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Gynaecological

Articles by Gynaecological

Youth volunteers handing out information on sexual & reproductive healthcare in Albania.
19 December 2018

Revolutionizing access to cervical cancer screening in rural Albania

Albania is home to 2,870,324 people, approximately half are women and girls. The political events of the 1990s saw Albania become one of the poorest countries in Europe, leaving the nation to try and rebuild their fractured infrastructure. Including an ill-equipped healthcare system, that is still struggling to keep up with demand. Today, Albania benefits from a universal healthcare system, but not without its issues. Albania has the lowest proportion of doctors for its population in Europe - 115 per 100,000, meaning those that live in hard to reach and rural areas face additional barriers to life-saving healthcare. Barriers to healthcare Cervical cancer is the 4th most common female cancer in women aged 15 to 44 years in Albania. Although Albania has a national cervical cancer screening programme, it is not widely promoted, and the service is not always available. Relying on the traditional method of screening – the Pap smear – further complicates women’s access, as the majority of health centers lack basic equipment and resources including gynaecological beds and specialist gynaecologists. The long processing times from the initial test to receiving the results adds further complication to women seeking cervical cancer screening. The situation worsens when it comes to rural areas, where 45 percent of the population lives. Many women also face financial barriers when it comes to accessing healthcare.  Increasing women’s access In December 2015, IPPF’s Member Association, the Albanian Centre of Population and Development (ACPD), began a campaign to increase women’s access to healthcare in rural areas. An alternative, faster and cost-effective cervical cancer screening tool and treatment plan were developed – a method known as VIA and Cryotherapy. What is VIA & Cryotherapy? Show more + Visual inspection of the cervix with acetic acid (VIA) is a process of screening and examining the cervix. Pre-cancerous lesions on the cervix will turn white when the acid is applied.  This simple procedure can be done in a clinic setting without the use of a laboratory and allows for immediate treatment of any pre-cancerous lesions with cryotherapy. Cryotherapy is a gynaecological treatment that freezes and destroys abnormal, pre-cancerous cervical cells. Cryotherapy is not a treatment for cervical cancer. VIA has the potential to revolutionize cervical cancer prevention efforts, particularly in low resource settings, because it eliminates the need for laboratories, transportation of specimens and provides immediate test results.   VIA needs less equipment and fewer specialists than traditional cervical cancer screening methods like Pap tests. Results from VIA are available immediately so women can be screened and treated in one single visit.  Working with the Ministry of Health and Social Protection (MoHSP), ACPD advocated for the nationwide inclusion of VIA and cryotherapy to Albania’s national cervical cancer screening program. There are many benefits to VIA, that include:   Relatively inexpensive compared to pap smears A simple process that can be done with minimal equipment Results and treatment (cryotherapy) for pre-cancerous cells are immediate Quick turnaround time means fewer women lost in follow-up Can be performed by a wide range of medical professionals after training   Since the launch of the campaign in 2015, ACPD has reached over 1000,000 women and men through their clinics, mobile outreach, videos and social media.  520 were young people and 390 men and women were based in rural areas. Between 2016-2017 3,274 women were screened and 70 healthcare providers were trained to give VIA tests and Cryotherapy treatment. So far, the results have been encouraging. Mrs. Brunilda Hylviu, head of ACPD says that “this cost-effective cervical cancer screening tool is well-accepted, and most women were thrilled by the idea that the pre-cancerous lesions could be screened and eliminated at the same visit. We have seen tears of joy in women’s eyes and got heartfelt hugs from women who have been examined with VIA. Health professionals have a positive attitude regarding VIA because they can see in practice how effective it is with patients.” She says staff working at the health centers are very enthusiastic about VIA seeing the value it has added to the services they provide for their communities.   National action plan for cervical screening For the Albanian Centre of Population and Development, 2018 is the year of advocacy. “What we ask from the Government is first to prepare a National Action Plan for the Screening of Cervical Cancer as other countries in the region did. Second, to include VIA as an effective method proved for screening in rural areas. We do agree that Albania as a European country should aim for highest standards of screening such as HPV, but considering that we still have areas where women live without potable water or electricity, we see VIA as an alternative screening method based on evidence approved by WHO. Our motto is that not a single woman should die from cervical cancer and a good national screening program that reaches every woman can achieve this objective.” The challenges ahead are still big, but Brunilda is hopeful that they can make a difference.  “I am hopeful that we will have a positive result and we will succeed”, she says.

Hope on the horizon - FGM in Somaliland
17 May 2018

Watch: Hope on the Horizon: FGM in Somaliland

Female genital mutilation (FGM) is a procedure that involves altering or injuring female genitalia for non-medical reasons.   It is estimated that almost 200 million women and girls worldwide have undergone some form of FGM. FGM has been recorded in 30 countries with Somaliland having one of the highest prevalence rates in the world at 98% for women and girls aged between 15 - 49 years old. Hope on the horizon documents the hard work IPPF member association SOFHA (Somaliland Family Health Association) is doing within the local community to help change minds and eventually bring an end to female genital mutilation (FGM). Slowly, but surely, attitudes are changing.

Amal during her outreach work to end FGM in Somaliland

"Dignity, respect and bravery are guiding principles for our work on female genital mutilation (FGM)"

I left Somaliland when I was 9 years old with my mother, brother, uncles, aunts and cousins. It was the civil war and we were lucky enough to reach Canada as refugees. I remember that time as a pleasant, warm, loving time where my cousins and I had a lot of freedom to play, walk to school and daydream. I am from Somaliland so of course I am part of the 97-98% or so of girls who undergo the female genital cut. I think it happened when I was around seven years old. I remember being restrained. I remember strangers being around and I remember peeing standing up and it burning. These memories don’t come up often and they don’t cause me pain. It’s a distant, childhood event. A cousin and a niece my age were there and we went through it together and afterwards our mothers and aunts took care of us. I grew up, went to school, questioned the world and my role in it for a time, got married, had kids and eventually went back to Somaliland. There I met Edna Adan Ismail and asked to volunteer with her. She opened her office, hospital and life to me and I became immersed in the maternal health issues of the women in my home country. The effort to end FGM Most were not as lucky as I had been. Because of FGM/C (female genital mutilation/circumcision), most had experienced recurring infections and difficulties in child birth. Some had formed cysts, some became infertile, and some had obstetric fistula. But few linked these problem to the cutting. At SOFHA (Somaliland Family Health Association) we’ve been working to help women (and men) understand these links and get the help they need. That’s only a part of the work. The effort to end FGM/C in Somaliland goes back almost 40 years. FGM/C programs and projects have been happening for at least the last 25 years. We’re now at the point where it’s recognized as a legitimate, critical, health and social issue. We’re on the cusp of a law against the practice and I have personally witnessed a transformation among the individuals who engage in this work. NGO and government staff tasked with working on FGM/C used to go into communities apologetically, “Sorry but we have to talk to you about this ‘issue’, we know it’s unpleasant but bear with us” to “I have 2 daughters and I have not cut them. This is a terrible practice and we must stop it now”. It fills me with great joy to see young women and men taking this personal stance and doing it confidently and proudly. But it’s not easy for most people to do this. It certainly wasn’t for me. This is personal. This is private. Before I got into the work I might have said, “What business is it of yours anyway? Do you really want me digging into your private life? Into your past and history? I am not a victim. I may be a survivor but not in the way you think and not for the reasons you imagine. I am bigger than this. This doesn’t define me.” Dignity, bravery, respect And it may not define most Somali women. I think that’s what confuses many people. Maybe it’s because it happens in childhood and those memories are lost or hidden or maybe because mothers and grandmothers have such good intentions or maybe because it’s so universal within the community? That’s why it’s a completely different experience for a young Somali girl born and brought up somewhere else. The experience is very personal and it varies from person to person. Dignity, respect and bravery are guiding principles for our work on female genital mutilation. In Somaliland, a dynamic young generation connected to the world through the internet, and integrated multi-pronged FGM/C programming, is helping us to influence a generation of Somalis to abandon the cut and break the cycle. It’s still some distance away but we see the end in sight. Words Amal Ahmed, the executive director of our Member Association in Somaliland (SOFHA) 

