Menstruation Matters!

Every 28 days, women and girls of all ethnicities, races, sizes, religions, and nationalities experience the same thing:

PERIODS.

For those of us living in high-income countries, we may get annoyed or even a bit moody when our beloved “Aunt Flow” comes to town, but we never lack access to essential, sanitary, and seemingly “life-saving” feminine products (i.e. tampons and/or pads).

As it turns out, feminine products are not seemingly life-saving, but actually life-saving – at least from an educational and economic standpoint. In 2010, UNICEF estimated approximately 10 percent of African adolescent girls do not attend school while menstruating. For those girls, keeping up with class lessons becomes an incredible challenge, as they inevitably miss a staggering 20 percent of school days. As a result, many female students drop out of school upon reaching puberty. Additional reasons for high female dropout rates include the fear of being ridiculed by their peers while menstruating, a lack of knowledge about the menstrual cycle, and a lack of clean and private sanitation facilities in schools. Fortunately, WomanCare Global recently announced its plan to improve global feminine hygiene.

Image Courtesy of WomanCare Global

Partnering with Evofem, a California-based bio-technology company, WomanCare Global aims to market, sell, and distribute their feminine hygiene products Amphora and Softcup to women and girls around the world.

Image Courtesy of AmphoraAmphora, a hormone-free, non-invasive contraceptive vaginal gel, is currently in Phase III of an extensive global clinical trial where it, thus far, has proven effective at protecting against unwanted pregnancies and various forms of sexually transmitted infections (STIs) – including HIV.

Image Courtesy of SoftcupOn the other hand, Softcup serves as a reliable alternative to tampons or pads, with over 120 million sold to date. A flexible cup worn internally around the cervix, Softcup collects (rather than absorbs) the menstrual flow, thereby eliminating any potential odor. Available in both reusable and disposable options, the Softcup can be worn for up to 12 hours and has a zero incidence rate of Toxic Shock Syndrome (TSS). Durable, flexible,and comfortable, one reusable Softcup could potentially last for an entire period.

What do products like Amphora and Softcup mean for women and girls in the developing world?

Because Amphora has been deemed effective at protecting against unwanted pregnancy and/or STIs, sexually-active women and girl users in low-income countries are better able to enjoy consensual sexual intercourse rather than fear its consequences.

For young female students, modern feminine hygiene products like Softcup equate to an increased school attendance rate and the potential to attain a high-level education, thus opening the door to widespread career opportunities and higher incomes. Similarly, adult women obtain an enhanced sense of freedom and independence by using products like Softcup, as they no longer have to constantly worry about most effectively timing bathroom breaks.

As a result, adult women using modern feminine hygiene products demonstrate a heightened ability to increase time spent working, to earn higher incomes, and to support their family – both economically and emotionally.

Planning on attending the 2013 Women Deliver Conference? You can learn more about the benefits of Amphora and Softcup from Saundra Pelletier, CEO of WomanCare Global and Evofem. Look out for their “Speaker’s Corner Session” at Exhibit Hall 2 on Wednesday, May 29th from 12:15-12:30 p.m.

For more information, please visit:

UNICEF & Education: Menstruating Girls

WomanCare Global Press Release

“No Pads, No School: Girls’ Education Going Down the Toilet,” Think Africa Press

Child Marriage: A Global Issue

The Journal of International Perspectives on Sexual and Reproductive Health recently released a report on early marriage, marital relations and intimate partner violence in Ethiopia. Early marriage, also referred to as child marriage is defined as marriage before the age of eighteen. Sixty-three percent of women in Ethiopia are married by the time they are eighteen. In many cases girls are married before they turn fifteen years old. In Ethiopia, and other countries, many child marriages are arranged by family members. Poverty, cultural beliefs and social norms generally contribute to the acceptance of the practice. Although less frequent, marriage through abduction is also practiced in Ethiopia.

Ethiopia_girls_lg
Photo Credit: UNFPA, 63% of women are married in Ethiopia by age 18

The aim of this study was to measure and analyze data that focused on comparing women who were married at early ages and those that were married in a later stage of adolescents. While the study focused on examining family backgrounds of both varying age groups it also took into consideration the nature of the marriage relationship. As to not put any girls at risk, only women between the ages of 20-24 were interviewed for this study. Topics such as education, intimate partner violence, HIV and gender roles was among the data collected.

A lack of education is just one of the many results of  child marriage. The study found that one in six women in Ethiopia was married before the age of fifteen. The opportunity to attend school is limited. In fact, seventy-nine percent of  girls under the age of fifteen do not have an opportunity to go to school. Educational levels were lower among families whose children married earlier.

