misoprostolreduced the more severe complications, andmore prompt and proper care of thecomplications prevented the evolution to deathwithin hospital.

The fact that this was a small country facilitatedthe change within a short period of time, but it isan indicator that the kind of intervention inducedthrough the FIGO Initiative is most probably alsohaving an effect in other, larger countries.

More indirect indicators, such as use of MVA andmisoprostol or medical abortion in general for thetreatment of incomplete abortion and legaltermination of pregnancy (LTP), show a relativelyslow but continuous progress, in particular, byintroducing its use in countries where strongresistance to the use of MVA has existed for a

long time. While those countries are neitherpriority countries nor important countries in size,the fact that we are reducing the number ofcountries where MVA is not used reinforces theconcept that it is a technology that has to beadopted by all. This is clearer in Latin America,where there is no longer any single country whichis not yet using MVA for the treatment ofincomplete abortion. This has been achieved byfollowing the strategy that we proposed at thebeginning of the last two year period, which wasto apply our comparative advantage of directrelations with key university teaching hospitals.The possibility of providing MVA kits with theminimum of delay when in obtaining access tothis technology was the sole limiting factor andalso a very important contribution to the progressachieved in MVA use.

The availability of misoprostol in every country isone of the main purposes of the Initiative and wetry to ensure that the countries introduce thatitem into their plans of action. The fact that theplan has to be prepared in conjunction with thegovernment, usually the Ministry of Health, isboth a disadvantage and an advantage. Adisadvantage, because misoprostol is seen as asymbol of facilitating abortion. As such, itbecomes a delicate political matter forgovernments. An advantage, because onceincluded in the plan, the Ministry of Healthbecomes an ally in the process of registeringmisoprostol, for reproductive health indications,including post-partum haemorrhage, or ingeneral. Our role is to advocate including theregistration of misoprostol in as many plans ofaction as possible. One mechanism has been tosupport studies on the effect of availability ofmisoprostol on the rate of abortion complicationsand deaths and on their publication. Theaccumulation of evidence showing theassociation between the availability ofmisoprostol and the reduction of abortion-relatedsevere maternal morbidity and mortality is a verystrong argument in support of introducingmisoprostol or of keeping it available.

Post-abortion contraception was almost non-existent in many countries, or just limited toreferring the patients to a family planning clinic.Within the last two years practically every countryhas introduced post-abortion contraception andthe two basic characteristics – provision of amethod before discharge and emphasis onLARC – are being progressively understood andbecoming part of such programmes, at least inuniversity teaching hospitals. Expansion to otherlarge hospitals is also in progress in severalcountries.

The most important qualitative change has beenthe inclusion of the provision of safe LTP, withinthe limits of the law, sometimes in the plans ofaction or at least in practice, without beingnecessarily in the plans of action. This ishappening both in priority and non-prioritycountries. In order to support such a change, wehave prepared and disseminated a slidepresentation with the aim of supporting broader

access to safe abortion services. Thiseducational material was used by a remarkablenumber of member obstetric and gynecologicalsocieties during their national conferences inorder to distribute the knowledge to themembers who practice in this area. We alsoprepared an article: ‘Evidences supportinggreater access to safe legal abortion’, incollaboration with Iqbal Shah, to be included in asupplement of the International Journal ofGynecology and Obstetrics (IJGO) – the ‘WorldReport on Women’s Health’, edited by ProfessorPurandare, President Elect of FIGO. Thissupplement will be distributed to all colleagueswho register for the next FIGO Congress, to beheld from 4–9 October 2015, in Vancouver,Canada. We expect that the next two years willbe marked by an increasing involvement ofobstetricians and gynecologists in the provisionof safe termination of pregnancy within the limitsof the law.

Evaluation of progress achieved during the last two yearsBy Professor Aníbal Faúndes, Project Director

Professor Aníbal Faúndes, Project Director

Moving forward theagenda on youngpeople, contraceptionand abortion

FIGO recently brought together 34obstetricians/gynecologists, medicalstudents, and delegates from youthadvocacy and reproductive healthorganisations for a workshop on ‘YoungPeople, Contraception and Abortion.’ Theaim was to move the agenda forwardregarding service quality, access, andpartnership in selected South Asiancountries.

The workshop, held in Colombo, Sri Lanka inMarch 2015 (funded by Marie StopesInternational), built on FIGO’s experiencedelivering regional workshops on unsafeabortion and regional discussion groupsbetween obstetricians and young people.The two-day interactive workshop involvedsessions on abortion and contraception,challenges and obstacles to providinginformation and services to young people,ethical issues in providing services, differenttypes of advocacy, and how providers canbe advocates.