nurse in IPPF-run clinic.  credits: IPPF/Jane Mingay/Georgia
05 February 2018

Supporting FGM survivors in Ireland

Ireland has taken important steps in recent years in the fight to end female genital mutilation (FGM). At the domestic level, the Criminal Justice (Female Genital Mutilation) Act was introduced in 2012 to prohibit FGM and, as part of its Overseas Development Assistance, Ireland has contributed towards the UNFPA-UNICEF Joint Programme on FGM, which is the largest global initiative to accelerate the elimination of FGM. Since 2014, the Irish Family Planning Association (IFPA) has provided comprehensive medical and psychological care to women and girls in Ireland who have experienced FGM. The FGM Treatment Service is publicly funded which enables the IFPA to provide care to affected women and girls free of charge. Although the practice is mostly concentrated in Africa and the Middle East, the phenomenon of global migration means women and girls affected by FGM live across the globe, including in Western Europe. It is estimated that more than 5,000 women and girls living in Ireland have experienced FGM. IFPA Medical Director Caitriona Henchion says, “FGM is recognised internationally as a violation of the human rights of women and girls. It causes harm and has no health benefits. In fact, it can result in short- and long-term health complications, such as pain, infection, menstrual problems, urinary tract problems and sexual difficulties.” The IFPA engages in outreach activities to promote awareness of the FGM Treatment Service amongst those who have experienced FGM. Dr Henchion explains, “A key challenge for us as a healthcare provider is raising awareness about this free service amongst affected communities. FGM can be difficult for women to talk about – it’s a very stigmatised topic. We want women to know our staff provide completely confidential, non-judgmental care. Our doors are open.” In our outreach work, the IFPA frames FGM as one of a range of sexual and reproductive healthcare issues impacting ethnic minority women and we provide information about cervical and breast screening, contraception, menopause and screening for sexually transmitted infections (STIs) alongside information about the FGM Treatment Service. This is in recognition of the fact that the issue of FGM is part of a wider set of issues in healthcare provision for women from minority ethnic backgrounds, particularly asylum seekers and refugees. The IFPA also educates frontline service providers, such as healthcare professionals, about FGM and its harms. Dr Henchion says, “FGM is not yet fully integrated into medical education in Ireland. As a result, healthcare providers may not understand what FGM is or how many women and girls are affected globally. We want to equip them with the knowledge to recognise FGM and refer women to existing services if needed.” While the provision of financial support for the FGM Treatment Service is an important aspect of efforts to address FGM, the State must take more ownership over the issue in order to effectively combat FGM. Legislation alone is insufficient to ensure the abandonment of the practice. The IFPA believes a government-led interagency committee, with representation from key government departments and other state and non-governmental bodies, is required to comprehensively tackle FGM. Such a committee could take responsibility for the development of a national action plan across the key areas of prevention, protection, provision (for women and girls who have experienced FGM) prosecution and promotion (of efforts to eradicate FGM). 

Clinic in Somaliland
05 February 2018

Female genital mutilation (FGM) is a human rights violation

Eliminating Female genital mutilation (FGM) is finally in the spotlight of the international policy agenda. It is part of the United Nations sustainable development goal 5 – to achieve gender equality and empower all women and girls, with a target to “eliminate all harmful practices, such as child, early and forced marriage and female genital mutilation”. The World Health Organization estimates that more than 200 million girls and women worldwide have been subjected to FGM, with approximately three million girls at risk each year. The majority of girls are cut before they turn 15 years old. Female genital mutilation (FGM) comprises of all procedures that involve altering or injuring the female genitalia for non-medical reasons and is recognized internationally as a violation of the human rights of girls and women. FGM is a human rights violation, a form of torture and an extreme form of violence and discrimination against girls and women, rooted in harmful gender norms. The continuation of FGM sustains massive gender inequalities in practising societies, as it limits opportunities for women and girls to realize their full rights and potential. In areas where FGM is prevalent, IPPF clinics are often the first point of contact for affected women. To date, IPPF has put in place various efforts to advance this work, including; the launch and dissemination of a Statement by the International Medical Advisory Panel (IMAP), offering programmatic recommendations to MAs on how to address FGM; provision of technical and financial support to implement FGM-related initiatives in key countries; partnership building. IPPF Member Associations (MAs) play a pivotal role in tackling social norms that hinder meaningful and equal participation in society including, FGM. MAs promote enabling legal environments and facilitate access to services and reparation, provide comprehensive care to women affected by FGM and generate evidence on best practice. "I cannot talk about the bedroom when all I experience is pain and recurrent infection. My husband knows this. We both agree that our daughter will never be cut' and growing understanding from young male peer educators, 'we do not need to cut our daughters at all, not even the 'sunna'. I will marry whoever I marry but she does not need to be cut. If I have daughters, they will not be cut, not at all." Somaliland Family Health Association (SOFHA) and the diaspora women at the frontline of change At a prevalence rate of 98.9% Somaliland has one of the highest rates of FGM in the world. With evidence showing that about 1 in 5 girls who have been subjected to FGM, had the procedure performed by a trained medical professional (in some countries it is as high as 3 in 4 girls). Somaliland Family Health Association (SOFHA), the IPPF MA in Somaliland is at the forefront of advocacy to end FGM. A baseline research carried out by SOFHA and partners showed that FGM is widespread and cuts across all ages and locations, including in urban and rural communities. Implemented with funding support from the Norwegian Development Agency (NORAD), “Empowering a first generation of Somalis to Abandon FGM”, is a flagship initiative that has gained momentum and is catalysing change from the grassroots upwards. Inspired by their belief in social norm change that is from their own experience and that of their peers, many Somali women from the diaspora are returning home to lead the struggle to end FGM. Amal Ahmed and Edna Adan Ismail, SOFHA executive director and president, are some of those leading the struggle by building partnerships with government ministries and civil society organisations (some of whose leaders are also returnees from the Diaspora), in schools and communities and reaching out to young women of the Somali diaspora - to build a movement for social change; "We recognise that to succeed in ending FGM - we must work at all levels and with all players, including religious leaders, young people, mothers and grandmothers; focusing on human rights and gender equality and to speak in a language that is understood". Yet the practice is far from over. Much more needs to be done, to anchor policy into practice. IPPF and Member Associations will continue to fight for change to ensure women and girls can live free from sexual and reproductive coercion and all forms of gender based violence.

