Newsletter March 2010
ICRH Belgium Newsletter
The 4th of March 2010
Kick off CERCA : community embedded reproductive health care for teenagers in Latin America
A new multi-partner research program starts on the 1st of March 2010 , coordinated by ICRH and financed by the FP7 program of the European Commission.
CERCA, Community Embedded Reproductive health Care for Adolescents in Latin America, is an interventional research project that seeks to contribute to global knowledge about how health systems can be more responsive to teenagers’ sexual and reproductive health needs . Its immediate objective is to create a community- embedded health care intervention that will empower adolescents. The partners involved are South Group - Bolivia, the University of Cuenca - Ecuador, the Amsterdam School for Social Sciences – Netherlands, the University of Kaunas – Lithuania, the University of Managua – Nicaragua and the Instituto Centro Americano de la Salud – Nicaragua.
Teenagers in Latin America are confronted with serious sexual and reproductive health problems and are at major risk for HIV and sexually transmitted infections, and for unwanted pregnancies, leading to a higher number of unsafe abortions and increased maternal health risk.
During a first stage the consortium will search for a better understanding of the socio-economic factors that shape reproductive and sexual health and healthcare policy in Latin America. Subsequently a comprehensive strategy for community-embedded interventions will be developed in three Latin American cities: Cochabamba, Cuenca and Managua. The interventions will target improved access to adolescent-friendly reproductive health care in primary health services, a supporting and enabling environment and strengthened adolescent competence to make healthy reproductive health choices. A strong emphasis will be placed on the use of the Internet to reach adolescents. The strategy will then be implemented and tested on its impact and applicability. The analysis of the implementation processes and the evaluation results will help to develop a framework for community-embedded interventions that improve the responsiveness of health systems to health needs. Policy-makers will be continuously involved in the research project as part of the project’s strategy to bridge the gap between health research and health policies.
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SENPERFORTO: Prevention of Sexual and Gender-based Violence in the European Reception & Asylum Sector.
From 15th &-17th of February, the international Steering Committee of the Senperforto project met in Malta, a European country that has to deal with the influx of many migrants who arrive there by boat.
After having visited several of the open reception centers, the multidisciplinary group of 14 partners from Belgium, The Netherlands, Ireland, Hungary, Greece, Malta, Spain and Portugal discussed the preliminary results of a study they conducted among professionals and young residents in reception facilities in their respective countries. This study inquires on the exact knowledge, attitude, practices and needs of both groups regarding sexual and gender-based violence, as well as on its prevention.
This study applies a Community- Based Participatory Research design and fuels the development of the Senperforto Frame of Reference for Prevention of SGBV in the European Reception & Asylum Sector. This Frame of Reference consists of a Standard Operating Procedure, a Code of Conduct, a SGBV Prevention Knowledge Set and a Make it Work!-Training Manual. The Senperforto Frame of Reference will be presented at an international seminar in Brussels and made available on CD-Rom as well as from the ICRH website from December 2010 onwards.
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PUBLICATIONS AND EVENTS
Book presentation ‘Vrouwen onder druk – seksualiteit in een multiculturele samenleving’. (Women under pressure – sexuality in a multicultural society)
On the 8th of March, Els Leye and Marleen Temmerman will present their new book to the press and the public.
Violence against women still occurs (too) frequently. In their book, Els Leye and Marleen Temmerman discuss less well-known and less visible forms of violence: female genial mutilation, honour-related violence and child marriage. Violence against refugee and migrant women, with and without papers, is also addressed.
Assistance that is confronted with culturally specific problems in our society does not always have a ready-made answer. Often the social workers lack sufficient background knowledge to address the needs of their clients in an effective way, or to identify problems at an early stage. With this book, Els Leye and Marleen Temmerman offer a lever to support and strengthen existing assistance for these vulnerable groups in our society.
‘Vrouwen onder druk’ focuses on the situation in European countries such as Belgium and the Netherlands. This publication is written in an accessible language and features many case studies.
The book will be presented to the press and wider public on the 8th of March, at De Griffioen, Koningstraat 1, 9000 Ghent, Belgium.
12:30am: Doors open
12:45am: Welcome speech: Hilde Vanmechelen (Publishing house LannooCampus)
1:00pm: Introduction by Prof.dr. Marleen Temmerman
1:15pm: Panel discussion with prof.dr. Marleen Temmerman (head of the Gynecology-Obstetrics Department at the Ghent University Hospital and Director of the ICRH), dr. Els Leye (ICRH/Ghent University) and Ines Keygnaert (ICRH/Ghent University). Moderator: Kris Smet (journalist)
‘Improved access increases postpartum uptake of contraceptive implants among HIV-positive women in Rwanda’
Long-acting reversible contraception (LARC) and sterilisation are the most cost-effective methods of contraception but are rarely used in sub-Saharan Africa, partially due to limited access. In their article, Nathalie Dhont et al. examine the impact of access on LARC uptake.
