August 2012 Newsletter

10660:Layout 1
10/8/12
12:43
Page 1
FIGO
FIGO
International Federation of
Gynecology and Obstetrics
[email protected]
www.figo.org
August 2012
FIGO prepares for global
gathering@Rome 2012
The FIGO President delivering his address at the Executive
Board dinner with Chinese officials
The FIGO President, with other participants, at a private Papal audience, on the occasion of the ‘Management of Infertility
Today’ Workshop, Vatican City (February 2012)
Dear Colleagues
Since our last communication in March, it has
been an extremely busy time for FIGO!
We have been accelerating our efforts to finalise
arrangements for the FIGO XX World Congress in
Rome, from 7 to 12 October 2012.
The Scientific Programme Committee has
performed a wonderful job in compiling an
exceptionally strong programme incorporating
basic- to cutting-edge knowledge in women’s
health. The agenda also involves top
representatives of UN organisations, NGOs,
sister professional organisations and
policymakers as our collaborative efforts are
essential to achieving the health-related
Millennium Development Goals (MDGs). The
Congress Organising Committee has been
working hard to ensure the comfort of all
attendees, and easy transportation to the
INSIDE:
Congress venue (on registration, participants will
receive a free travel card for use on public
transport to be utilised throughout the Congress).
The social and cultural programmes are
outstanding and include a Papal Audience on
Wednesday 10 October. The Local Organising
Committee is sponsoring 30 Fellowships for
young colleagues from developing countries in
Members of the Executive Board participating in an
educational seminar, Beijing (May 2012)
Centres of Excellence in Italy, and it is also
hosting seven Pre-Congress educational and
training courses in Italian hospitals.
I am highly encouraged by the enthusiasm of
thousands of my colleagues from all over the
world who have already registered for this
Congress. Please do join us for what promises to
be one of the most memorable ever, and during
which we shall celebrate launching the new
African Federation of Obstetrics and Gynecology
(AFOG). I would like to thank the World Health
Organization’s (WHO) Regional Office for Africa
for its staunch support of this forthcoming
enterprise.
FIGO leading the way in global
education and training
With rapid developments in science and
technology, and the evolution of evidence-based
and person-centered management of various
women’s health conditions, it is essential to
strengthen our education and training
programmes to enable the passing on of
knowledge and skills to ‘grassroots’ obstetricians
and gynecologists in remote rural areas. Since
October 2009, our Committee for Capacity
Building in Education and Training has conducted
more than 54 sessions and workshops around
the globe, particularly in developing countries.
For example, an outstanding hands-on workshop
continued on page 2
World Congress countdown | Executive Board meets in Beijing | Gynuity’s
Beverly Winikoff | Dr André Lalonde reviews SMN Initiative | Latest from LOGIC
International Federation of Gynecology and Obstetrics | August 2012
1
10660:Layout 1
10/8/12
12:43
Page 2
FIGO prepares for global gathering@Rome 2012
Continued from page 1
Burkina Faso Workshop
(one of a series) on ‘Ultrasound and Basic
Surgical Skills’ for 40 obstetricians and 30
midwives was organised in Burkina Faso by
Professor Eric Jauniaux, in collaboration with the
Societé de Gynécologues et Obstétriciens du
Burkina (SOGOB).
Following on from the success of the hands-on
workshop on Minimally Invasive Surgery (MIS),
held in Khartoum last February, a further course
is scheduled there from 17–20 September 2012,
while another is planned for the Ukraine. Thanks
are due to Olympus Surgical Technologies
Europe for its robust support of this programme.
As Dr David Adamson (Chair of the FIGO
Committee for Reproductive Medicine) and
myself were very encouraged with the great
success of three workshops on ‘A Basic and
Advanced Clinical and Laboratory Training
Course in Infertility, including ART for Developing
Countries’, a fourth workshop is planned in
collaboration with the International Islamic Center
for Population Studies and Research (IICPSR), Al
Azhar University, from 8–12 December 2012.
Many thanks to IBSA International for its support
of these Committee activities.