A nurse administering a HIV test
23 January 2018

The Global Gag Rule: The impact in Burundi

Burundi is landlocked between Democratic Republic of the Congo, Rwanda, and Tanzania. Of the estimated 10.72 million population, 67% live below the poverty line. Association Burundaise pour le Bien-Etre Familial, (ABUBEF) set up in 1991, provides a range of essential services, with a strong focus on HIV. Around 84,000 people are living with HIV in Burundi, of whom 12,000 are children under 14.  ABUBEF’s focus is on HIV prevention and management: from youth-friendly counselling to programmes to prevent mother-to-child transmission.   The withdrawal of US funding due to the Global Gag Rule will drastically reduce and, in some instances, close ABUBEF’s vital healthcare services and programmes. It is estimated that loss of funding to ABUBEF through the global gag rule will deny 117,016 people access to safe, sexual and reproductive healthcare. ABUBEF currently supports around 2, 123 people with anti-retroviral treatment, who will be affected by the cuts. Donavine Uwimana, Executive Director of ABUBEF, “The GGR affects our very existence, with a forecasted funding cut of 39% in 2017 as well as a major decline in the supply of almost all sexual and reproductive health and HIV commodities.” ABUBEF provides services to a range of clients including people living with HIV such as pregnant women, internally displaced persons and sex workers. The impact through funding losses affects service provision – including safe delivery for HIV-positive women, and a reduction in medical staff and drugs and commodities available. IPPF is trying to find alternative funds to fill the gaps – a combination of long- and short-term measures to avoid closures and reductions in services. Donavine explains how far-reaching the impact is for ABUBEF: “Almost all contraceptives, HIV reagents, STI drugs, antiretroviral and consumables for HIV management are procured through UNFPA, USAID and US-financed government programmes, which will be affected by the GGR,” she says. IPPF visited several ABUBEF run projects at risk of closure across Burundi that included a centre in Kirundo for vulnerable women such as sex workers and survivors of gender-based violence.  And in Ngozi, an HIV clinic that provides mobile clinics, and a maternity ward with a focus on the prevention of mother-to-child transmission. Learn more about the Global Gag Rule Help us bridge the funding gap

IPPFの支援を受ける家族(スリランカ)

New International Planned Parenthood Federation and Marie Stopes International agreement to strengthen future global family planning services

International Planned Parenthood Federation and Marie Stopes International (MSI) announced at their annual Donors meetings this week, a new Organisational Agreement between the two organisations to respond to the challenging environment in delivering sexual and reproductive health services and rights. IPPF and MSI will commit each of their organisational strengths to maximize the benefit to women and girls from each and every dollar received. The agreement, signed by IPPF Director General, Tewodros Melesse and Simon Cooke, MSI’s Chief Executive Officer, acknowledges the value of both competition and cooperation. It is will drive quality, efficiency across services, advocacy efforts and data capture at global, regional and national levels. The agreement also will look at a joint effort to develop national plans in 12 countries. Tewodros Melesse, IPPF Director General, said on signing the agreement “It is evident that the global environment for sexual and reproductive health and rights services has changed. This means that we have to find new ways to improve how we drive services at country level. This agreement is an opportunity to make sustainable change and also ensure that each and every client will get the best experience and care wherever and whoever they are.” Simon Cooke, CEO of Marie Stopes International, said: “We look forward to working in greater collaboration with IPPF on specific projects, to ensure that many more women and girls in developing countries are able to receive the contraception and safe abortion services that will help them take control of their futures. The priority for both our organisations is to get the best outcome for the millions of women worldwide who depend on our services.” The agreement covers three areas of cooperation: Operations: Greater coordination to reduce duplication at national level Mobilise joint strengths to address service gaps in national health systems Extend geographic coverage for SRHR services Increase mix of service delivery channels Strengthen systems for cross referral where needed Strength supply chains Facilitate learning and sharing Work within client’s individuals rights frameworks Delivers providers’ needs Advocacy: Aligned missions for joint advocacy efforts Advocacy that expands access for most underserved Mapping and division of labour of policy and advocacy in different spheres Key deliverables at national and global level that cover advocacy issues, joint plans and accountability of FP2020 progress and implementation Data: Sharing and supporting use of data tools and processes for effectiveness Data sharing for advocacy Joint initiatives to improve indicators and reporting Improving health outcomes through supporting use of client based data Develop a shared research agenda Subscribe to IPPF's updates

IDP camp in Yemen, served by IPPF
17 May 2017

Humanitarian crises are not temporary, nor are sexual and reproductive health needs

Women and girls are disproportionately affected in humanitarian crises and face multiple sexual and reproductive health challenges in these contexts. IPPF has been providing much needed support to vulnerable communities through our global federation of member associations, who provide contextualised, timely and tailored interventions drawing on local partners' knowledge and expertise. However, recent shifts in the global political landscape are concerning and threaten to undermine IPPF's mission and impact on the ground. We live in a time when crises, whether brought on by human causes or natural disaster, have displaced more people than at any point since the Second World War. The needs of those driven from their homes are not transitory. Refugees now find themselves facing impermanent conditions for an average of 20 years. They must resort to living in temporary shelters or makeshift accommodation, and their refugee status often leaves them ineligible to access public healthcare and education. The UN reports there are more than 125 million people worldwide in need of humanitarian assistance. Of those, a quarter are women and girls between the ages of 15 and 49. And one in five of these women and girls is likely to be pregnant. A woman who has been forced to flee is particularly vulnerable. More than 60% of maternal deaths take place in humanitarian and fragile contexts, according to the UN Population Fund (UNFPA). At least half of these women’s lives could easily be saved. And yet women and girls affected by humanitarian crises face other risks too. A breakdown in civil order following disasters consistently increases the occurrence of sexual violence, exposure to sexually transmitted infections including HIV, and unintended pregnancies. After the 2015 cyclone in the Pacific Island nation of Vanuatu, a counselling centre recorded a 300% spike in gender-based violence referrals. Likewise, a study with Syrian refugee women displaced by conflict found that more than 50% experienced reproductive tract infections, almost a third had experienced gender-based violence, and the majority had not sought medical care. IPPF is at the forefront of delivering life-saving services. Our sexual and reproductive health program in crisis and post-crisis situations (SPRINT), established in 2007 and supported by the Australian Government, has ensured access to essential sexual and reproductive health services for women, men and children in times of crisis. Under the banner of our new IPPF Humanitarian division, the SPRINT initiative is now part of a global movement that seeks to provide all those affected by crises worldwide with dignity, protection and care. As a federation of 142 locally-owned but globally connected member associations, IPPF has a unique model for providing these vital humanitarian services. Our focus on valuing local solutions means our responses are rapid and sustainable. We see it as vital to be on the ground before, during, and after crises. Member associations work to mitigate against sexual and reproductive health (SRH) issues ahead of a crisis to reduce negative impacts, and remain afterward to assist communities to recover and rebuild their lives. When Cyclone Winston struck Fiji in February last year, IPPF’s local member association, the Reproductive and Family Health Association of Fiji (RFHAF), was already preparing to mobilise teams of volunteers and health staff. Initially, sexual and reproductive health was not prioritised at a national level, thus the first challenge was to convince the Government of Fiji and lead agencies of the critical importance of including sexual and reproductive health issues in the response. With support from IPPF and SPRINT personnel, RFHAF successfully advocated with the government to include reproductive health concerns into the post-cyclone needs assessment, and supported the Government in carrying this assessment out. Coordination and collaboration was critical as the damage was across an extensive area on several islands. Working in partnership with the Ministry of Health (MoH), UNFPA, Red Cross Society and local non-government agencies, RFHAF provided SRH care to remote areas identified as being worst hit by the cyclone. Colleagues from SPRINT and RFHAF split into three teams, moving into the field simultaneously to conduct 37 mobile medical missions to reach women and girls, with vulnerable pregnant women and new mothers prioritised. Comprehensive follow up beyond the initial response post-cyclone was a particular challenge for an organisation of just 11 staff. To address this, RFHAF leveraged their existing partnership with the MoH to facilitate training and handover of SRH service provision to district nurses and sub-divisional health centres, once these facilities were again operational. The response in Fiji utilised the Minimum Initial Service Package for Reproductive Health, which IPPF helped to pioneer. Commonly referred to as ‘the MISP’, the package is a series of priority life-saving interventions that IPPF seek to implement as soon as possible following a crisis.