Between May 2005 and January 2007 a cohort study named AMATA (meaning milk in Kinyarwanda) enrolled and followed 562 HIV-positive women from 28 weeks of gestation until 9 months after delivery in four centers in and around Kigali, Rwanda. The primary objective of the study was to compare two strategies to prevent postnatal mother-to-child transmission: breastfeeding with maternal highly active antiretroviral therapy or formula feeding. The study was funded by the Ministry of Foreign Affairs of the Grand Duchy of Luxembourg. Within the framework of this study, the postpartum uptake of contraceptive implants was also investigated. HIV-positive pregnant women attending two urban clinics in Rwanda were followed prospectively in a perinatal HIV transmission cohort study. Women attending one clinic were referred to public family planning (FP) services for all contraceptive methods (Site A) and women attending the other clinic (SiteB) were offered implants and intrauterine devices (IUDs) on-site.
Results: Fifty-three percent of the pregnant women reported an intention to use LARC or to be sterilised after delivery. The uptake of implants was significantly higher at Site B (38%) than Site A (6%). The IUD uptake was extremely low at both sites (2%). Twenty-eight of the 39 women at Site B who had intended to start using a LARC actually did so as compared to only one out of 23 at Site A.
Conclusion: When access to LARC was provided, a substantial number of HIV-positive women started using hormonal implants, but not IUDs, in the postpartum period. HIV and FP services should consider improving access to implants to reduce the number of unintended pregnancies.
Improved access increases postpartum uptake of contraceptive implants among HIV-positive women in Rwanda
Dhont N, Ndayisaba GF, Peltier CA, Nzabonimpa A, Temmerman M, van de Wijgert J.
Eur J Contracept Reprod Health Care. 2009 Dec;14(6):420-5.PMID: 19929645
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‘Barriers to HIV testing in Europe: a systematic review’
In the European Union (EU) and neighbouring countries, HIV/AIDS has one of the highest morbidity and mortality rates of all infectious diseases. An estimated 30% of people living with HIV are unaware of their infection, and may therefore not benefit from timely treatment or may unknowingly transmit HIV to others.
Increased HIV testing and counselling and decreasing the number of undiagnosed people has been identified as a priority area for HIV prevention. To this end, a better understanding of the factors that obstruct (early) HIV testing, as experienced by clients (patients) and health care providers, as well as of the barriers at institutional or policy level, is urgently needed. Against this background we conducted a systematic literature review on barriers to HIV testing and counselling in Europe. A total of 24 studies published in international peer-reviewed journals were identified that met the review’s eligibility criteria. The barriers described are centralised around low risk perception; fear and worries; accessibility of health services, reluctance to address HIV and to offer the test; and scarcity of financial and well-trained human resources. The results of this review showed that there is lack of structured information on barriers considering (1) legal, administrative and financial factors; (2) attitudes and practices of health care providers and (3) perception of patients. Such data is critical to improve effectiveness of HIV testing and counselling.
Barriers to HIV testing in Europe: a systematic review
Jessika Deblonde; Petra De Koker; Francoise F. Hamers; Johann Fontaine; Stanley Luchters; Marleen Temmerman
The European Journal of Public Health 2010; doi: 10.1093/eurpub/ckp231
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"Sex work and the 2010 FIFA World Cup: time for public health imperatives to prevail"
Sex work is receiving increased attention in southern Africa. In the context of South Africa's intense preparation for hosting the 2010 FIFA World Cup, anxiety over HIV transmission in the context of sex work has sparked debate on the most appropriate legal response to this industry.
Drawing on existing literature, the authors highlight the increased vulnerability of sex workers in the context of the HIV pandemic in southern Africa. They argue that laws that criminalise sex work not only compound sex workers' individual risk for HIV, but also compromise broader public health goals. International sporting events are thought to increase demand for paid sex and, particularly in countries with hyper-endemic HIV such as South Africa, likely to foster increased HIV transmission through unprotected sex.
The 2010 FIFA World Cup presents a strategic opportunity for South Africa to respond to the challenges that the sex industry poses in a strategic and rights-based manner. Public health goals and growing evidence on HIV prevention suggest that sex work is best approached in a context where it is decriminalised and where sex workers are empowered. In short, the authors argue for a moratorium on the enforcement of laws that persecute and victimise sex workers during the World Cup period.
The full text of the article is available at: http://www.globalizationandhealth.com/content/6/1/1
Sex work and the 2010 FIFA World Cup: time for public health imperatives to prevail
Marlise L Richter, Matthew F Chersich, Fiona Scorgie, Stanley Luchters, Marleen Temmerman and Richard Steen
Globalization and Health 2010, 6:1
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STATA training for ICRH Belgium staff
The HIV/STI team of ICRH Belgium has decided to start using STATA statistical software. In order to ensure a smooth introduction of the software, a three day training was organized.
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