The workshop met its three aims of 1)increasing knowledge, specifically regardingmedical eligibility and quality of careconsiderations, 2) creating awareness of andmutual understanding between the differentgroups represented with a view to futurecollaboration, and 3) improving advocacyskills needed for the following: ensuringyoung people are viewed as a priority groupwith specific needs, and increasing youngpeople's access to quality information,education, and safe contraceptive andabortion services. The group also wrote amission statement and country-based actionplans to be delivered over the next sixmonths.

9

FIGO PUBLICATIONSIntroducing Dr Richard Adanu –new Editor of IJGO

from IJGO’s dedicated web platform(www.ijgo.org) more than doubled in 2014 to70,500.

In 2014, we published two supplements andbegan work on the nine supplements planned for2015 – our highest number yet. These includethe World Report on Women’s Health, guestedited by FIGO’s President-Elect, ProfessorChittaranjan Narahari Purandare and Dr Adanu,and the FIGO Cancer Report 2015, guest editedby Professor Lynette Denny. These will bepublished in time for the FIGO World Congress2015, to be held in Vancouver. Plans areunderway for an IJGO author workshop, whichwill be held in collaboration with the BritishJournal of Obstetrics and Gynaecology,Obstetrics & Gynecology, and the Journal ofObstetrics and Gynaecology Canada. We alsohope to see many people at the IJGO and FIGOcongress booth, where we will be promoting thejournal.

IJGO’s journal twitter feed (IJGOLive) hasseen a steady increase since it began in July2014. The new FIGO website contains newand improved dedicated IJGO pages, whichfeature a new section, the ‘Editor’s MonthlyPick’. Here, the Editor chooses his favouritearticle from the current issue and provides ashort commentary about the paper. Lastly, in abid to make the journal available to researcherson the move, a journal iPad app is alsoavailable.

Clare Addington, IJGO managing editor,commented: ‘The journal saw some significantchanges last year that we are confident willcontinue to strengthen IJGO’s position as aunique journal in the field, tackling myriadwomen’s health issues that other journals maynot publish so readily. Our truly internationalreach, with a focus on issues from low- andmiddle-income countries, is something to beproud of.’

In ternat iona l Federat ion of Gynecology and Obstet r ics | May 2015

Dr Richard Adanu chaired his first meeting asIJGO Editor-in-Chief at the annual meeting ofthe Editorial Board held in late February.

IJGO, the official publication of FIGO, had abusy and positive year in 2014, which sawseveral significant changes in the editorial officeand promotion of IJGO via social media.Importantly, Dr Adanu successfully took thehelm from Dr Timothy Johnson, who continuesas Editor Emeritus. Abi Cantor joined the teamin May as Deputy Managing Editor; herexpertise and dedication have been crucial forthe continued improvement of IJGO. IJGO wassaddened to learn of the deaths in 2014 of twoIJGO Board members – Dr Harold Kaminetzky(Editor Emeritus) and Dr Louis Keith (AssociateEditor Emeritus). Their contributions wereremembered in obituaries published in IJGOand they will be sorely missed by the FIGOfamily.

Continuing on from record increases in 2013,the journal received approximately 1,400 newsubmissions in 2014. IJGO was fourth in thelist of most downloaded articles among 16women’s health journals published by Elsevier,with 488,000 downloads. Article downloads

IJGO welcomes a new Editor

Richard M K Adanu, MBChB, MPH was namedthe new Editor of the International Journal ofGynecology and Obstetrics (IJGO) in late 2014.He is a Fellow of the Ghana College ofSurgeons; Fellow of the West African College ofSurgeons; Dean of the School of Public Healthat the University of Ghana; Professor ofPopulation, Family and Reproductive Health;and a Consultant in obstetrics and gynecologyat the University of Ghana. He has been Editorof the Contemporary Issues in Women’s Healthsection and a member of the IJGO EditorialBoard. He has a particular interest in women’shealth issues pertaining to low-resourcecountries.

Dr Adanu… you are at the helm ofIJGO (www.ijgo.org) at a mostexciting period in its history. Whatwill you enjoy most about your newposition?I will most enjoy working with the team of highlyresourceful people on the Editorial Board and inthe journal office. These are all people who arevery passionate about women’s health and arecommitted to ensuring that the IJGO continuesto improve. Using the journal as a medium tohighlight current important issues in clinicalobstetrics and gynecology and women’sreproductive health will also be a very enjoyablething to do. The Board is also committed toensuring that contributions to the journal are from

diverse regions of the world, emphasising ourinternational nature.

IJGO has increasingly modernised:access to the journal throughelectronic media is growing apace –it is available as an app(www.ijgo.org/content/mobileaccessinstructions), and now has apresence on Twitter (@IJGOLive).How will you build on this?The journal will work to have a greater presenceon the social media platform. We intend toregularly send out tweets about the activities ofthe journal office and the Editorial Board. Ournews section on ‘Contemporary Issues onWomen’s Health’ will also provide material thatcan be broadcast on these social mediaplatforms. A new feature is the ‘Editor’s choice’,where one article will be highlighted each monthon Twitter. We will continue to encourage authorsto provide pictures and videos related to theirarticles, which can be featured on the IJGOwebsite.

