The INFO Project Blog

Two months ago I landed in Addis Ababa, Ethiopia to carry out the Africa-based segment of the Elements of Family Planning Success Project. Activities are now in full swing! There is a growing interest in knowledge management in this country and region, so this project is very timely. In addition, social networking sites, such as African Path Village are gaining in popularity.

I’ve demonstrated the FP Success Web site to several Ethiopian colleagues, including the staff of the Ethiopian AIDS Resource Center and members of the Implementing Best Practices (IBP) Initiative’s Ethiopia Country Team.

I’m excited to be involved with both IBP activities in Ethiopia and the FP Success Project and hope to channel the two efforts to work together. In April I accompanied Suzanne Reier and Dr. Abonesh Hailemariam, two colleagues working on IBP from the WHO, to the northern region of Tigray. There we met with representatives from the IBP partner organizations USAID/DELIVER, Pathfinder, the Relief Society of Tigray (REST), and the Regional Health Bureau. This team had previously identified that logistics and contraceptive supply was an issue in this region, and are now working together to address this problem. While touring some of the local clinics we had the opportunity to meet with some of the region’s Health Extension Workers who talked about their experiences with community outreach. This trip provided a great snapshot of the family planning situation in rural Ethiopia and what local organizations are doing to work towards family planning success.

I have also started working on the Population Reports issue on this topic. This report will be unique in that it will combines opinions, lessons learned, best practices from FP programmers around the world with the latest evidence-based research. The report, along with an e-learning course, will be available in September, so stay tuned!

What else has INFO been up to in Africa? Two weeks ago I attended the conference “Investing in Young People’s Health and Development: Research that Improves Policies and Programs” in Abuja, Nigeria. At the conference I presented “Using Knowledge Management to Improve Reproductive Health Programs for Young People,” which focused on how the INFO Project uses the Knowledge Management principles to develop information products and services to “get the right knowledge to the right people at the right time.”

While I was in Nigeria I had the opportunity to interview three family planning professionals for the FP Success Web site. Bright Ekweremadu, Managing Director of Nigeria’s Society for Family Health spoke about effective communication and outreach strategies. I also conducted two interviews with Pathfinder staff: Mike Egboh, the Pathfinder Nigeria Country Director, spoke about leadership and Dr. Habib Sadauki, Senior FP/RH Advisor, weighed in on integrated programs.

We have several interviews planned for Ethiopia, including Dr. Abonesh Hailemariam of WHO and Dr. Gelila Kidane, Country Director for EngenderHealth.

Look for these interviews soon on www.fpsuccess.org!

Until recently, the topic of population was not frequently associated with addressing climate change. Now, thanks to collaborative efforts from experts in both fields, the world is beginning to recognize that reducing unmet need for contraception not only helps women to prevent unintended pregnancies, it can also can have a positive impact on the environment.

On February 20, fellow INFO staffer Vanessa Mitchell and I attended the panel discussion, “Population and Climate Change: Relationships, Research, and Responses” at the Woodrow Wilson International Center for Scholars. This event featured Brian O’Neill, scientist at the Institute for the Study of Society and the Environment, and Joseph Speidel, adjunct professor in the Department of Obstetrics, Gynecology & Reproductive Sciences at UCSF. (Dr. Speidel has a long history with INFO. He played a key role in creating the INFO Project’s precursor, the Population Information Program, and is a faithful reviewer of Population Reports. He also serves on INFO’s Editorial Advisory Committee.) The discussion marked the launch of a year-long meeting series sponsored by the Environmental Change and Security Program on population-health-environment issues.

Dr. O’Neill’s talk focused on the correlation between population size and emissions, noting that aging and urbanization may significantly affect the outlook for future emissions. He also points out that long-term climate change goals may be less costly if we are not facing a population boom. Read the rest of this entry »

In an article published today in the Lancet, Oxford University researchers report that women taking combined oral contraceptives (COCs) for 15 years halved their chances of developing ovarian cancer. Although the findings are not unexpected (we’ve known for over 20 years that COCs help protect against this disease) this study, which pools worldwide data from 45 studies, confirms that that protection begins soon after a woman starts taking COCs, and increases with increasing duration of use. Read the rest of this entry »

Antiretrovirals (ARVs) given as prophylaxis reduce mother-to-child transmission (MTCT) of HIV by decreasing replication of HIV–and thus the amount of virus–in pregnant women and by protecting newborns during and after exposure to HIV. The simplest regimen, and the most practical and cost-effective regimen in resource-low settings, is a single dose of neviripine (NVP) given to the mother at the onset of labor plus a single dose for the infant soon after birth. This intervention can reduce MTCT by one-third.

The recent issue of Population Reports, “Family Planning Choices for Women With HIV” highlights what providers and women with HIV need to know about preventing mother-to-child transmission.

To date, studies have not found that ARVs given as prophylaxis during pregnancy for MTCT place mothers and infants at greater risk for serious or life-threatening events. There is a concern, however, that women who have received NVP during pregnancy will develop NVP-resistant mutations of HIV, which, if spread, would make it difficult to successfully treat infected mothers and their babies with NVP in the future.

The topic came to our attention today with news from AFP about reduced drug resistance in a new drug therapy.

The article discusses results of a recent clinical trial published in the latest issue of the Lancet. Researchers found that adding a single dose of tenofovir and emtriciabine (two other NNRTI ARVs) at delivery reduced maternal resistance to NNRTIs by 50%. The study notes that this finding is “especially relevant now that both drugs have been incorporated into first-line treatment in many African countries.”

These results are good news for mothers with HIV and for programs in resource-scarce settings. Adding the new single-dose combination to to the standard single-dose NVP treatments is a low-cost, feasible approach to protect the health of mothers with HIV and the health of their future children.

Click here for more resources on preventing mother-to-child transmission of HIV.

Posted by Katie Richey, INFO Project

Our South African colleague raises some key issues. Sexual violence and male involvement are important aspects of any FP/HIV initiative. All women with HIV, including those who encounter sexual violence, need access to health care providers who are knowledgeable about family planning and reproductive health in the context of HIV.

Providers can help women with HIV make informed reproductive health decisions and plan how to talk with their partners about contraception and safer sex. The World Health Organization counseling tool, “Reproductive Choices and Family Planning for People Living with HIV” offers guidance for providers to help women make informed choices and includes tips on talking with partners.

Does anyone have additional input on provider’s perceptions of counseling and providing care to women with HIV? In your experience, are providers aware that women with HIV can use nearly any family planning method? Do women with HIV encounter unnecessary medical barriers to family planning?

Catherine E. Richey, MPH
Senior Technical Writer
The INFO Project
Johns Hopkins Bloomberg School of Public Health