The Executive Board endorsed the Training
Curriculum on Bioethics in Human Reproduction
and Women’s Health for Developing Countries,
developed by the FIGO Committee for Ethical
Aspects of Human Reproduction and Women's
Health. This Curriculum will be a tremendous help
for developing countries both in pre-service and
in in-service training of healthcare professionals. I
sincerely thank Ford Foundation for its support of
this project.
The FIGO Fistula Initiative – ensuring high quality
clinical training for the care of women with
obstetric fistula – is progressing well.
Accreditation for training centres has taken place
and training centres are now identified (see
Professor Rushwan’s report on page three).
Thanks are due to the United Nations Population
Fund (UNFPA), and a host of other high profile
partners.
MDG 2015 Countdown and
FIGO global partnerships
FIGO has joined forces in global efforts to
accelerate progress to achieve the health-related
Millennium Development Goals. On invitation
from the Director of WHO’s RHR/HRP, I
participated in the 29th Scientific and Technical
Advisory Group (STAG) meeting held in Geneva
in February. Discussions mainly centred on the
strategic direction of the department and the
HRP research breakthroughs contributing to
saving women’s and children lives.
In February, I participated in a special workshop,
‘The Management of Infertility Today’, organised
by the Pontifical Academy for Life, the Vatican,
Italy, delivering a lecture on ‘The Global Changing
Prevalence of Infertility’, and its impact on
population policy and family planning. The
highlight of the visit was a private Papal
Audience.
2
In May I participated in the 5th International
Parliamentarians’ Conference on the
Implementation of the International Conference
on Population and Development (ICPD)
Programme of Action, in Istanbul, organised by
UNFPA and the European Parliamentary Forum
on Population and Development (EPF). I
presented in the first plenary session of the
conference a lecture on ‘Scaling up Strategies to
Reduce Maternal Deaths: Achievements and
Persistent Challenges’.
In June, I held a meeting with UNFPA’s Deputy
Executive Director (Programme) and the
Assistant UN Secretary-General Dr Kate Gilmore
during her exploratory visit to Africa. I discussed
with her how best we can utilise Faith-Based
Organisations for the implementation of ICPD’s
PoA, and achieving the health-related MDGs, and
shared IICPSR’s experience at national, regional
and international levels.
Also that month, FIGO joined the Population
Council and Reproductive Health Supplies
Coalition (RHSC) and held a meeting on LongActing, Reversible Contraception (LARC) in
Bellagio. The group produced a statement which
was submitted to a special London Summit
meeting – which I attended – organised in July by
the UK Government, the Bill & Melinda Gates
Foundation and UNFPA. Many Presidents, First
Ladies, Ministers and leaders from UN
organisations and NGOs attended. A video
message was sent from Hillary Clinton, and an
address given by UK Prime Minister David
Cameron. The meeting was extremely
successful, with pledged commitments of 2.6
billion US dollars from donor governments and
other partners, and 2 billion US dollars from
developing countries, to provide for the unmet
need for contraception for 120 million women
and girls in developing countries by 2020. Shortly
after this Summit, FIGO met with the Population
Council and the RHSC to discuss how best to
utilise the statement to improve access to LARC.
Japan (April 2012): I met with the JSOG
leadership and the Japanese International
Cooperation Agency (JICA) to discuss the
involvement of Japan in FIGO’s global women’s
health activities. FIGO will develop a concept
proposal to take this initiative forward.
• 60th ACOG Annual Clinical Meeting (American
College of Obstetricians and Gynecologists),
San Diego, USA (May 2012): I discussed with
ACOG’s leadership its support of FIGO’s
Congress, and the progress of its initiative on
global maternal health with FIGO, the Royal
College of Obstetricians and Gynaecologists
(RCOG) and the Society of Obstetricians and
Gynaecologists of Canada (SOGC).
• 38th NFOG Congress (Nordic Federation of
Societies of Obstetrics and Gynecology),
Bergen, Norway (June 2012): I delivered a
lecture on ‘Ethics in Human Reproduction and
Women’s Health’. I discussed with Professor
Knut Hordnes, Congress President, and Dr
Goran Berg, NFOG President, strengthening
collaboration and coordination between FIGO
and NFOG in developing countries where FIGO
and NFOG both have ongoing progress.
