International Federation of Gynecology and Obstetrics

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FIGO
FIGO
International Federation of
Gynecology and Obstetrics
[email protected]
www.figo.org
December 2012
‘Working together towards the
common goal of improving sexual
and reproductive health’
– new FIGO President in global rallying call
Professor Sir Sabaratnam Arulkumaran, FIGO President
Dear Colleagues
I would like to thank Professor Gamal Serour
for the tremendous job he has done in leading
FIGO over the past three years. To the FIGO
membership and the national societies, I am
most grateful to you for having the trust in me
and providing the mandate for me to be FIGO
President. The Officers and the Executive
Board members have worked extremely well
with the Chief Executive, the Administrative
Director, the staff, and with the national
societies over the last several decades. They
have brought FIGO to its current position,
which is recognised globally. On behalf of FIGO
I would like to acknowledge our colleagues and
the people of Italy who have welcomed us. I
CONGRESS
SPECIAL ISSUE
should fail in my duty if I did not also thank my
wife, Gayatri, and my children, Shankari,
Nishkantha, and Kailash.
My theme over the next three years is not a new
one; it is to ‘continue to work together’ during the
period 2012 to 2015. FIGO will continue to build
on the good work completed so far and will work
on the Millennium Development Goals (MDGs)
and reproductive health issues.
There are several issues of concern: maternal
health (ie morbidity and mortality), preterm births,
stillbirths, subfertility, cancer, domestic violence,
female genital mutilation, fistula, and sexual and
reproductive health. In addition to carrying out
activities in these areas, I will focus on maternal
mortality, stillbirth, unmet need for family
planning, and safe abortion care. FIGO will also
continue with some emphasis on HIV/AIDS, and
its other activities will continue. These activities
cannot be conducted by FIGO alone and we will
work in collaboration with a number of national
organisations and governments.
The essential partners that have helped FIGO
over the years include the World Health
Organization (WHO), the Partnership for
Maternal, Newborn and Child Health, Family
Health International (FHI), the International
Confederation of Midwives (ICM), the
International Paediatric Association (IPA), the
International Confederation of Nurses (ICN), the
International Planned Parenthood Federation
(IPPF), EngenderHealth, and Gynuity; in addition
to donors such as USAID, UKAID, the Bill and
Melinda Gates Foundation, an anonymous donor,
Ford Foundation, and others. I am extremely
grateful to them and look forward to their
continued support. There are others such as
UNFPA, the World Bank, UNICEF, and industry
partnership that are essential for FIGO to
function. I would like to thank the staff of FIGO
and its partner organisations for helping us to
come this far.
Principles that govern success
There are five principles behind recent success
stories.
1. Governments have to make saving mothers
a national priority and strengthen the
existing coalition.
2. Focus should be given to selected issues
rather than trying to target too many
activities.
3. Ownership at the grass-roots level must be
strengthened.
4. Continuous innovation and maximisation of
available resources.
5. Accountability by measuring outcomes to
strive for continued improvement.
Whatever the projects, FIGO will need to abide
by these five principles if we are to succeed.
Whether we are going to provide safe abortion
care, reduce stillbirths, or provide contraception,
we must get the support of government. We
need to innovate as to how best we can
implement contraception, provide the ownership
to the women, provide the needed care, and be
accountable.
Strengthen existing coalitions
Here we can learn from the FIGO LOGIC project,
the aim of which is to strengthen the national
societies. The project has been able to link a
professional society with the government and
establish a good working relationship with
Ministries of Health. The project will continue until
October 2013. FIGO will try to encompass other
continued on page 2
FIGO welcomes new President | UNFPA Chief highlights MDG challenge |
Launch of African Federation of Obstetrics and Gynaecology (AFOG)
| ‘Why Did Mrs X Die, Retold’ premiere
International Federation of Gynecology and Obstetrics | December 2012
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New FIGO President in global rallying call
Continued from page 1
societies to build a South–South collaboration.
Focus will be given to items that are most
needed in a particular country, such as
reductions in deaths from haemorrhage, unsafe
abortion, or hypertensive disorders. During my
term of office, I want to concentrate on how best
to resolve unmet need for family planning (MDG
5b). Voluntary family spacing with postpartum
family planning programmes including longacting reversible contraceptives might be the key
for mothers attending for delivery at a health
facility. We should take that opportunity and
provide whatever contraceptive method is
desired.
Focus on a few selected issues
Safe abortion care
Globally, it is estimated that there are 210 million
pregnancies and 40 million abortions, half of
which are unsafe. About 70,000 women die as a
result of septic abortion and five million are
admitted with complications. We have to work on
the principles of primary, secondary, and tertiary
prevention by making contraceptives and
emergency contraception available, by making
abortion a safe procedure, and by providing
postabortion contraception. We should work
toward reducing the vast majority of unsafe
abortions occurring in low-resource countries. At
the FIGO Pre-Congress Workshop, six
recommendations were made as to how best to
provide safe abortion permitted by law. This
information will be disseminated to FIGO’s
national societies.
Contraception
A total of 222 million women have an unmet need
for contraception. Contraception can help to
reduce 10% of child mortality and 30%–50% of
abortion. The Pre-Congress Workshop produced
a strategy detailing how we can make this work
through the national societies. The Resolution
that was passed by the General Assembly will be
posted on the FIGO website. There are certain
strategies that we will implement. We would like
to include family planning in general nurse and
midwifery training. We will engage general
practitioners and primary care providers. We shall
develop a standard FIGO model curriculum for
family planning and will engage the national
societies to disseminate this information. We will
work to facilitate task shifting; for example in
India, abortion is legal but the number of facilities
and providers are not enough and women seek
abortion from providers who are not qualified.