A young female client helped by a project via IPPF

Global Gag Rule expansion will leave a fatal legacy for generations

The lives of millions of the world’s poorest women and girls are in jeopardy because of the expansion of the US Global Gag Rule (GGR), IPPF’s Director General has said. The expansion of the GGR (or Mexico City Policy) will deny critical health care to many of the poorest women on the planet, forcing millions of them into unplanned pregnancies, unsafe abortions and leading to thousands of deaths. Tewodros Melesse was speaking after the announcement of the policy expansion last night. It means that access to critical affordable, high quality integrated reproductive healthcare services like contraception, Zika information, maternal health, ante-natal care, reproductive cancers, and HIV prevention and treatment will be denied around the world. The policy will hit hardest the women living at the margins of society – the poorest, the most remote and those under 25. Leaving millions behind and forced into unintended pregnancy, ill health or death because the essential services they need have or are being shut down. Tewodros Melesse, Director General, said: “This expansion of the Global Gag Rule is unprecedented and the largest of its kind. Leaving behind the hardest to reach and often poorest of marginalised women and communities is the worst possible situation. This policy asks IPPF to stop providing support, counselling and services which are entirely legal in the countries where our members provide them and women depend on them. We cannot do that. The consequences are fatal and will span generations. We believe women should be able to decide what happens to their bodies, safely and legally. We cannot accept a demand which we know will only increase the number of women being forced into pregnancy or worse. “    IPPF estimates that the withdrawal in funding from the Federation will lead to an additional 20,000 maternal deaths, 4.8 million unintended pregnancies and 1.7 million unsafe abortions.     The expanded policy also obstructs the potential health partnerships on the ground in developing countries where IPPF Member Associations work closely with other medical organizations for referrals and support of clients. This means that the very valuable space between medical providers and patients will be compromised as referrals options become limited and as valuable services are closed. USAID has been a proud supporter of family planning and public health programming for decades. The enormous expense on USAID to administer this kind of order, for what could be a limited time, means the very money allocated to what they have done best – saving lives will be hugely diminished in impact and effectiveness. International Planned Parenthood Federation will lose 100 M USD in critical funding. On behalf of their members, the Federation issued a statement in January explaining why they can't sign the Global Gag Rule.   Subscribe to our updates!

IPPF clinician from Uganda

All of the clients, all of the time: Our staff never turn anyone away

At the end of a long day, Anicia, closes the clinic with praise for her colleagues who never turn anyone away. "We open at 8am. From 8am we will be receiving a variety of clients for different services - whether post-abortion care, whether antenatal care - we have to give them all the services. We may end up to 10pm, because we'll never chase our clients, we'll never close the place when we have a client inside. People come when they have no hope. You receive them, and you give them hope by treating them properly and giving them quality services. The client gets better and will never forget you. And follow them up on the phone. "How are you doing?" It's good for us to know that they're doing well. Others even tell us 'The way you handle us, we love it so much'." Follow a day in the life of our team and clients in Gulu, Uganda 07:00 08:00 9:00 10:00 11:00 12:00 13:00 14:00 15:00 16:00 17:00 22:00 Prev Next 7am: The team prepare for the long day ahead "Every year tens of thousands of Ugandans come to our clinic. Everyone is welcome. Here are just a few of the people that we served in one day last month." READ MORE 8am: Nancy, 19, becomes a volunteer "I was suffering but when I came here, I was treated and I got better. Now I'm inspired to volunteer here" READ MORE 9am: Monica, 25, a sex worker's story "I am sex working. I came here for Hepatitis B testing and also counselling. I have so many personal problems, but here….they’re so caring." READ MORE 10am: Jane, 23, saved by family planning "After multiple miscarriages, family planning here has helped me a lot. I'm glad we've been able to space the number of children we've had. I am not growing old, I am fresh." READ MORE 11am: Vicky, handling disabilities "I'm deaf so accessing services is hard, but here they really try to speak in sign language." READ MORE 12pm: Dorcus, first time patient "This is the first time I've ever come here, I like the service. They give good counselling so I recommend coming." READ MORE 1pm: Christine, 45, a grandmother's tale of living with HIV "I am living with HIV and had HPV. They treated me and now I'm free of cervical cancer." READ MORE 2pm: Lilian, struggling mother of six with sickle cell " I have sickle cell disease and so do all my children. I want to have my tube removed so that I don't get pregnant again but I don't know if my husband will allow it." READ MORE 3pm: Brenda and Francis get fertility treatments "Fertility treatment is a sensitive issue in Uganda but they help us a lot and we get proper treatment." READ MORE 4pm: Joyce, 25, repected regardless of her disability "I realised that at this place they don't segregate. Us people with disabilities have challenges at the main hospitals. You go there, people around look at you as if you are not a human being and you don't fall sick." READ MORE 5pm: Mobile clinic provides outreach services to remote villages "Our outreach to remote communities is a 'one-stop-centre'. We give family planning, vaccines for HPV, malaria, and Hepatitis B, HIV testing and more." READ MORE 22pm: Still giving the last client our very best "Together, we have great teamwork. Sometimes we're still working up to 10pm because we never chase out our clients. We’ll never close the place when we have a client inside. People come when they have no hope." READ MORE