• 68th SOGC Annual Clinical Meeting, Ottawa,
Canada (June 2012): This presented a special
opportunity to discuss strengthening
collaboration between FIGO and the SOGC in
the light of the new SOGC leadership, and also
the selection of Vancouver as the site of the
2015 Congress. The highlight of this meeting
was attending the Council and the Past
Presidents’ dinner where I was awarded the
Honorary SOGC Fellowship. I am immensely
proud to be recognised in this way, and am
grateful to the SOGC Council for bestowing
this great honour.
Our thanks to China:
Executive Board 2012
Our 72nd Executive Board meeting was held in
Beijing, China, in May 2012. It was a superbly
organised event, and it well reflected that FIGO’s
relationship with its member societies is getting
stronger and stronger. In fact, we have already
received requests to host the 2013 meeting from
several member societies. I know that both FIGO
staff and Board members were overwhelmed by
the great hospitality and warmth of our Chinese
colleagues, and their excellent organisation. I am
extremely grateful to the Chinese Government
and the Chinese Society of Obstetrics and
Gynecology (CSOG) for their kindness and their
commitment to the overall success of this
important annual event.
Strengthening collaboration with
member and regional societies
Over the past few months I have participated in a
large number of regional and national society
meetings, delivering presentations, chairing
sessions and workshops and holding meetings
and discussions with key society representatives.
These included:
• 64th JSOG Annual Congress (Japanese
Society of Obstetrics and Gynecology), Kobe,
64th JSOG Annual Congress (Japanese Society of
Obstetrics and Gynecology), Kobe, Japan (April 2012)
The FIGO Executive Board visiting the Beijing Obstetrics
and Gynecology Hospital
Colleagues and friends: as I end this message,
there is still a great deal for FIGO to accomplish
before the start of the Congress. I am very much
looking forward to welcoming you all to what I
know will be one of the most memorable FIGO
Congresses since the start of its history.
I wish you a productive summer and safe travels
to Rome.
Best wishes
FIGO President Gamal Serour
International Federation of Gynecology and Obstetrics | August 2012
10660:Layout 1
10/8/12
12:43
Page 3
CHIEF EXECUTIVE’S OVERVIEW
FIGO@Rome 2012: The place to be
Dear Colleagues
Dr Catherine Hamlin with Chief Executive Hamid Rushwan
and Lord Naren Patel
Photo courtesy of the MCHIP Program
By the time you receive
this summer edition of
the Newsletter, the XX
FIGO World Congress
will be just a few short
weeks away. The
various organising
Committees are putting
the finishing touches to
what will be a most
tremendous event. If
FIGO Chief Executive,
you have not already
Hamid Rushwan
done so, please secure your registration at
http://www.figo2012.org/registration to avoid
disappointment. This triennial FIGO event is the
culmination of three years’ exceptional hard work
and planning, and we are thrilled that so many of
our global colleagues are set to join us. More
news about the Congress can be found on page
10.
Meetings and travels have been extremely brisk
since my last reporting. In early March, I attended
a Technical Consultation on the World Health
Organization (WHO) Recommendations on PostPartum Haemorrhage, in Montreux. The meeting
was held to review available evidence and update
the global recommendations on prevention and
management of post-partum haemorrhage (PPH)
– the leading cause of maternal mortality – and it
addressed major issues both for women who
give birth in a medical setting and for those who
deliver at home. The WHO and stakeholders are
developing a new set of guidelines on the
prevention and treatment of PPH, based on new
scientific evidence, and this will be circulated to
stakeholders for endorsement.
Training Initiative using FIGO’s Training Manual,
and a course for the Training of Trainers will be
conducted in Addis in the very near future. The
Hamlin Fistula Hospital will provide an excellent
training facility for the FIGO Initiative.
In Tanzania, we visited the Comprehensive
Community Based Rehabilitation Tanzania
(CCBRT), a well recognised hospital with an
impressive track record of fistula activity. Two
experienced surgeons are ready to participate in
the Training Initiative, utilising the manual, and
Fellowships are being finalised for training eight
trainers and a selection of trainees.
The last site we visited was in Arusha, where Dr
Andrew Browning provides general obstetrical
and gynecological services in a new hospital.
There are only a few fistula cases being treated
here, and therefore the centre is not able to
accommodate or provide training. However it is
anticipated that training will be conducted in
Arusha on an ad-hoc basis, depending on the
caseload for trainees.