Strengthening community
ownership: ‘Maternity ecosystem’
Strengthening ownership at the grass-roots level
is vital. What can we do to mobilise women,
families, and the community? The charity
‘Women and Children First’ has been working
with several local organisations in countries to
mobilise the community to come together every
few weeks. This has been shown to be effective
in reducing child and maternal mortality and
morbidity. FIGO hopes to participate to see how
we can activate the community along with the
national and regional societies to make the
impact even stronger.
Community mobilisation is part of the ‘maternity
ecosystem.’ Key issues concern healthcare
delivery, availability, acceptability, affordability, and
appropriateness. The issues involved are the
hospital or health facility, the community or the
home, and the financial and physical barriers. We
need to prioritise the services we want to
strengthen; for example, contraceptive services
or abortion services or emergency obstetric care.
We need to have a dialogue to see how these
barriers can be overcome by strengthening the
national societies. In Sri Lanka, where I come
from, having community midwives provide
prenatal and postnatal care and contraception
has worked effectively. These successful models
need to be exploited and FIGO will explore these
issues with ICM.
Continuous innovation and
maximising resources
The fourth principle of success is to continually
innovate to maximise available resources. In
Mozambique, training of surgical assistants to
perform caesarean deliveries has been
successful. There are other good examples. We
have to maximise available resources and devise
different ways of working. For example, offering
postpartum and postabortion contraception is a
great opportunity or situation that has to be used
maximally and effectively.
Accountability
The final principle is accountability. We have to
measure what we are doing and the outcomes. If
we cannot measure, we cannot improve on what
we do. FIGO will measure the outcomes of the
projects it undertakes and disseminate the
information in a useful way.
organisations for help with training. We must also
build public/private partnership within countries.
Most of all we have to work with our fellow
professional organisations – midwifery, nursing,
paediatric, and anaesthetic organisations.
Conclusion
By doing what we plan to do, not only will we
tackle MDG 5 but we will also tackle MDG 1,
which is poverty. If a woman effectively uses
contraception and is not going to have a baby for
two or three years, she will have time to work and
earn money. She will have time to look after the
baby and the child for primary education (MDG
2); she will take the children to school and once
they are educated, they can become equal
partners with men (MDG 3). She will also take the
children for vaccinations and resolve any child
health problems (MDG 4). If she has five children
in five years, she will not be able to accomplish
this. Hence, it is crucial that we advise about
family spacing to achieve MDGs 1 to 5. Tackling
MDG 5 will resolve many underlying issues. MDG
5 can be tackled to a great extent by
concentrating on contraception and safe abortion
care.
I would like to finish with two quotes. The first is
from Professor Thoraya Obaid, former Executive
Director of UNFPA, who said: ‘It keeps startling
me that at the beginning of the 21st century, at a
time when we can explore the depths of the sea
and build an international space station, we have
not been able to make childbirth safe for all
women around the world. This is one of the
greatest social deficiencies of our time.’ This is a
fact and this tragedy is happening every year. The
reason for this tragedy was spelt out many years
ago by Professor Mahmoud Fathalla, a Past
President of FIGO, who said: ‘Women are not
dying because of diseases we cannot treat. They
are dying because societies have yet to make the
decision that their lives are worth saving.’
We have to spend time and money to derive the
maximal impact. I want everyone here to commit
to make this a personal priority. Ensure you can
make a compelling case for change and get
inspired by others’ success. With inspiration,
commitment and collaboration we can save more
lives.
My very best wishes.
Working in partnership
As mentioned, there are a number of tasks and
FIGO cannot do it alone. We need the help of
advocacy groups such as the White Ribbon
Alliance, policy makers like WHO, facilitators such
as the Partnership for Maternal, Newborn and
Child Health; we need advisors and technical
support, such as JPHEIGO; we need the help of
donors – the Bill and Melinda Gates Foundation,
USAID, UKAID – and we need nongovernmental
Professor Sir Sabaratnam Arulkumaran
FIGO President (2012–2015)
This is an edited extract from the inaugural address given by
Professor Sir Sabaratnam Arulkumaran at the XX FIGO World
Congress, Rome, Italy, 12 October, 2012.
The full text will be available in the March issue of IJGO: Int J
Gynecol Obstet 2013;120(3):XX–XX.
The new FIGO President and Immediate Past-President, with Past Presidents: S Arulkumaran, G Serour, M Fathalla, D Shaw, S Sheth, A Acosta, J Sciarra
2
International Federation of Gynecology and Obstetrics | December 2012
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CHIEF EXECUTIVE’S OVERVIEW
Dear Colleagues
Our Congress in Rome is over, and I would like to
extend my sincere thanks to everyone who made
it such a success. The feedback we have
received from delegates has been superb. FIGO
attracted 8,000 visitors from over 170 countries –
a tremendous attendance. Our Scientific
Programme was commended for its exceptional
breadth and the calibre of its speakers. The event
was a wonderful opportunity to touch base with
our existing global colleagues, and also to meet
many new ones for the first time – I am pleased
to report that many fresh developments have
arisen for FIGO in the weeks following the
Congress, and we greatly look forward to
consolidating new ideas and strategies with
global collaborators.