Youth volunteers handing out information on sexual & reproductive healthcare in Albania.
19 December 2018

Revolutionizing access to cervical cancer screening in rural Albania

Albania is home to 2,870,324 people, approximately half are women and girls. The political events of the 1990s saw Albania become one of the poorest countries in Europe, leaving the nation to try and rebuild their fractured infrastructure. Including an ill-equipped healthcare system, that is still struggling to keep up with demand. Today, Albania benefits from a universal healthcare system, but not without its issues. Albania has the lowest proportion of doctors for its population in Europe - 115 per 100,000, meaning those that live in hard to reach and rural areas face additional barriers to life-saving healthcare. Barriers to healthcare Cervical cancer is the 4th most common female cancer in women aged 15 to 44 years in Albania. Although Albania has a national cervical cancer screening programme, it is not widely promoted, and the service is not always available. Relying on the traditional method of screening – the Pap smear – further complicates women’s access, as the majority of health centers lack basic equipment and resources including gynaecological beds and specialist gynaecologists. The long processing times from the initial test to receiving the results adds further complication to women seeking cervical cancer screening. The situation worsens when it comes to rural areas, where 45 percent of the population lives. Many women also face financial barriers when it comes to accessing healthcare.  Increasing women’s access In December 2015, IPPF’s Member Association, the Albanian Centre of Population and Development (ACPD), began a campaign to increase women’s access to healthcare in rural areas. An alternative, faster and cost-effective cervical cancer screening tool and treatment plan were developed – a method known as VIA and Cryotherapy. What is VIA & Cryotherapy? Show more + Visual inspection of the cervix with acetic acid (VIA) is a process of screening and examining the cervix. Pre-cancerous lesions on the cervix will turn white when the acid is applied.  This simple procedure can be done in a clinic setting without the use of a laboratory and allows for immediate treatment of any pre-cancerous lesions with cryotherapy. Cryotherapy is a gynaecological treatment that freezes and destroys abnormal, pre-cancerous cervical cells. Cryotherapy is not a treatment for cervical cancer. VIA has the potential to revolutionize cervical cancer prevention efforts, particularly in low resource settings, because it eliminates the need for laboratories, transportation of specimens and provides immediate test results.   VIA needs less equipment and fewer specialists than traditional cervical cancer screening methods like Pap tests. Results from VIA are available immediately so women can be screened and treated in one single visit.  Working with the Ministry of Health and Social Protection (MoHSP), ACPD advocated for the nationwide inclusion of VIA and cryotherapy to Albania’s national cervical cancer screening program. There are many benefits to VIA, that include:   Relatively inexpensive compared to pap smears A simple process that can be done with minimal equipment Results and treatment (cryotherapy) for pre-cancerous cells are immediate Quick turnaround time means fewer women lost in follow-up Can be performed by a wide range of medical professionals after training   Since the launch of the campaign in 2015, ACPD has reached over 1000,000 women and men through their clinics, mobile outreach, videos and social media.  520 were young people and 390 men and women were based in rural areas. Between 2016-2017 3,274 women were screened and 70 healthcare providers were trained to give VIA tests and Cryotherapy treatment. So far, the results have been encouraging. Mrs. Brunilda Hylviu, head of ACPD says that “this cost-effective cervical cancer screening tool is well-accepted, and most women were thrilled by the idea that the pre-cancerous lesions could be screened and eliminated at the same visit. We have seen tears of joy in women’s eyes and got heartfelt hugs from women who have been examined with VIA. Health professionals have a positive attitude regarding VIA because they can see in practice how effective it is with patients.” She says staff working at the health centers are very enthusiastic about VIA seeing the value it has added to the services they provide for their communities.   National action plan for cervical screening For the Albanian Centre of Population and Development, 2018 is the year of advocacy. “What we ask from the Government is first to prepare a National Action Plan for the Screening of Cervical Cancer as other countries in the region did. Second, to include VIA as an effective method proved for screening in rural areas. We do agree that Albania as a European country should aim for highest standards of screening such as HPV, but considering that we still have areas where women live without potable water or electricity, we see VIA as an alternative screening method based on evidence approved by WHO. Our motto is that not a single woman should die from cervical cancer and a good national screening program that reaches every woman can achieve this objective.” The challenges ahead are still big, but Brunilda is hopeful that they can make a difference.  “I am hopeful that we will have a positive result and we will succeed”, she says.

Hope on the horizon - FGM in Somaliland
17 May 2018

Watch: Hope on the Horizon: FGM in Somaliland

Female genital mutilation (FGM) is a procedure that involves altering or injuring female genitalia for non-medical reasons.   It is estimated that almost 200 million women and girls worldwide have undergone some form of FGM. FGM has been recorded in 30 countries with Somaliland having one of the highest prevalence rates in the world at 98% for women and girls aged between 15 - 49 years old. Hope on the horizon documents the hard work IPPF member association SOFHA (Somaliland Family Health Association) is doing within the local community to help change minds and eventually bring an end to female genital mutilation (FGM). Slowly, but surely, attitudes are changing.

Amal during her outreach work to end FGM in Somaliland

"Dignity, respect and bravery are guiding principles for our work on female genital mutilation (FGM)"

I left Somaliland when I was 9 years old with my mother, brother, uncles, aunts and cousins. It was the civil war and we were lucky enough to reach Canada as refugees. I remember that time as a pleasant, warm, loving time where my cousins and I had a lot of freedom to play, walk to school and daydream. I am from Somaliland so of course I am part of the 97-98% or so of girls who undergo the female genital cut. I think it happened when I was around seven years old. I remember being restrained. I remember strangers being around and I remember peeing standing up and it burning. These memories don’t come up often and they don’t cause me pain. It’s a distant, childhood event. A cousin and a niece my age were there and we went through it together and afterwards our mothers and aunts took care of us. I grew up, went to school, questioned the world and my role in it for a time, got married, had kids and eventually went back to Somaliland. There I met Edna Adan Ismail and asked to volunteer with her. She opened her office, hospital and life to me and I became immersed in the maternal health issues of the women in my home country. The effort to end FGM Most were not as lucky as I had been. Because of FGM/C (female genital mutilation/circumcision), most had experienced recurring infections and difficulties in child birth. Some had formed cysts, some became infertile, and some had obstetric fistula. But few linked these problem to the cutting. At SOFHA (Somaliland Family Health Association) we’ve been working to help women (and men) understand these links and get the help they need. That’s only a part of the work. The effort to end FGM/C in Somaliland goes back almost 40 years. FGM/C programs and projects have been happening for at least the last 25 years. We’re now at the point where it’s recognized as a legitimate, critical, health and social issue. We’re on the cusp of a law against the practice and I have personally witnessed a transformation among the individuals who engage in this work. NGO and government staff tasked with working on FGM/C used to go into communities apologetically, “Sorry but we have to talk to you about this ‘issue’, we know it’s unpleasant but bear with us” to “I have 2 daughters and I have not cut them. This is a terrible practice and we must stop it now”. It fills me with great joy to see young women and men taking this personal stance and doing it confidently and proudly. But it’s not easy for most people to do this. It certainly wasn’t for me. This is personal. This is private. Before I got into the work I might have said, “What business is it of yours anyway? Do you really want me digging into your private life? Into your past and history? I am not a victim. I may be a survivor but not in the way you think and not for the reasons you imagine. I am bigger than this. This doesn’t define me.” Dignity, bravery, respect And it may not define most Somali women. I think that’s what confuses many people. Maybe it’s because it happens in childhood and those memories are lost or hidden or maybe because mothers and grandmothers have such good intentions or maybe because it’s so universal within the community? That’s why it’s a completely different experience for a young Somali girl born and brought up somewhere else. The experience is very personal and it varies from person to person. Dignity, respect and bravery are guiding principles for our work on female genital mutilation. In Somaliland, a dynamic young generation connected to the world through the internet, and integrated multi-pronged FGM/C programming, is helping us to influence a generation of Somalis to abandon the cut and break the cycle. It’s still some distance away but we see the end in sight. Words Amal Ahmed, the executive director of our Member Association in Somaliland (SOFHA) 