Beijing press conference
Conference – held in partnership with the
Obstetrical and Gynaecological Society of
Malaysia (OGSM) – where I chaired a FIGOsponsored session: Misoprostol for the
prevention and treatment of post-partum
haemorrhage: From clinical evidence to
operational realities (see our update on FIGO’s
misoprostol initiative on page nine).
Shortly afterwards, I flew to Washington to
participate in two important meetings: the ‘Child
Survival Call to Action’ organised by the United
Nations Children’s Fund (UNICEF) and the United
States Agency for International Development
(USAID), and a preceding briefing/consultation
meeting on Countdown to 2015 combined with a
civil society forum about the ‘Call to Action’,
organised by Save the Children.
At June-end, I travelled to the WHO in Geneva to
represent FIGO at the 25th Meeting of the Policy
and Coordination Committee (PCC),
Development and Research Training in Human
Reproduction (HRP) – the
UNDP/UNFPA/WHO/World Bank Special
Programme of Research. This meeting coincided
with the 40th Anniversary Celebration of the HRP.
Olympus and FIGO join forces on MIS
WHO PPH meeting (Montreux)
Fistula site visits set the scene for
accreditation
At April-end, I travelled to Ethiopia and Tanzania
with Lord Patel, Chair of the FIGO Committee for
Fistula, to carry out site accreditation visits as
part of the planned implementation of the
structured fistula surgery training programme
using the Global Competency-Based Fistula
Surgery Training Manual, developed by FIGO and
partners.
Four centres were visited. In Ethiopia, the Gondar
Fistula Centre (65-bedded), directed by Dr Mulu
Muleta and Dr Ambaye Wolde Michael, was well
equipped, but needs transportation to bring more
patients from the surrounding rural areas, as well
as additional equipment. In Gondar we met with
a physician who had travelled from Bangladesh
to begin six weeks’ training in fistula surgery. He
is part of a FIGO-organised training programme
that aims to increase the global number of
physicians trained to provide treatment for
women living with fistula.
We also visited the Addis Ababa Fistula Hospital,
run under the guidance of Dr Catherine Hamlin.
This hospital is very well established, with six
satellite centres, and it has a large caseload. The
doctors are extremely committed to the FIGO
L–R (Gondar Fistula Centre): Fistula surgery trainee (from
Bangladesh); nurse; Dr Ambaye Wolde Michael; Professor
Hamid Rushwan; Dr Mulu Muleta; nurse; Lord Naren Patel
FIGO held its annual Executive Board meeting in
Beijing, in May, and I would like to take this
opportunity to thank once again the Chinese
Society of Obstetrics and Gynecology (CSOG) for
its superb organisation of this important event (a
full report is on page five). We received great
hospitality from our Chinese hosts, and special
mention must go to President Dr Jinghe Lang,
and Former President Dr Zeyi Cao.
I am extremely pleased to report that the first
FIGO-Olympus Workshop on Minimally Invasive
Surgery (MIS) – organised in conjunction with the
Obstetrical and Gynaecological Society of the
Sudan – was successfully conducted at Soba
University Hospital, Khartoum, Sudan, at the end
of February. This is as a result of a new
collaboration recently agreed with Olympus
Surgical Technologies Europe, which is
sponsoring the establishment of three FIGO
training centres in Africa, East Europe and
possibly Latin America, as well as the trainees
and trainers.
This highly successful Workshop set the optimum
standards for future events, and the second
course will run from 17–20 September 2012.
FIGO would like to extend its gratitude to the
Obstetrical and Gynaecological Society of the
Sudan for its robust efforts in helping the
collaboration to achieve its goals.
The first course for MIS in Kiev, the Ukraine, is
planned for September 2012. Details will be
available soon on www.figo.org
I wish you all safe travels to Rome, and a highly
enjoyable and successful few days at the
Congress. Thank you for supporting FIGO’s good
work.