The Congress gave a
platform to many voices,
but I am especially pleased
and proud that the remake
of the World Health
Organization’s iconic 1980s
film ‘Why Did Mrs X Die?’
took place at our Opening
Ceremony. It was indeed an
honour to welcome
Professor Mahmoud
Fathalla, a pioneer in the Safe Motherhood
movement, and a former FIGO President, to the
proceedings – without his involvement and
valuable input this project could not have been
achieved. Special thanks must of course go to
Professor Gwyneth Lewis and Amy Gadney, of
Hands On for Mothers and Babies
(www.handsonformothersandbabies.org) for
their dedication and commitment to this
enterprise, from conception to final delivery!
Another ‘first’ for the Congress was the launch of
the new African Federation of Obstetrics and
Gynecology (AFOG), a Federation that has taken
many years to materialise for our African
colleagues. Under the able leadership of its newly
elected President, Dr Yirgu Gebrehiwot (President
of the Ethiopian Society of Obstetricians &
Gynecologists – ESOG), the Federation will hold
its first Officers’ meeting in Brazzaville, February
2013, hosted by WHO. I look forward to
reporting on its progress.
I am particularly pleased that FIGO was able to
provide a significant number of Fellowships to
professionals from low- and middle-resource
countries, thanks to the generosity of
collaborators the United States Agency for
International Development (USAID) and Marie
Stopes International (MSI). I know that many who
participated were immensely grateful for the
opportunity to sharpen their professional
education, and take back home with them much
needed new knowledge on the latest
developments in the field of obstetrics and
gynecology.
As experience has proved, three years is not a
long time in the field of event planning, and it will
certainly not be long before the next Congress is
upon us – Vancouver 2015 promises to be
equally exciting, and work has already begun in
earnest. We are greatly looking forward to
progressing the planning of Congress activities
with Dr Jennifer Blake, the new Chief Executive
Officer of the Society of Obstetricians and
Gynaecologists of Canada (SOGC), one of
FIGO’s highly valued collaborators.
Travels have been brisk of late. Just before
Rome, I was invited by the International Planned
Parenthood Federation (IPPF) to participate in a
‘High Level Expert Consultation on Islam and
Women’s Health’ in Kuala Lumpur, Malaysia
(22–24 September). The range of challenges
impacting young women and girls in particular
across our Muslim-populated countries is
significant, and the conference focused on the
progress made in countries and regions based
on international, regional and country initiatives –
including the UN Secretary General’s ‘Global
Strategy for Women and Children’s Health’ – and
also on identifying challenges, gaps and barriers
and possible solutions to help accelerate
women’s health in Muslim-populated countries.
The meeting came out with the Kuala Lumpur
Declaration, which made excellent
recommendations for the promotion of women’s
health and rights in Muslim communities.
Directly after the Congress, I attended the 13th
Executive Board Meeting of the Partnership for
Maternal, Newborn and Child Health (PMNCH) in
Abuja, Nigeria (15–20 October). The meeting
discussed reports and workplans for 2013. I also
attended the Second Global Symposium on
Health Systems Research, Beijing, China (31
October–3 November), where I was asked by Dr
Mubashar Sheikh, Executive Director of the
Global Health Workforce, to represent FIGO in a
panel session entitled: ‘Skills mix to achieve
universal health coverage: a global systematic
review and country case studies on roles and
impact of mid-level health workers’. This
discussed issues relating to task-shifting/sharing
to tackle the massive shortage of health care
workers.
In early November, I was invited to Paris by the
International Menopause Society to participate in
an ‘International Workshop for the development
of a Global Consensus on HRT’. Later in the
month I represented FIGO at the 60th
Anniversary of the IPPF which was celebrated in
Johannesburg, South Africa. I wish to
congratulate the IPPF on its years of commitment
to sexual and reproductive healthcare and rights.
Its work in these all-important fields is unrivalled,
and it commands enormous respect from
collaborating organisations across the world.
Activities in early 2013 will include attending the
LOGIC Initiative’s Technical Advisory Group (TAG)
January meeting in Arusha, Tanzania, followed by
presenting at the Second International Congress
on Women’s Health and Unsafe Abortion
IWAC2013) in Bangkok, Thailand.
The 2013 FIGO diary is already filling up with
many collaborative activities, and I look forward
to reporting on them in due course. In the
meantime, I wish to thank you all for your great
support of FIGO at the end of what has been an
exceptionally busy and challenging year. I am
looking forward to working closely with our new
President, Professor Sir Sabaratnam
Arulkumaran, Officers and Executive Board. I
naturally extend my sincere thanks to PastPresident Professor Gamal Serour for his superb
overseeing of FIGO over the past three years,
and to the outgoing Officers and Executive Board
members who have made immense contributions
to the promotion of FIGO’s work.
I wish you and your families a peaceful Christmas
and New Year break.
My very best wishes.
Professor Hamid Rushwan
FIGO Chief Executive
International Federation of Gynecology and Obstetrics
FIGO House
Waterloo Court, 10 Theed Street
London SE1 8ST, UK
Tel: +44 20 7928 1166
Fax: +44 20 7928 7099
Email: [email protected]
The International Federation of Gynecology and
Obstetrics is a UK Registered Charity (No 1113263;
Company No 5498067) registered in England and
Wales. The Registered Office is shown above.