nurse in IPPF-run clinic.  credits: IPPF/Jane Mingay/Georgia
05 February 2018

Supporting FGM survivors in Ireland

Ireland has taken important steps in recent years in the fight to end female genital mutilation (FGM). At the domestic level, the Criminal Justice (Female Genital Mutilation) Act was introduced in 2012 to prohibit FGM and, as part of its Overseas Development Assistance, Ireland has contributed towards the UNFPA-UNICEF Joint Programme on FGM, which is the largest global initiative to accelerate the elimination of FGM. Since 2014, the Irish Family Planning Association (IFPA) has provided comprehensive medical and psychological care to women and girls in Ireland who have experienced FGM. The FGM Treatment Service is publicly funded which enables the IFPA to provide care to affected women and girls free of charge. Although the practice is mostly concentrated in Africa and the Middle East, the phenomenon of global migration means women and girls affected by FGM live across the globe, including in Western Europe. It is estimated that more than 5,000 women and girls living in Ireland have experienced FGM. IFPA Medical Director Caitriona Henchion says, “FGM is recognised internationally as a violation of the human rights of women and girls. It causes harm and has no health benefits. In fact, it can result in short- and long-term health complications, such as pain, infection, menstrual problems, urinary tract problems and sexual difficulties.” The IFPA engages in outreach activities to promote awareness of the FGM Treatment Service amongst those who have experienced FGM. Dr Henchion explains, “A key challenge for us as a healthcare provider is raising awareness about this free service amongst affected communities. FGM can be difficult for women to talk about – it’s a very stigmatised topic. We want women to know our staff provide completely confidential, non-judgmental care. Our doors are open.” In our outreach work, the IFPA frames FGM as one of a range of sexual and reproductive healthcare issues impacting ethnic minority women and we provide information about cervical and breast screening, contraception, menopause and screening for sexually transmitted infections (STIs) alongside information about the FGM Treatment Service. This is in recognition of the fact that the issue of FGM is part of a wider set of issues in healthcare provision for women from minority ethnic backgrounds, particularly asylum seekers and refugees. The IFPA also educates frontline service providers, such as healthcare professionals, about FGM and its harms. Dr Henchion says, “FGM is not yet fully integrated into medical education in Ireland. As a result, healthcare providers may not understand what FGM is or how many women and girls are affected globally. We want to equip them with the knowledge to recognise FGM and refer women to existing services if needed.” While the provision of financial support for the FGM Treatment Service is an important aspect of efforts to address FGM, the State must take more ownership over the issue in order to effectively combat FGM. Legislation alone is insufficient to ensure the abandonment of the practice. The IFPA believes a government-led interagency committee, with representation from key government departments and other state and non-governmental bodies, is required to comprehensively tackle FGM. Such a committee could take responsibility for the development of a national action plan across the key areas of prevention, protection, provision (for women and girls who have experienced FGM) prosecution and promotion (of efforts to eradicate FGM). 

Clinic in Somaliland
05 February 2018

Female genital mutilation (FGM) is a human rights violation

Eliminating Female genital mutilation (FGM) is finally in the spotlight of the international policy agenda. It is part of the United Nations sustainable development goal 5 – to achieve gender equality and empower all women and girls, with a target to “eliminate all harmful practices, such as child, early and forced marriage and female genital mutilation”. The World Health Organization estimates that more than 200 million girls and women worldwide have been subjected to FGM, with approximately three million girls at risk each year. The majority of girls are cut before they turn 15 years old. Female genital mutilation (FGM) comprises of all procedures that involve altering or injuring the female genitalia for non-medical reasons and is recognized internationally as a violation of the human rights of girls and women. FGM is a human rights violation, a form of torture and an extreme form of violence and discrimination against girls and women, rooted in harmful gender norms. The continuation of FGM sustains massive gender inequalities in practising societies, as it limits opportunities for women and girls to realize their full rights and potential. In areas where FGM is prevalent, IPPF clinics are often the first point of contact for affected women. To date, IPPF has put in place various efforts to advance this work, including; the launch and dissemination of a Statement by the International Medical Advisory Panel (IMAP), offering programmatic recommendations to MAs on how to address FGM; provision of technical and financial support to implement FGM-related initiatives in key countries; partnership building. IPPF Member Associations (MAs) play a pivotal role in tackling social norms that hinder meaningful and equal participation in society including, FGM. MAs promote enabling legal environments and facilitate access to services and reparation, provide comprehensive care to women affected by FGM and generate evidence on best practice. "I cannot talk about the bedroom when all I experience is pain and recurrent infection. My husband knows this. We both agree that our daughter will never be cut' and growing understanding from young male peer educators, 'we do not need to cut our daughters at all, not even the 'sunna'. I will marry whoever I marry but she does not need to be cut. If I have daughters, they will not be cut, not at all." Somaliland Family Health Association (SOFHA) and the diaspora women at the frontline of change At a prevalence rate of 98.9% Somaliland has one of the highest rates of FGM in the world. With evidence showing that about 1 in 5 girls who have been subjected to FGM, had the procedure performed by a trained medical professional (in some countries it is as high as 3 in 4 girls). Somaliland Family Health Association (SOFHA), the IPPF MA in Somaliland is at the forefront of advocacy to end FGM. A baseline research carried out by SOFHA and partners showed that FGM is widespread and cuts across all ages and locations, including in urban and rural communities. Implemented with funding support from the Norwegian Development Agency (NORAD), “Empowering a first generation of Somalis to Abandon FGM”, is a flagship initiative that has gained momentum and is catalysing change from the grassroots upwards. Inspired by their belief in social norm change that is from their own experience and that of their peers, many Somali women from the diaspora are returning home to lead the struggle to end FGM. Amal Ahmed and Edna Adan Ismail, SOFHA executive director and president, are some of those leading the struggle by building partnerships with government ministries and civil society organisations (some of whose leaders are also returnees from the Diaspora), in schools and communities and reaching out to young women of the Somali diaspora - to build a movement for social change; "We recognise that to succeed in ending FGM - we must work at all levels and with all players, including religious leaders, young people, mothers and grandmothers; focusing on human rights and gender equality and to speak in a language that is understood". Yet the practice is far from over. Much more needs to be done, to anchor policy into practice. IPPF and Member Associations will continue to fight for change to ensure women and girls can live free from sexual and reproductive coercion and all forms of gender based violence.