Best wishes
Executive Board in session
Keeping our global momentum
In June – a hectic month – I travelled to Kuching,
Malaysia, for the Royal College of Obstetricians
and Gynaecologists’ (RCOG) 10th Annual
International Federation of Gynecology and Obstetrics | August 2012
FIGO Chief Executive
Hamid Rushwan
3
10660:Layout 1
10/8/12
12:43
Page 4
PEOPLE
Q and A with Beverly Winikoff, MD, MPH (President of Gynuity Health Projects)
After almost 30
years of work on
Reproductive Health
based in large
organisations,
Dr Beverly Winikoff
opened the doors
of Gynuity Health
Projects in
2003. Gynuity
(www.gynuity.org), as
it is more commonly
Beverly Winikoff, MD, MPH,
known, is a small
President of Gynuity Health
research and technical
Projects
assistance organisation with an energetic 30strong staff base, most of whom are public
health professionals.
Gynuity is dedicated to the idea that all people
should have access to the fruits of medical
science and technology, and it works globally to
ensure that reproductive health technologies are
widely available at reasonable cost, provided in
the context of high-quality services, and offered
in a way that recognises the dignity and
autonomy of each individual. Efforts are focused
particularly on resource-poor environments,
underserved populations, and challenging
subject matter. Dr Winikoff saw in a small
organisation the opportunity to create flexible
models of research and implementation,
emphasising ways in which existing medicines
and health technologies could be provided in a
more woman-centred fashion and made more
available and acceptable.
Dr Winikoff, how did Gynuity’s
relationship with FIGO evolve?
Gynuity and FIGO have an extensive history of
collaboration on several special initiatives aimed
at addressing principal causes of maternal
mortality, including post-partum haemorrhage
(PPH). Over the years, we have joined forces to
help translate key findings of clinical research
(implemented by Gynuity and other international
agencies) into policy guidance and clinical
protocols. FIGO, along with other international
agencies, has joined a five-year initiative led by
Gynuity [see page nine] with the aim of translating
a large and growing body of scientific evidence
on misoprostol for PPH into operational reality, so
that all women will have access to a uterotonic
for the prevention and/or treatment of PPH.
The initiative, funded by the Bill & Melinda Gates
Foundation, encompasses a range of scientific,
operational and policy issues related to the use of
misoprostol for PPH care. As a part of this
collaborative effort, FIGO plays a critical role in
advocacy for and dissemination of evidencebased information for providers and clinical
policymakers. Its member societies continue to
be instrumental in setting and advancing the
standards of PPH care locally, including the
integration of evidence- based norms on the use
of misoprostol.
IJGO: from strength to strength in 2012
FIGO’s official publication, the
International Journal of Gynecology
& Obstetrics (IJGO), has continued
its success over the past 12
months and is experiencing a
particularly busy year in 2012.
Clare Addington, IJGO Managing
Editor, said: ‘The most recent Impact
Factor, for 2011, 2.045, is its highest
to date, and in 2011 the journal
received 1323 submissions. The
2011 acceptance rate is predicted to
be 22 per cent and the Journal
continues to increase the annual
number of reviewers (702 in 2011)
and the geographic representation of
those contributing reviews.’
IJGO Editorial Board Meeting in progress (London, February 2012)
The annual meeting of the IJGO Editorial Board was convened in London in February 2012 and
was attended by its Editor – Dr Timothy Johnson – Associate Editors, and members of the Editorial
Office. The meeting reviewed the content of the FIGO 2012 World Report
on Women’s Health, which will be guest edited by FIGO’s PresidentElect, Professor Sir Sabaratnam Arulkumaran, and will be published in
time for the FIGO 2012 Congress in Rome. The Report comprises 20
articles under the challenging topic of ‘Improving Women’s Health’, and
contains contributions from, among others, authors from FIGO’s
Committees, project teams, and collaborating organisations.
Clare added: ‘A particular focus of the Editorial Board Meeting was the
development of the IJGO website – www.ijgo.org – and opportunities
for implementation of new technologies for reader interaction, such as
video hosting.’
At the FIGO Congress in Rome, IJGO will host an author workshop
Dr Timothy R B Johnson,
IJGO Editor
entitled ‘An Insider's Guide to Getting Published’, to be held on Thursday
11 October. The session is an opportunity for authors to hear from IJGO’s editorial team about how
to maximize their chances of getting their research published – from understanding the submission
process and article requirements, to tips from the Editor about what the Journal is looking for and
from Associate Editors giving insights into how to develop and write a paper.