President:
Professor Sir Sabaratnam Arulkumaran
(United Kingdom)
President-Elect:
Professor Chittaranjan Narahari Purandare (India)
Administrative Director:
Bryan Thomas
Past-President:
Professor Gamal Serour (Egypt)
Readers are invited to send all comments, articles and
reports (by email to [email protected] or on
disk) to the FIGO Secretariat no later than 1 March
2013 for the next issue.
Vice President:
Professor Ernesto Castelazo Morales (Mexico)
Honorary Secretary:
Professor Gian Carlo Di Renzo (Italy)
Honorary Treasurer:
Professor Wolfgang Holzgreve (Switzerland)
Chief Executive:
Professor Hamid Rushwan (Sudan/UK) (Ex-offico)
International Federation of Gynecology and Obstetrics | December 2012
The views expressed in articles in the FIGO Newsletter
are those of the authors and do not necessarily reflect
the official viewpoint of FIGO.
Produced and edited by the FIGO Secretariat © FIGO
2012.
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‘FIGO OBJECTIVES ON TRACK FOR 2015’
Professor Gamal Serour speaks
at Rome 2012
Colleagues, during the
past three years, I have
had the honour and
pleasure to humbly
serve as President of
FIGO. It has been an
enriching and
rewarding experience
for me, and thank you
for your trust.
In my inaugural address in Cape Town, October
2009, I said: ‘FIGO, building upon its past
achievements, is undertaking a change – a
change that will make FIGO more visible and
palpable to obstetricians and gynecologists
around the globe, particularly those in lowresource countries.’ I have worked tirelessly over
the past three years to fulfil my promises. The
core of my change was education and training of
obstetricians and gynecologists, and capacity
building of member societies in developing
countries.
In Cape Town I proposed an 8-point *workplan to
enable FIGO to play its role as a leading global
professional organisation in women’s health.
Today I can confidently say that I am delighted to
see this ambitious workplan implemented, and in
a sustainable way.
*The 8-Point Plan
1: Advocacy, partnerships, and
commitments
2: Continuing with ongoing projects
3: Establishing a Committee for Capacity
Building in Education and Training
4: Establishing a Committee for
Reproductive Medicine
5: Optimising utilisation of FIGO
Committees and Working Groups and
their outcomes to increase their
visibility
6: Ethics curriculum development in
reproductive and sexual health for
low-resource countries
7: Improving the management,
communication, and involvement of
member societies and regional
federations
8: Strengthening collaboration with UN
organisations, world federations,
NGOs, FBOs and the private sector
[*Please also refer to Professor Serour’s Introduction in
the FIGO Three-Year Report 2009–2012, available on
http://www.figo.org/publications]
Colleagues, I have been privileged to work
alongside an excellent hardworking team towards
a common goal, directing individual
accomplishments towards organisational
objectives. We had the necessary ‘fuel’ that
allowed common people to attain uncommon
results.
It is most appropriate for me to say now to all
FIGO Past Presidents who inspired me; to my
Fellow FIGO Officers; the FIGO Chief Executive
Professor Hamid Rushwan; Executive Board
4
Some FIGO representatives with Congress staff
members; Chairs and Members of FIGO
Committees and Working Groups; and my
secretarial staff, particularly Mr Bryan Thomas
and Mrs Marie-Christine Szatybelko at FIGO HQ,
and Mrs Azza El Tobgi and Mrs Gihan El Feki in
the Cairo office: you have all shown outstanding
and exceptional commitment, enthusiasm,
volunteerism and dedication which I greatly
treasure.
I also say to various UN organisations, global
NGOs, sister professional organisations and
medical industries: you all, through your support
and our collaborative efforts, helped FIGO to play
the role it is supposed to fulfil to the best of its
ability. Thank you so much for your support.
The number of women dying in pregnancy and
childbirth annually at long last declined in 2010 to
the figure of 287,000 maternal deaths, a global
decline of 47 per cent since 1990. However, this
is not enough to achieve MDG 5a by 2015. For
every woman who dies, around 20 more suffer
near-miss and complications which jeopardise
the quality of their lives. Ninety-eight per cent of
all these deaths and morbidities occur in
developing countries and are mostly preventable.
Contraception alone can prevent 30 per cent of
maternal deaths.
President’s Session press conference: L–R: Professor
Serour; Dr Paul De Lay (UNAIDS); Dr Flavia Bustreo (WHO);
Dr Babatunde Osotimehin (UNFPA)
Today there are 222 million couples with unmet
need of modern contraceptives in the developing
world. Providing these unmet needs of
contraceptives would prevent 21 million
unplanned births, 26 million abortions, 79,000
maternal deaths, and 1.1 million infant deaths.
Indeed, Margaret Chan, the Director-General of
the World Health Organization, said: ‘Family
planning deserves a much higher place in the
international health agenda, especially in
countries where fertility and unmet need are
high.’
We should not forget that annually there are 340
million new curable STIs, mostly in the 20–24 age
group, resulting in 1.8 million AIDS-related
deaths, and 275,000 cancer of the cervix related
deaths. Three million girls and women are
subjected to Female Genital Mutilation (FGM) and
50,000–100,000 develop obstetric fistula
annually.
There is a huge unmet need of RSH information
and services for young people, particularly
adolescent girls. Dr Babatunde Osotimehin,
UNFPA Executive Director, said: ‘Today
pregnancy and childbirth related complications
are the major causes of death among girls 10–19
years old in most developing countries.’