A nurse administering a HIV test
23 January 2018

The Global Gag Rule: The impact in Burundi

Burundi is landlocked between Democratic Republic of the Congo, Rwanda, and Tanzania. Of the estimated 10.72 million population, 67% live below the poverty line. Association Burundaise pour le Bien-Etre Familial, (ABUBEF) set up in 1991, provides a range of essential services, with a strong focus on HIV. Around 84,000 people are living with HIV in Burundi, of whom 12,000 are children under 14.  ABUBEF’s focus is on HIV prevention and management: from youth-friendly counselling to programmes to prevent mother-to-child transmission.   The withdrawal of US funding due to the Global Gag Rule will drastically reduce and, in some instances, close ABUBEF’s vital healthcare services and programmes. It is estimated that loss of funding to ABUBEF through the global gag rule will deny 117,016 people access to safe, sexual and reproductive healthcare. ABUBEF currently supports around 2, 123 people with anti-retroviral treatment, who will be affected by the cuts. Donavine Uwimana, Executive Director of ABUBEF, “The GGR affects our very existence, with a forecasted funding cut of 39% in 2017 as well as a major decline in the supply of almost all sexual and reproductive health and HIV commodities.” ABUBEF provides services to a range of clients including people living with HIV such as pregnant women, internally displaced persons and sex workers. The impact through funding losses affects service provision – including safe delivery for HIV-positive women, and a reduction in medical staff and drugs and commodities available. IPPF is trying to find alternative funds to fill the gaps – a combination of long- and short-term measures to avoid closures and reductions in services. Donavine explains how far-reaching the impact is for ABUBEF: “Almost all contraceptives, HIV reagents, STI drugs, antiretroviral and consumables for HIV management are procured through UNFPA, USAID and US-financed government programmes, which will be affected by the GGR,” she says. IPPF visited several ABUBEF run projects at risk of closure across Burundi that included a centre in Kirundo for vulnerable women such as sex workers and survivors of gender-based violence.  And in Ngozi, an HIV clinic that provides mobile clinics, and a maternity ward with a focus on the prevention of mother-to-child transmission. Learn more about the Global Gag Rule Help us bridge the funding gap

IPPFの支援を受ける家族(スリランカ)

New International Planned Parenthood Federation and Marie Stopes International agreement to strengthen future global family planning services

International Planned Parenthood Federation and Marie Stopes International (MSI) announced at their annual Donors meetings this week, a new Organisational Agreement between the two organisations to respond to the challenging environment in delivering sexual and reproductive health services and rights. IPPF and MSI will commit each of their organisational strengths to maximize the benefit to women and girls from each and every dollar received. The agreement, signed by IPPF Director General, Tewodros Melesse and Simon Cooke, MSI’s Chief Executive Officer, acknowledges the value of both competition and cooperation. It is will drive quality, efficiency across services, advocacy efforts and data capture at global, regional and national levels. The agreement also will look at a joint effort to develop national plans in 12 countries. Tewodros Melesse, IPPF Director General, said on signing the agreement “It is evident that the global environment for sexual and reproductive health and rights services has changed. This means that we have to find new ways to improve how we drive services at country level. This agreement is an opportunity to make sustainable change and also ensure that each and every client will get the best experience and care wherever and whoever they are.” Simon Cooke, CEO of Marie Stopes International, said: “We look forward to working in greater collaboration with IPPF on specific projects, to ensure that many more women and girls in developing countries are able to receive the contraception and safe abortion services that will help them take control of their futures. The priority for both our organisations is to get the best outcome for the millions of women worldwide who depend on our services.” The agreement covers three areas of cooperation: Operations: Greater coordination to reduce duplication at national level Mobilise joint strengths to address service gaps in national health systems Extend geographic coverage for SRHR services Increase mix of service delivery channels Strengthen systems for cross referral where needed Strength supply chains Facilitate learning and sharing Work within client’s individuals rights frameworks Delivers providers’ needs Advocacy: Aligned missions for joint advocacy efforts Advocacy that expands access for most underserved Mapping and division of labour of policy and advocacy in different spheres Key deliverables at national and global level that cover advocacy issues, joint plans and accountability of FP2020 progress and implementation Data: Sharing and supporting use of data tools and processes for effectiveness Data sharing for advocacy Joint initiatives to improve indicators and reporting Improving health outcomes through supporting use of client based data Develop a shared research agenda Subscribe to IPPF's updates

IDP camp in Yemen, served by IPPF
17 May 2017

Humanitarian crises are not temporary, nor are sexual and reproductive health needs

Women and girls are disproportionately affected in humanitarian crises and face multiple sexual and reproductive health challenges in these contexts. IPPF has been providing much needed support to vulnerable communities through our global federation of member associations, who provide contextualised, timely and tailored interventions drawing on local partners' knowledge and expertise. However, recent shifts in the global political landscape are concerning and threaten to undermine IPPF's mission and impact on the ground. We live in a time when crises, whether brought on by human causes or natural disaster, have displaced more people than at any point since the Second World War. The needs of those driven from their homes are not transitory. Refugees now find themselves facing impermanent conditions for an average of 20 years. They must resort to living in temporary shelters or makeshift accommodation, and their refugee status often leaves them ineligible to access public healthcare and education. The UN reports there are more than 125 million people worldwide in need of humanitarian assistance. Of those, a quarter are women and girls between the ages of 15 and 49. And one in five of these women and girls is likely to be pregnant. A woman who has been forced to flee is particularly vulnerable. More than 60% of maternal deaths take place in humanitarian and fragile contexts, according to the UN Population Fund (UNFPA). At least half of these women’s lives could easily be saved. And yet women and girls affected by humanitarian crises face other risks too. A breakdown in civil order following disasters consistently increases the occurrence of sexual violence, exposure to sexually transmitted infections including HIV, and unintended pregnancies. After the 2015 cyclone in the Pacific Island nation of Vanuatu, a counselling centre recorded a 300% spike in gender-based violence referrals. Likewise, a study with Syrian refugee women displaced by conflict found that more than 50% experienced reproductive tract infections, almost a third had experienced gender-based violence, and the majority had not sought medical care. IPPF is at the forefront of delivering life-saving services. Our sexual and reproductive health program in crisis and post-crisis situations (SPRINT), established in 2007 and supported by the Australian Government, has ensured access to essential sexual and reproductive health services for women, men and children in times of crisis. Under the banner of our new IPPF Humanitarian division, the SPRINT initiative is now part of a global movement that seeks to provide all those affected by crises worldwide with dignity, protection and care. As a federation of 142 locally-owned but globally connected member associations, IPPF has a unique model for providing these vital humanitarian services. Our focus on valuing local solutions means our responses are rapid and sustainable. We see it as vital to be on the ground before, during, and after crises. Member associations work to mitigate against sexual and reproductive health (SRH) issues ahead of a crisis to reduce negative impacts, and remain afterward to assist communities to recover and rebuild their lives. When Cyclone Winston struck Fiji in February last year, IPPF’s local member association, the Reproductive and Family Health Association of Fiji (RFHAF), was already preparing to mobilise teams of volunteers and health staff. Initially, sexual and reproductive health was not prioritised at a national level, thus the first challenge was to convince the Government of Fiji and lead agencies of the critical importance of including sexual and reproductive health issues in the response. With support from IPPF and SPRINT personnel, RFHAF successfully advocated with the government to include reproductive health concerns into the post-cyclone needs assessment, and supported the Government in carrying this assessment out. Coordination and collaboration was critical as the damage was across an extensive area on several islands. Working in partnership with the Ministry of Health (MoH), UNFPA, Red Cross Society and local non-government agencies, RFHAF provided SRH care to remote areas identified as being worst hit by the cyclone. Colleagues from SPRINT and RFHAF split into three teams, moving into the field simultaneously to conduct 37 mobile medical missions to reach women and girls, with vulnerable pregnant women and new mothers prioritised. Comprehensive follow up beyond the initial response post-cyclone was a particular challenge for an organisation of just 11 staff. To address this, RFHAF leveraged their existing partnership with the MoH to facilitate training and handover of SRH service provision to district nurses and sub-divisional health centres, once these facilities were again operational. The response in Fiji utilised the Minimum Initial Service Package for Reproductive Health, which IPPF helped to pioneer. Commonly referred to as ‘the MISP’, the package is a series of priority life-saving interventions that IPPF seek to implement as soon as possible following a crisis.