You are the first Editor from a low-resource country in the journal’s 50-year history. How important is this?This is extremely important and it sends a veryclear message about the fact that FIGO works

with obstetricians and gynecologists from allparts of the world. It also highlights the fact thatinvestment made over the years in low-incomecountries to train academic obstetrician-gynecologists is yielding dividends. FIGO hasdone, and continues to do, a lot of work in Africa,and I feel highly honoured that I can represent thecontinent in service to FIGO in this way.

Dr Richard Adanu, IJGO Editor

(courtesy of the IJGO editorial office)

FIGO MEMBER PROFILE – SOGC

10 In ternat iona l Federat ion of Gynecology and Obstet r ics | May 2015

Collaborating for Quality Care – Aninvitation from the Society of Obstetriciansand Gynaecologists of CanadaBy Dr Jennifer Blake, CEO, SOGC

The Society ofObstetricians andGynaecologists ofCanada (SOGC),founded in 1944, isCanada’s oldestprofessional medicalassociation. For over70 years, the SOGChas worked topromote excellence inthe practice ofobstetrics andgynecology and toadvance the health of

women through leadership, advocacy,collaboration and education. As the leadingauthority on reproductive health care inCanada, the SOGC sets national standards foreducation and clinical practice related towomen’s health issues.

The key to the SOGC’s long tenure andnumerous achievements has been a firmcommitment to quality care and a devoted effortto embrace collaboration. It is comprised of over3,500 professional members, includinggynecologists, obstetricians, family physicians,nurses, midwives and allied health professionals.Throughout the years, we have learned the valueof multi-disciplinary teamwork, as wecontinuously strive to bring together experts fromvarious fields of study to contribute differentperspectives on topics related to women’shealth. We also welcome members from aroundthe world, recognising the value they bring insharing research and experience of practicingmedicine in varying settings.

In our quest to ensure that every woman receivesthe highest standard of quality care, the SOGCgathers the expertise of its members tocontribute to the development, review andupdating of hundreds of clinical practiceguidelines. These guidelines and the informationtherein are then shared during continued medicaleducation events throughout the year and arealso adapted for the creation of public educationtools, so that both health professionals and thepublic have access to the most up to date healthinformation they need. Every guideline that iscreated is based on the highest scientificevidence and involves a rigorous review andvalidation process.

The SOGC’s continued medical education eventsallow our members to update their skills andknowledge with the latest research andinnovations in the field of obstetrics andgynecology. We pride ourselves on offering top-notch medical education. The Advances inLabour and Risk Management (ALARM) course,for example, is recognised around the world as aleading educational initiative for healthprofessionals working in obstetrics. The course ispresented by a multi-disciplinary group ofvolunteers and the content is updated on aregular basis. The ALARM course, and itsderivative the ALARM International Program, hasextended beyond borders and has been adaptedfor use in over 28 countries around the world.

For the past two decades, the SOGC, through itsGlobal Health Program, has worked to contributeto global health equity by leading andparticipating in projects that aim to improvewomen’s health outcomes in low-resource

countries. SOGC members have volunteered todeliver training in emergency obstetric andneonatal care, to adapt guidelines for use in othercountries, to develop quality assurance tools,and to build organisational capacity of Ob/Gynassociations in low-resource countries. Throughthis work, the SOGC has had the honour ofcollaborating with ob/gyn associations aroundthe world, making new friendships and sharingknowledge and experience.

We have had the privilege of working closely withFIGO on these endeavors. The FIGO SavingMothers and Newborns Project and the FIGO-LOGIC Initiative allowed us to grow as a Societyas we learned from our colleagues in countriessuch as Haiti, Uganda, Burkina Faso, and more.Beyond our collaboration on internationalprojects, the SOGC has had a specialrelationship with FIGO for many years. It hasbeen an honour to have Canadianrepresentatives participate on the FIGO Board ofDirectors and on numerous committees, to helpshape the policies and practices that becomeinternational standards. Canada, as a bilingualcountry with a multi-cultural population, hasmany valid lessons to share in our field ofobstetrics and gynecology which could beadapted and applied in other countries that areworking to improve the quality of care deliveredto women.