2010–2012 have been highly successful years for
campaigning and commitments for the
improvement of maternal and newborn health,
with the launch of several initiatives including the
Global Strategy for Women’s and Children’s
Health; the ‘Every Woman, Every Child’ Initiative;
the Muskoka Initiative; and the ground-breaking
London summit on Family Planning in July, calling
for unprecedented international political
commitment and resources to pledge US$4.6
billion to provide an additional 120 million women
in the world’s poorest countries with
contraception by the year 2020.
Martin Luther King Jr said: ‘Of all the forms of
inequality, injustice in health care is the most
shocking and inhumane.’
Ban Ki-moon, UN Secretary-General, said: ‘By
giving mothers to be the services they need
before, during and after pregnancy and by
providing quality health care to all women, we
can save lives, prevent suffering and accelerate
progress towards all the MDGs.’
I say to mothers, sisters and daughters who have
needlessly lost their lives and the many more
women who have suffered injuries during
pregnancy and childbirth: please forgive us,
because some of our societies failed to value
your life. FIGO has joined forces to minimise this
happening again to current and future
generations, and to share in saving the lives of 16
million women and children by 2015. Rest
assured that women will no longer be the silent
victims and unheard voices of substandard
health care.
Today, more than ever before, we have the
political commitment, knowledge, knowhow,
capacity and committed resources to make a
significant stride in saving the lives of women and
newborns.
To all those involved in the preparation of this
Congress: thank you for your unyielding efforts,
dedication and determination to make it a real
success, and for your continuing efforts during
the coming five days to make it one of the most
enjoyable and memorable Congresses in FIGO’s
history.
To my family, patients and Al Azhar University:
thank you so much for your continuous support
and sacrifice, which has enabled me to fulfil my
duties as FIGO President to the best of my ability
over the past three years.
The good news is that, at 1pm on Friday 12
October, the baton will be picked up by Professor
Sir Sabaratnam Arulkumaran, the incoming FIGO
President, and then I will have much more time
for you …hopefully!
My very best wishes to all.
Professor Gamal Serour
FIGO Immediate Past President
This is an edited version of the speech delivered by
Professor Gamal Serour at the Congress Opening
Ceremony
International Federation of Gynecology and Obstetrics | December 2012
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CONGRESS NEWS
UNFPA Chief opens FIGO Congress,
highlighting challenge of MDGs
An extract from UNFPA Executive Director Dr Babatunde Osotimehin’s speech
We are inaugurating this XX FIGO Congress of
Gynecology and Obstetrics two and a half
years before the world will hit the deadline
agreed by world leaders to reach the
Millennium Development Goals. Although great
progress has been achieved in several of the
goals, the one that concerns obstetricians and
gynecologists the most, Goal 5 on improving
maternal health, is lagging behind in many
countries of the developing world. Women,
especially poor women, still die while pregnant
or in childbirth, often of preventable causes.
One woman dies every
two minutes giving
birth or in pregnancy.
These are preventable
deaths. Let us be
honest: these are
women that could have
been saved if one of us
could have assisted
them in their pregnancy
Dr Babatunde Osotimehin
and delivery, or could
have provided them with contraceptives, or
attended to complications arising from pregnancy
or childbirth.
Much more work needs to be done to meet the
MDG targets. Gynecologists, obstetricians and
midwives are the most natural professional
partners, together with governments, multilateral
organisations, civil society and women
themselves, to push hard on actions towards
achieving the health-related MDGs, particularly
MDG5.
We must work together to meet this achievable
goal. But in order to do so, we should ensure
that women and adolescent girls have access to
sexual and reproductive health services in an
integrated way, that they receive these services
– voluntary high-quality family planning, maternal
health, especially access to emergency obstetric
care and skilled birth attendants, and STI
prevention, including prevention of HIV – in the
same place, at the same time, by the same
provider. By doing this, we will support
strengthening health systems at all levels, but
especially at the grass-roots level, close to where
women live. It is there we have our major gap in
human resources for health. There are not
enough providers in places near to and
immediately accessible to women.
To realise the MDGs, governments need to take
responsibility for the public health needs of their
citizens, for maternal health, family planning,
sexual health, in the only equitable manner
that works – by providing publicly funded,
well-resourced services and by adding health
workers in those places that lack them. We
should make sure that we give a definite solution
to the most challenging gap of a functioning
health system, that is, its workforce shortage,
quality and equitable distribution. We all know
that a health system that can prevent maternal
death is a functioning system.
Addressing the human resources for the health
shortage gap will require innovative ideas,
comprehensive solutions. It is not enough to train
more health workers if policies do not address
this issue in a comprehensive way, if the number
of health workers that drop out of the system
once they are trained is around 50 percent as is
the case in some countries in Africa; the reason
is because there are not enough work incentives
for them to remain employed. UNFPA looks
forward to working closely with professional
associations like FIGO and the International
Confederation of Midwives, along with other UN
agencies like UNICEF, WHO, UNAIDS, UN
Women and the World Bank to address these
issues together.
(printed with kind permission from UNFPA)
FIGO honours figureheads in global
maternal and newborn health
The FIGO Congress Opening Ceremony is traditionally the occasion on
which to feature the series of awards traditionally made to obstetrician/
gynecologists who have excelled in their service to FIGO or to women’s
health. Awards are also given to highly distinguished people outside this
profession who have performed a service to women’s health.