A young female client helped by a project via IPPF

Global Gag Rule expansion will leave a fatal legacy for generations

The lives of millions of the world’s poorest women and girls are in jeopardy because of the expansion of the US Global Gag Rule (GGR), IPPF’s Director General has said. The expansion of the GGR (or Mexico City Policy) will deny critical health care to many of the poorest women on the planet, forcing millions of them into unplanned pregnancies, unsafe abortions and leading to thousands of deaths. Tewodros Melesse was speaking after the announcement of the policy expansion last night. It means that access to critical affordable, high quality integrated reproductive healthcare services like contraception, Zika information, maternal health, ante-natal care, reproductive cancers, and HIV prevention and treatment will be denied around the world. The policy will hit hardest the women living at the margins of society – the poorest, the most remote and those under 25. Leaving millions behind and forced into unintended pregnancy, ill health or death because the essential services they need have or are being shut down. Tewodros Melesse, Director General, said: “This expansion of the Global Gag Rule is unprecedented and the largest of its kind. Leaving behind the hardest to reach and often poorest of marginalised women and communities is the worst possible situation. This policy asks IPPF to stop providing support, counselling and services which are entirely legal in the countries where our members provide them and women depend on them. We cannot do that. The consequences are fatal and will span generations. We believe women should be able to decide what happens to their bodies, safely and legally. We cannot accept a demand which we know will only increase the number of women being forced into pregnancy or worse. “    IPPF estimates that the withdrawal in funding from the Federation will lead to an additional 20,000 maternal deaths, 4.8 million unintended pregnancies and 1.7 million unsafe abortions.     The expanded policy also obstructs the potential health partnerships on the ground in developing countries where IPPF Member Associations work closely with other medical organizations for referrals and support of clients. This means that the very valuable space between medical providers and patients will be compromised as referrals options become limited and as valuable services are closed. USAID has been a proud supporter of family planning and public health programming for decades. The enormous expense on USAID to administer this kind of order, for what could be a limited time, means the very money allocated to what they have done best – saving lives will be hugely diminished in impact and effectiveness. International Planned Parenthood Federation will lose 100 M USD in critical funding. On behalf of their members, the Federation issued a statement in January explaining why they can't sign the Global Gag Rule.   Subscribe to our updates!

IPPF clinician from Uganda

All of the clients, all of the time: Our staff never turn anyone away

At the end of a long day, Anicia, closes the clinic with praise for her colleagues who never turn anyone away. "We open at 8am. From 8am we will be receiving a variety of clients for different services - whether post-abortion care, whether antenatal care - we have to give them all the services. We may end up to 10pm, because we'll never chase our clients, we'll never close the place when we have a client inside. People come when they have no hope. You receive them, and you give them hope by treating them properly and giving them quality services. The client gets better and will never forget you. And follow them up on the phone. "How are you doing?" It's good for us to know that they're doing well. Others even tell us 'The way you handle us, we love it so much'." Follow a day in the life of our team and clients in Gulu, Uganda 07:00 08:00 9:00 10:00 11:00 12:00 13:00 14:00 15:00 16:00 17:00 22:00 Prev Next 7am: The team prepare for the long day ahead "Every year tens of thousands of Ugandans come to our clinic. Everyone is welcome. Here are just a few of the people that we served in one day last month." READ MORE 8am: Nancy, 19, becomes a volunteer "I was suffering but when I came here, I was treated and I got better. Now I'm inspired to volunteer here" READ MORE 9am: Monica, 25, a sex worker's story "I am sex working. I came here for Hepatitis B testing and also counselling. I have so many personal problems, but here….they’re so caring." READ MORE 10am: Jane, 23, saved by family planning "After multiple miscarriages, family planning here has helped me a lot. I'm glad we've been able to space the number of children we've had. I am not growing old, I am fresh." READ MORE 11am: Vicky, handling disabilities "I'm deaf so accessing services is hard, but here they really try to speak in sign language." READ MORE 12pm: Dorcus, first time patient "This is the first time I've ever come here, I like the service. They give good counselling so I recommend coming." READ MORE 1pm: Christine, 45, a grandmother's tale of living with HIV "I am living with HIV and had HPV. They treated me and now I'm free of cervical cancer." READ MORE 2pm: Lilian, struggling mother of six with sickle cell " I have sickle cell disease and so do all my children. I want to have my tube removed so that I don't get pregnant again but I don't know if my husband will allow it." READ MORE 3pm: Brenda and Francis get fertility treatments "Fertility treatment is a sensitive issue in Uganda but they help us a lot and we get proper treatment." READ MORE 4pm: Joyce, 25, repected regardless of her disability "I realised that at this place they don't segregate. Us people with disabilities have challenges at the main hospitals. You go there, people around look at you as if you are not a human being and you don't fall sick." READ MORE 5pm: Mobile clinic provides outreach services to remote villages "Our outreach to remote communities is a 'one-stop-centre'. We give family planning, vaccines for HPV, malaria, and Hepatitis B, HIV testing and more." READ MORE 22pm: Still giving the last client our very best "Together, we have great teamwork. Sometimes we're still working up to 10pm because we never chase out our clients. We’ll never close the place when we have a client inside. People come when they have no hope." READ MORE