This year will also see the publication of two IJGO Supplements, the FIGO Cancer Report, and an
online book of the abstracts presented at the FIGO Congress.
Clare ended: ‘In April, we welcomed Helen Metherell as a new Editorial Assistant. We are delighted
to have her on board and look forward to a productive second half of 2012.’
4
How do you see Gynuity’s work with
FIGO progressing in the future?
As part of the ongoing collaboration, the
dissemination of new evidence on misoprostol in
PPH management to providers is being facilitated
by FIGO via a number of expert panels planned
and implemented at national, regional and
international meetings, including the 2012 FIGO
World Congress in Rome where a half-day
session is planned. New materials, including
training tools, protocols and guidelines on the
use of misoprostol in PPH management, are also
forthcoming in several languages. To highlight
new research and its implications as findings
become available, a number of peer-reviewed
scientific articles and special publications will also
appear in FIGO’s specialist global publication, the
International Journal of Gynecology & Obstetrics
(IJGO).
Our project on misoprostol has allowed us to
ask, and try to answer, such provocative
questions as:
• How can we use the potential of misoprostol
for treatment as well as for prevention of PPH?
• Since some women will develop excessive
post-partum bleeding no matter what
prophylactic they are given, how can we
encourage health systems to plan treatment
strategies at the same time as they are being
urged to develop prevention programmes?
• Can misoprostol be used for both prevention
and treatment in the same woman?
• Is it easier and more cost-effective to use
oxytocin in Uniject or misoprostol for prevention
in community-based programmes?
• Can women be given misoprostol to
self-administer for prevention of PPH in home
births?
What do you find most satisfying
and challenging about your work?
It is extremely gratifying to see the blossoming of
collaborations and to be able to join with likeminded colleagues in projects that create
change. An exhilarating part of Gynuity’s work is
the opportunity to follow creative leads in
research on women’s health. We push ourselves
to look for new ways to provide services and new
technologies to incorporate in them. We aim to
develop safe and effective, affordable, acceptable
technologies that are delivered in a womanfriendly way, and enhance the autonomy and
well-being of each person.
Our collaboration with FIGO is particularly
precious to us for its potential to have real impact
on women’s lives. By mustering the power of the
ob/gyn community in support of new ways to
attend to women having babies, especially in the
poorest and most underserved areas of the
world, our research becomes meaningful. We are
very grateful for the opportunity.
For more information on Gynuity’s activities, visit
www.gynuity.org
International Federation of Gynecology and Obstetrics | August 2012
10660:Layout 1
10/8/12
12:43
Page 5
Beijing welcomes FIGO for 2012
Executive Board Meeting
The 2012 FIGO Executive Board Meeting was
held at the Crowne Plaza Park View Wuzhou
Beijing Hotel, Beijing, China in May 2012, in
conjunction with the Chinese Society of
Obstetrics and Gynecology (CSOG) and
supported by the Beijing Royal Integrative
Medicine Hospital.
Chief Executive Hamid Rushwan said: ‘FIGO
would like to thank its Chinese hosts – most
especially CSOG’s President Dr Jinghe Lang, and
Former President Dr Zeyi Cao – for a superbly
organised meeting and the accompanying
excellent hospitality which was greatly
appreciated. The event was a valuable
opportunity for FIGO officials to “touch base” with
our esteemed Chinese colleagues, and to
familiarise ourselves with current obstetrical and
gynecological issues in this fascinating part of the
world.
‘Thanks are also due to the FIGO Secretariat staff
– Bryan Thomas and Marie-Christine Szatybelko
– for their usual excellent handling of all Board
Meeting arrangements.’
seminars, and to CSOG for its tremendous
contribution in helping us to run the events so
smoothly and successfully.’
Seeing the Chinese picture
A briefing session on the state of women’s health
in China and, in particular, maternal and newborn
health, was held during the trip. Representatives
of CSOG, the Ministry of Health and a number of
international organisations were invited to present
an overview of women’s health to the Executive
Board meeting participants.
FIGO seminar speakers in Chengdu
encompassed the broad spectrum of global
women’s health issues, outlining FIGO’s activities
in various countries. These activities formed the
basis of the seminars’ educational topics,
drawing on the rich experience of our
Committees and Working Groups.