In Rome, Professor Hamid Rushwan presented FIGO Distinguished Merit
Awards to Dr Ralph Hale, former Executive Vice-President of the
American College of Obstetricians and Gynecologists (ACOG) and a
Professor Chiara Benedetto
member of the FIGO Executive Board for many years; Dr Sergio Pecorelli, (EBCOG President), Master
former Chair of FIGO’s Committee on Gynecologic Oncology, and former of Ceremonies
Editor of the highly influential FIGO Annual Report on the Results of Treatment in Gynecologic
Cancer; and Dr Duru Shah, who represents FOGSI at FIGO and is also a member of FIGO’s Ethics
Committee.
FIGO’s second awards category, the FIGO Recognition Awards, honoured Michelle Bachelet,
former President of Chile, and the first Under-Secretary-General and Executive Director of UN
Women; Sarah Brown, CEO of the Office of Gordon and Sarah Brown, and Global Patron of the
White Ribbon Alliance for Safe Motherhood; and Jill Sheffield, founder and president of Women
Deliver, and former president of Family Care International.
L–R: Professor Gamal Serour, Dr Duru Shah, Dr Sergio
Pecorelli, Dr Ralph Hale and Sarah Brown
Professor Serour with Jill Sheffield
International Federation of Gynecology and Obstetrics | December 2012
Women obstetrician/
gynecologists
recognised at FIGO
General Assembly
In 1997, for the first time, FIGO presented a
number of Awards in Recognition of Women
Obstetricians/Gynecologists to doctors,
nominated by their peers, who had made a
special contribution internationally or
nationally to promote the development of
science and scientific research in the fields of
gynecology and obstetrics; and who,
throughout their career, had promoted better
healthcare for women, mothers and their
children.
The awards were
officially presented
as an inclusive part
of the Rome 2012
General Assembly,
to highlight their
importance.
The recipients
were described by
Professor Gamal
Serour during the
awards ceremony
as ‘prime
representatives of
female practitioners
in their home
nations’.
A recipient
FIGO’s congratulations extend to: Professor
Kohinoor Begum (Bangladesh); Dr Sylvia
Ayeley Deganus (Ghana); Professor Kristina
Gemzell Danielsson (Sweden); Dr Vesna I
Kesic (Serbia, Montenegro and Republic of
Srpska); Dr Lucy Lopez Reyes (Peru); Dra
Blanca Rosa Manzano Ovies (Cuba); Dra
Técia Maria de Oliveira Maranhão (Brazil); Dr
Kamini Rao (India); Dr Duria Abdellewahab
Mohammed Rayis (Sudan); and Dr Sudha
Sharma (Nepal).
Professor Gamal Serour presenting the award to Dr
Kamini Rao (India), a former Chair of the FIGO
Committee for Women’s Sexual and Reproductive
Rights
Some of the award recipients
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CONGRESS NEWS
New African Federation of Obstetrics and
Gynaecology (AFOG) launched at Congress
A new African Federation of Obstetrics and
Gynaecology (AFOG) was launched at a
historic meeting during the Rome Congress on
8 October 2012. Over 20 national societies and
a host of interested observers attended the
meeting, which was chaired by Chief Executive
Professor Hamid Rushwan.
Remarks were given by Professor Joseph
Karanja, ECSAOGS President; Professor Eusèbe
Alihonou, SAGO’s First and Past-President;
Professor E Maaouni, Maghreb Federation
President; and Professor Bomi Ogedengbe, West
African College of Surgeons President. They
outlined the work of their organisations and their
ready support for the establishment of an African
Regional Federation.
Special inaugural addresses were given by Dr
Luis Sambo, Regional Director, WHO AFRO and
Professor Gamal Serour, FIGO Past-President.
The Constitution of the new Federation was
endorsed, and elections took place to select the
Federation’s Officers and decide on the location
of its Secretariat.
Elected Officers:
• President: Dr Yirgu
Gebrehiwot, (Ethiopia)
• Vice President: Professor
Eusèbe Alihonou (Benin)
• President Elect: Professor
Oladapo Ladipo (Nigeria)
• Honorary Secretary: Dr
Amir Elnahas (Sudan) The
Secretariat will be housed
by the Obstetrical &
Gynaecological Society
Dr Yirgu Gebrehiwot,
new AFOG President
of the Sudan
• Honorary Treasurer: Professor Bhaskar Goolab
(South Africa)
Professor Hamid Rushwan commented: ‘This is
an enormous achievement for all of the
obstetricians and gynecologists in Africa, who
have been working hard towards the
establishment of a pan-African body to bring
them together and target the improvement of
women’s health in the region, and the science
and practice of obstetrics and gynecology.
‘I encourage all societies in the African region to
give AFOG full support and to work hard towards
building a strong regional body that will help
promote the importance of women’s health in
Africa.’
FIGO adopts new
General Assembly
Resolution at Rome
2012
During Rome 2012, a Resolution on
‘Unmet Need for Voluntary Contraception’
was approved, which can be accessed at
http://www.figo.org/projects/general,
along with previous Resolutions.
‘Professional associations
must play major part in
tackling MDGs’, concludes
President’s Session 2012
A traditional Congress highlight, the ‘President’s
Session’ – which this year focused on ‘The Role
of Professional Organisations in Accelerating
Progress on Health-Related Millennium
Development Goals’ – took place in front of a
packed audience on the first day of the
Congress.