The majority of  child marriages take place in rural areas of Ethiopia. Child marriage is prevalent in the Amhara region. Many young girls are raped in their first sexual encounter. Violence from their husband is a normal part of every day life. Women who were married under the age of 15, do not even recall having known or met their husband prior to the marriage. Girls who are married younger are at a greater risk of  being infected with HIV as well as experiencing complications in childbirth. The age of a girl and her educational level both play a positive and vital role in her knowledge and involvement in the marriage. Girls who are married at younger ages, and to much older men, are at a disadvantage for gaining any type of decision making power in the relationship with their husbands. A young girl’s priorities are shifted to early and she no longer has an option for education. Girls who are married young are forced to mature before they are physically or psychologically ready.

Child marriage continues to be a gross human rights violation and one that affects a majority of young girls around the world. In their latest 2012 Progress for Children report, UNICEF cites that one in every four girls in the developing world between the ages of 15-19 are currently married.

More than one third of women in the developing world marry during childhood
Photo Credit: Childinfo.org
More than one third of women in the developing world marry during childhood

The World Health Organization estimates that over 39,000 child marriages happen every single day. That is 14.2 million girls that are married annually who are under the age of eighteen.

“Child marriage is an appalling violation of human rights and robs girls of their education, health and long-term prospects,” says Babatunde Osotimehin, M.D, Executive Director, UNFPA.

Ethiopia is just one of many countries where child marriage is a common practice. The top ten countries with the highest rates of child marriage are:

Niger
Chad and Central African Republic
Bangladesh
Guinea
Mozambique
Mali
Burkina Faso
South Sudan
Malawi

Child marriage has devastating physical and psychological effects on young girls.

The Facts:
Girls who are married as children are:

  • Robbed of their education
  • Suffer severe health consequences from child birth, such as obstetric fistulas, maternal death and disability
  • Are at increased risk for intimate partner violence and contracting HIV
Child marriage2
Photo Courtesy: tooyoungtowed.org

Despite the fact that there are laws against child marriage this practice is still an ever growing issue in our world today.  Findings from this study place an emphasis on addressing early adolescent age groups in Ethiopia as well as targeting rural areas of the country. Recommendations from this study focus on education as an essential tool for reducing child marriage in Ethiopia and around the world. Most girls interviewed in this study had never been to school even prior to being married. There is an overall lack of opportunity for girls to receive an education. When a girl is empowered through education she is able to provide a solid foundation for herself and others in her community. Much of the information gleaned through this study is very common in child marriage cases around the world. The information is essential to frame adequate programs and policies that address the issue.

Community-based initiatives that ensure girls are enrolled in solid educational programs are an essential foundation for combating the issue of child marriage. The report recommends a livestock programs as a method to reducing the risk of child marriage.  A project called Berhane Hewan provides an incentive to families for keeping their children in school.

Although this global issue continues to increase, there has actually  been a slight reduction in child marriages in Ethiopia since 2005. Studies such as this one show the harsh realities related to the lack of opportunity for education among girls as well as the reality of being married before they are emotionally, physically or psychologically ready. Child marriage will continue to occur in Ethiopia and other countries unless there is a shift in cultural and social norms. Programs or interventions to combat child marriage must be holistic and focus on the entire community. Education for girls must be made a priority.

The United Nations Commission on the Status of Women met in March to specifically discuss the issue of child marriage. Their strategies and  recommendations to combat the issue of child marriage are as follows:

  • Supporting and enforcing legislation to increase the minimum age of marriage for girls to 18 years;
  • Providing equal access to quality primary and secondary education for both girls and boys;
  • Mobilizing girls, boys, parents and leaders to change practices that discriminate against girls and to create social, economic, and civic opportunities for girls and young women;
  • Providing girls who are already married with options for schooling, employment and livelihood skills, sexual and reproductive health information and services (including HIV prevention), and offering recourse from violence in the home;
  • Addressing the root causes of child marriage, including poverty, gender inequality and discrimination, the low value placed on girls and violence against girls.

Want to learn more about Child Marriage? Watch Destaye’s Story

Want to learn about organizations combating the issue of child marriage?
Check out:
World Vision
Campaign to End Fistula
Girls Not Brides
UNICEF 
CARE
UNFPA/UN Women

Full Report: Erulkar, A. (2013). Early Marriage, Marital Relations and Intimate Partner Violence in Ethiopia. International Perspectives on Sexual and Reproductive Health.  Vol 39, 1

For further reading: UNFPA: Marrying too Young: Ending Child Marriage 

Maternal Mortality: Progress and Potential in Nigeria

Image courtesy of The Global Poverty Project
Image courtesy of The Global Poverty Project

When it comes to achieving Millennium Development Goal 5 – reducing maternal mortality ratio by 75 percent and granting universal access to reproductive health by 2015 – Nigeria is fighting an uphill battle. Here are some quick facts to illustrate just how staggering maternal healthcare (or lack thereof) is in Nigeria:

  1. Nigeria is currently ranked among the top ten most dangerous countries for a woman to give birth, placed alongside Afghanistan, Haiti, Liberia and Sudan.
  2. In 2010, approximately 40,000 women passed away giving birth and another 1 to 1.6 million suffered serious disabilities related to their pregnancy and/or childbirth.
  3. Data from The World Health Organization suggests that 630 of every 100,000 childbirths result in a maternal death.
  4. Nigerian women face a 1 in 29 chance of dying from childbirth whereas the average risk throughout Sub-Saharan Africa is 1 in 39.  (The risk in developed countries is as low as 1 in 3,800.)