The SOGC’s close relationship to FIGO, as wellas with other global networks such as thePartnership for Maternal, Newborn, and ChildHealth (PMNCH), has allowed our strong nationalvoice to join others around the world for evengreater impact in advocating for global healthequity. In 2010, these efforts resulted in makingmaternal health a priority topic for the G8Summit, with investments promised anddelivered by several country governments. Sincethen, Canada’s investment in global maternalhealth has grown remarkably, with our PrimeMinister embracing the cause as Canada’snumber one priority for internationaldevelopment. Once again, the underlying reasonfor this success has been embracing the idea ofcollaboration. Canadian medical associations,NGOs and universities have grouped together toform the Canadian Network for Maternal,Newborn, and Child Health (CANMNCH) and areworking together toward the common goal ofimproving the health of women and childrenaround the world.

We have seen the success that results fromworking together, from speaking as a unifiedvoice and collaborating to achieve a commongoal. FIGO offers us an opportunity to gather asa global community of workers in the field ofobstetrics and gynecology to achieve more thanany one of our Societies could do on its own. Welook forward to welcoming the world of ob/gynsto Canada this October at the 21st FIGO WorldCongress, to celebrate our success as a teamand to plan for our future goals.

It is an exciting time for maternal and child healthin Canada and we are eager to share theexcitement with our colleagues from around theworld. Surrounded by the beautiful landscape ofVancouver, the Rocky Mountains will inspire us toset our goals high, because a world where everywoman receives quality care is achievable, aslong as we work together.

Dr Jean Chamberlain, SOGC member volunteer on theFIGO Saving Mothers and Newborns Project, 2006 to 2011.Dr Chamberlain’s participation in this project had such agreat impact on her life, that she has since devoted hercareer to the continued efforts of improving maternal andnewborn health in low-resource countries by founding theorganisation Save the Mothers.

Friendships made during a visit of SOGC membervolunteers Dr Celine Bouchard and Dr Michel Fortier toBurkina Faso (for the SOGC’s Cervical Cancer PreventionProject, 2007–2015).

During the SOGC’s AnnualClinical and ScientificConference, SOGC’s CEO DrJennifer Blake helps SOGCmember Dr Robert Reidcomplete the Test YourMenopause IQ Quiz, aninteractive learning tooldeveloped for healthprofessionals to update theirknowledge on managementof menopause.

SOGC member and former Acting Executive Vice Presidentand Associate Executive Vice President of SOGC, Dr VytaSenikas, welcomes colleagues from Uganda, Dr JollyBayeza and Dr Dan Murokora, at the SOGC’s 2011 AnnualClinical Meeting in Vancouver.

Dr Jennifer Blake, ChiefExecutive Officer, SOGC

(All photographs courtesy of the SOGC)

Save the Date: Vancouver 2015

www.figo2015.org

11In ternat iona l Federat ion of Gynecology and Obstet r ics | May 2015

Diary Dates2nd European Congress on IntrapartumCare21–23 May 2015, Porto, Portugalwww.ecic2015.org19th Ain Shams Obstetrics and GynecologyInternational Conference (ASOGIC)27–28 May 2015, Cairo, Egyptwww.asogic.com24th Asian and Oceanic Congress ofObstetrics and Gynaecology 20153–6 June 2015, Kuching, Sarawak, Malaysiawww.aocog2015.comInternational UrogynecologicalAssociation’s 40th Annual meeting9–13 June 2015, Nice, Francewww.iugameeting.org

FIGO accepts no responsibility for the accuracy of the external event information. Inclusion of any event does not necessarily mean that FIGO either endorses or supports it (unless otherwise stated).

14th World Congress in Fetal Medicine 201521–25 June 2015, Crete, Greecewww.fetalmedicine.org/fmf-world-congress

XXII World Congress of the InternationalSociety for the Study of Vulvovaginal Disease(ISSVD)27–29 July 2015, New York, USAwww.newyork.issvd.org

Swedish Society of Obstetrics andGynecology 201524–27 August 2015, Jonkoping, Swedenwww.sfog.se/start/kalender

7th World Congress on Ovulation Induction3–5 September 2015, Bologna, Italywww.ovulationinduction2015.org

CoGEN: Controversies in preconception, preimplantation and prenatal genetic diagnosis: How will genetics technology drive the future?25–27 September 2015, Paris, Francewww.comtecmed.com/cogen/2015PCS World Congress of Urology 2015(WCU-2015)30–31 October 2015, Warsaw, Polandwww.pcscongress.com/wcu201512th World Congress of Perinatal Medicine3–6 November 2015, Madrid, Spainwww.wcpm2015.com2nd International Conference onGynecology & Obstetrics16–18 November 2015, San Antonio, USAwww.gynecology.conferenceseries.com

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*Low-Resource Countries according to the World Bank classification**Registrars, trainees and midwives are required to submit an official letter on their Institution’s letterhead OR photocopy of their2015/2016 ID from the Institution where they are studying/working, indicating proof of their status, which can be uploaded at the time ofregistration. Registration will not be processed without receipt of this documentation.

Please note, the FIGO 2015 Organising Committee has made an effort to ensure that registration feesare in line with the previous two FIGO Congresses.

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