The panel – introduced by Sarah Brown, CEO of
the Office of Gordon and Sarah Brown, and
Global Patron of the White Ribbon Alliance for
Safe Motherhood – was comprised of major
figures in global maternal and newborn health: Dr
Flavia Bustreo (Assistant Director General, Family
and Community Health, WHO); Professor Sergio
Augusto Cabral (President, IPA); Frances DayStirk (President, ICM); Professor Paul Howell
(President, Obstetric Anaesthetists Association
and Chair of Obstetric Committee, WFSA); Dr
Babatunde Osotimehin (Executive Director,
UNFPA); Dr Luis Sambo (Regional Director for
Africa, WHO); Professor Gamal Serour (Past
President, FIGO); Professor Jill Sheffield
(President, Women Deliver); and Dr Paul De Lay
(Deputy Executive Director, Programme,
UNAIDS).
Questions posed – moderated by Dr Joanna
Cain – covered the role and importance of
professional organisations in achieving the
health-related Millennium Development Goals,
the challenges faced, and how professional
organisations can be promoted in this respect.
LOGIC at the Congress
The Leadership in Obstetrics & Gynaecology for Impact and Change
(LOGIC) Initiative in Maternal and Newborn Health (MNH) is supporting
eight FIGO Member Associations in their endeavours to improve MNH
policy/clinical practice and their organisational capacities.
FIGO LOGIC organised two successful sessions at the XX FIGO World
Congress: one session on the implementation of facility-based Maternal
Death Reviews (MDRs) and Near Miss Reviews (NMRs)1 in low-resource
countries, and one session on organisational capacity strengthening of
professional associations in obstetrics and gynecology.
MDRs/NMRs
• ESOG (Ethiopia) shared their analysis of MDR/NMR data from nine
public hospitals and reported on improved maternal health services,
including improved availability of health workers, blood and ambulances.
• SOGON (Nigeria) is working with Government authorities and other
partners to agree on the way forward for implementing MDRs in Nigeria,
including guidelines, protocols and tools.
• SOGOC (Cameroon) has provided MDR
training and set up Committees in five
hospitals as well as developed guidelines and
summary tools.
• SOGOB (Burkina Faso) is working with the
Ministry of Health (MoH) and other partners to
roll-out MDRs nationally in Burkina Faso.
Organisational capacity
strengthening
6
Launch of FIGO LOGIC Toolkit
FIGO LOGIC has developed, in collaboration with the Society of
Obstetricians and Gynaecologists of Canada (SOGC), an electronic Toolkit
with organisational capacity strengthening resources and tools for health
professional associations.
The Toolkit brings together a collection of information,
resources and tools for anyone interested in fostering
organisational change within a health professional association,
either through the conduct of occasional activities or by
initiating a more thorough capacity building process.
Using the Toolkit will lead to better understanding of what
makes an organisation strong; what the different elements of
organisational capacity building are; how a change process
can be initiated; and how practical activities can be
conducted to support such change processes.
The Toolkit is available in English, French and Spanish at
www.figo-toolkit.org
International
Federation
of Gynecology
and Obstetrics
• FOGSI (India) has developed into a successful
professional association over the last 60
years. It is represented on numerous
Government of India bodies, and has 216
member societies and 27,000 members.
• AMOG (Mozambique) has gone through an extensive strategic planning
process, which has enabled the association to engage constructively
with partners. Achievements include the provision of technical expertise
Dr Segun Adeoye, LOGIC
Project Manager with the
Society of Gynaecology and
Obstetrics of Nigeria
(SOGON), carries the FIGO
LOGIC banner
to the MoH, including on MDRs, emergency obstetric care, and longlasting contraceptives.
• NESOG (Nepal) has successfully improved communication with its
members, including via their website, text messages, Facebook and
distribution of a newsletter and an academic journal.
• AOGU (Uganda) has used Maternal and Perinatal Death Review data to
advocate for increased resources for MNH and improvements in
services. For example, in collaboration with partners, AOGU helped
influence the Ugandan government to increase funding for reproductive
health by 30 per cent.
Electronic toolk
it on
Strengthening
Organisat
Capacity of Heal ional
th
Professional
Associations
Fédération interna
tionale
de gynécologie
et d’obstétriqu
e
1 A facility-based MDR is a “qualitative, in-depth investigation of the
causes of and circumstances surrounding maternal deaths” in health
facilities, while a NMR is the “identification and assessment of cases in
which pregnant women survive obstetric complications” (Lewis,
Gwyneth, 2003. ”Beyond the Numbers: reviewing maternal deaths and
complications to make pregnancy safer”, British Medical Bulletin 2003;
67: 27–37, The British Council, 2003.)
Trousse d’out
ils élect
sur le renforcem ronique
ent des
capacités orga
nisationnelles
des associatio
ns de
professionnels
de la santé
Federación Intern
acional
de Ginecología
y Obstetricia
Serie de Herra
mientas sobre
el Fortalecim
iento de la
Capacidad Orga
nizacional
de las Asociacio
nes de
Profesionales
de la Salud
Toolkit bookmark
International Federation of Gynecology and Obstetrics | December 2012
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CONGRESS NEWS
‘Why did Mrs X Die, Retold’
– remake of WHO film
premiered at Rome 2012
‘Why Did Mrs X Die, Retold’ – a short animated
film telling the story of one unfortunate woman’s
journey through pregnancy and childbirth – was
launched at the FIGO World Congress in Rome
on 7 October 2012.
It is a remake of the World Health Organization
seminal 1980’s film ‘Why Did Mrs Die?’, which is
based on a lecture by a pioneer in the Safe
Motherhood Movement, Professor Mahmoud
Fathalla (a former FIGO President). The film paints
an accurate picture of the dangers women are
facing across the world, and the need to help
them.