To clarify: 14 percent of all maternal deaths in the world occur in Nigeria.

However, not all hope is lost.  Abiye and Saving Lives at Birth: A Grand Challenge for Development are two programs currently working to decrease maternal mortality in Nigeria.

The Abiye program, meaning “Safe Motherhood” in the Yoruba language, was launched in 2009 by Nigeria’s Ondo State government and has already seen major progress in diminishing maternal deaths in the region.  The success of Abiye is often attributed to Governor Olusegun Mimiko, the Ondo State health commissioner and brains behind the program.  The program began with extensive surveys at the community level, allowing programmers to gain a better understanding of why Nigeria suffered from such a high maternal mortality rate. Investigators discovered four major “delays” contributed to maternal deaths that inevitably became the backbone of the program:

1)    The delay in deciding to seek care (due to education, mistrust of health facilities, or family constraints);

2)    The delay in reaching care (due to distance, infrastructure, or communication);

3)    The delay in receiving appropriate care upon arrival (due to inadequate manpower, supplies, drugs, or health infrastructure);

4)    The delay in referral (when complications beyond local facility capacities arise).

The Abiye program works to eliminate problems surrounding these delays through various means and has, so far, experienced dramatic improvement in maternal health.  Before implementation, health facilities in the Ondo State delivered approximately 100 children annually. Within one year, healthcare facilities completed more than 2,000 deliveries and after two years that number rose to more than 6,000. A 2013 report by the Center for Strategic and International Studies highlights the Abiye program as a major success and encourages others to seek similar innovative approaches towards improving maternal health.

The next question you might be asking is: How can I help? This is where Saving Lives at Birth: A Grand Challenge for Development comes into play.  The program – affiliated with major international development players including USAID, the Bill & Melinda Gates Foundation, DFID, Grand Challenges Canada, the World Bank, and the Government of Norway – challenges others to find innovative tools, ideas and/or approaches for the prevention and treatment of pregnant women and newborns in poor, hard-to-reach communities.  The program aims to foster a community of learning and innovation in order to:

1)    Support the development and health outcomes for pregnant women and their babies in low-resource settings;

2)     Develop, refine, and test the impact of solutions that have previously measured promising health outcomes in a limited setting and have the potential for scale-up.

Saving Lives at Birth’s unique approach could only be successfully implemented in today’s interconnected world of Facebook and Twitter.  By using social media to its advantage, thousands of potential solutions are submitted and evaluated, thereby increasing the possibility that a solution to Nigeria’s maternal mortality epidemic is within our grasp.

Sources/Read More:

Maternal Health in Nigeria: With Leadership, Progress is Possible

Saving Lives at Birth: A Grand Challenge for Development

Nigeria: Studies Pick Ondo Health Project As Most Promising Cure for Childbirth Deaths

Contraception: Is it Controversial?

These are the key facts that WHO has published in their media centre about family planning:

  • An estimated 222 million women in developing countries would like to delay or stop childbearing but are not using any method of contraception.
  • Some family planning methods help prevent the transmission of HIV and other sexually transmitted infections.
  • Family planning reduces the need for unsafe abortion.
  • Family planning reinforces people’s rights to determine the number and spacing of their children.

Yet, contraception, a key tool for family planning, remains controversial. Melinda Gates speaks about this in her TED Talk:

The Gates Foundation and several other international organizations and donor countries want to make a change to this. The Family Planning Summit in London took place on the World Population Day, Wednesday, 11 July, 2012. The objectives of this summit were to:

  1. Revitalize global commitments to family planning and access to contraceptives as a cost-effective and transformational development priority
  2. Improve the access and distribution of contraceptive supplies
  3. Remove and reduce barriers to family planning

During the summit participants, both developing countries, donors and international development agencies committed a total of $ 4.6 billion to improve access to contraception and voluntary family planning services to 120 million more women by 2020. This is a great step forward in the empowerment of women and improving the status of girls and women in their societies, households, and relationships – giving them the possibility to make empowered and informed choices to take care of themselves and their children.

You can join the commitment to making contraception less controversial.

Sign the pledge and read women’s personal stories here. There is no controversy in contraception.

Want to learn more?