The remake
was overseen by
Dr Gwyneth Lewis
and Ms Amy
Gadney of Hands
On for Mothers
and Babies,
an organisation
making educational
tools for women in poor areas of the world:
www.handsonformothersandbabies.org
The film can be viewed at the following link:
http://www.handsonformothers
andbabies.org/ or access it via the FIGO
website: http://www.figo.org/news/
why-did-mrs-x-die-retold-launchedfigo-world-congress-2012-0010519
Professor Hamid Rushwan,
FIGO Chief Executive,
commented: ‘FIGO was
indeed privileged to be
given this remarkable film to
launch at the Congress. We
wish to extend our sincere
thanks to Dr Gwyneth
Lewis, Amy Gadney and
Emily Goldner for their
unstinting dedication and
Professor Mahmoud
professionalism. Above all,
Fathalla, former FIGO
we thank Professor
President
Mahmoud Fathalla, without whom this excellent
project could not have been achieved. The film is
as moving and relevant today as it was 30 years
ago – it continues to be a necessary call to arms
for the global health community.’
You can also read: ‘On Safe Motherhood At 25
Years… Looking Back, Moving Forward’, by
Professor Mahmoud Fathalla, at the above FIGO
link.
Rebranded FIGO Cancer
Report 2012 available
The former ‘Annual Report on the results of
treatment in Gynecologic Cancer’ has been
retitled the ‘FIGO Cancer Report’ and the
latest edition was launched to tie in with the
FIGO Congress.
It brings together updates on the staging and
management guidelines on each site-specific
gynecological cancer, and Gestational
Trophoblastic Disease; and separate
chapters from a developed and developing
world perspective on pathology,
chemotherapy and radiation.
The system that has been used for collecting
international data on gynecological
malignancies is being reconstructed and
modernised and will be available at the next
World Congress in 2015.
The Report is available from the FIGO
Secretariat at €30 (email [email protected]).
Global attention for
2012 World Report on
Women’s Health
L–R: Professor Sir Sabaratnam Arulkumaran (FIGO),
Report Editor, with contributors Dr Mike Mbizvo
(WHO), Dr Wolfgang Holzgreve (FIGO) and Dr André
Lalonde (FIGO) at the press launch
World Report contributor
Frances Day-Stirk (ICM)
‘Although Millennium Development Goal
(MDG) 5 encompasses the reduction of
maternal mortality and the improvement of
sexual and reproductive health, every MDG
has an impact on women’s health as they
affect women most: eradication of poverty,
gender equality, education, reduction of child
mortality, HIV/AIDS, tuberculosis, and
malaria,’ commented Professor Sir
Sabaratnam Arulkumaran, presenting the
World Report on Women’s Health at the
Congress on 8 October.
The Report – published by FIGO every three
years to coincide with the Congress – is an
overview of the major areas within women’s
global maternal and reproductive health. The
goal of the 2012 Report – the theme of
which is ‘Improving Women’s Health’ – is to
focus on these wider issues, expanding the
focus for professionals beyond the traditional
basic obstetric functions.
‘The medical activities that need to be
implemented to prevent maternal mortality
and morbidity are known, but global progress
cannot be achieved unless effective policies
are introduced by governments that enable
women to access such care,’ Professor
Arulkumaran explained.
He added: ‘The FIGO 2012 World Report
on the topic of improving women's health
provides ample information to allow
everyone to take action at an individual,
institutional, and professional level. It is a
call for action based on evidence. It
addresses how we can act, in addition to
what has happened or what is currently
going on. One single organisation or
government cannot achieve these tasks.
In addition to the global cooperation of
partner organisations, every one of us
has to take some responsibility to
improve women’s health.’
The 2012 Report is published as a
Supplement (Volume 119, Supplement 1)
to the International Journal of
Gynecology & Obstetrics (IJGO), and is
available at http://www.ijgo.org/
issues?issue_key=S00207292(12)X0011-0
Unveiling ‘The FIGO
Fertility Tool Box™’:
Facilitating the
achievement of universal
access to reproductive
health
The FIGO Fertility Tool Box™, consisting of six
components dealing with overcoming personal
and societal barriers to infertility care, prevention,
diagnosis, treatment, referral and resolution, plus
the FIGO Fertility Daisy™, which deals with why
one should care about infertility, was launched in
Rome by Professor David Adamson, Chair of the
FIGO Committee for Reproductive Medicine.
He said: ‘The Tool Box is simple, usable, and
evidence-linked; a very flexible tool for adaptation
in different environments and countries. It is
hoped that it will be used by many providers of
women’s healthcare to increase access to quality,
cost-effective infertility prevention and
management. We have taken into account the
international sensitivities with respect to culture,
religion, politics and economics.’
He added: ‘Infertility, specifically in low-resource
settings, is important and its management is
justified by the positive impact on quality of life,
burden of disease, political commitments, nondiscrimination, family planning, prevention of
sexually-transmitted infections, affordability and
protection of resources – each item symbolised
by a petal of the daisy.
‘Though the tool is intended primarily for
women’s healthcare providers, we hope it will
also be used by policy makers.’
The FIGO Fertility Tool Box™ can be accessed at
http://www.figo.org/news/resources/
FIGO_Fertility_Tool_Box
Professor Adamson (right, alongside former FIGO Honorary
Secretary Professor Ian Fraser) at the Reproductive
Medicine press conference
An online snapshot
International Federation of Gynecology and Obstetrics | December 2012
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