‘Lecture topics included maternal mortality, postpartum haemorrhage, unsafe abortion, obstetric
fistula, cancer prevention, ethics problems and
women’s sexual rights, and speakers comprised
the Chairs of FIGO’s Committees and Working
Groups, as well as Board Members.
‘It is always important that the host country plays
a vibrant and significant role in the development
of these popular seminars, so the programme is
traditionally completed with the contribution of its
speakers and topics. China focused on its issues
of maternal mortality, early diagnosis of cancer,
and preservation of fertility.’
Executive Board 2012
FIGO President Gamal Serour with the Minister of Health
FIGO field visit: focus on Beijing
Obstetrics and Gynecology Hospital
A visit to the well-regarded Beijing Obstetrics and
Gynecology Hospital took place during the trip:
founded in 1959, it is the largest obstetrics and
gynecology hospital in Beijing, and highly
advanced in perinatology and women’s
reproductive health. It is also notable for serving
as a World Health Organization (WHO) research
and training centre for women’s health in China.
Executive Board in session
Seminar participants
He added: ‘We are pleased to report that
attendance was superb – more than 700
students in Beijing and 300 in Chengdu – with
plenty of discussion and participation among
both students and speakers. We performed the
same anonymous multiple choice test questions
before and after the seminar, and the results were
similar in both: a 40 per cent increase in correct
answers, which truly reflected the positive impact
of these events.’
Chief Executive Professor Hamid Rushwan (right) with
hospital staff
FIGO Administrative Director Bryan Thomas (left) and
FIGO Senior Administrator and Committee Manager
Marie-Christine Szatybelko with colleague Yonggang
Shang
A number of valuable related activities took place
alongside the main Executive Board business:
Women’s Health:
Contemporary Challenges
FIGO President-Elect Professor Sir Sabaratnam
Arulkumaran (centre) views facilities
The FIGO Committee for Capacity Building in
Education and Training organises the now
traditional educational seminar during the period
of the Executive Board Meeting. In China, two
events were held, one in Beijing and one in
Chengdu, under a common theme: Women’s
Health: Contemporary Challenges.
Professor Luis Cabero-Roura, Committee Chair,
explained: ‘The seminar programme – starting
with a lecture from the FIGO President –
Chief Executive Hamid Rushwan commented:
‘This valuable visit provided FIGO with an
excellent overview of the state of current
maternal and newborn healthcare in China.
‘It was clear from our tour of the hospital that
medical professionals have been trained to
rigorous standards: we were greatly impressed
with their calibre and dedication, and the
subsequent high quality robust care provided to
mothers and babies.’
President Gamal Serour (right) with CSOG’s Former
President Dr Zeyi Cao
He ended: ‘FIGO – in particular, the Committee
for Capacity Building in Education and Training –
wishes to express its sincere gratitude to the
speakers who generously participated in the
International Federation of Gynecology and Obstetrics | August 2012
5
10660:Layout 1
10/8/12
12:43
Page 6
SAVING MOTHERS AND NEWBORNS INITIATIVE
Looking back; moving forward
(2006–2011, funded by the Swedish International Development Cooperation Agency – www.sida.se – and FIGO)
FIGO’s recently concluded Saving Mothers and
Newborns Initiative resulted in great challenges
and opportunities for low- and middle-resource
countries in their quest to make a tangible
difference in the reduction of maternal and
newborn morbidity and mortality, and to the
achievement of MDG goals 4 and 5,’ said Dr
André Lalonde, Project Director, and Chair of
the FIGO Committee for Safe Motherhood and
Newborn Health.
L–R: Dr André Lalonde, Chair FIGO SMNH Committee; Mr
José Mujica, President Of Uruguay; Economist Daniel
Olesker, Minister of Health; Leonel Briozzo, director of
project, Sub Secretario de Salud Pública
Peru training
objectives: to strengthen the capacity of national
professional associations to engage in maternal
and newborn health through the design and
implementation of projects, and to strengthen cooperation between FIGO and national societies,
and between societies in regions of differing
economic levels.
‘Further secondary aims were to strengthen the
co-operation between national societies and the
national stakeholders involved in safe
motherhood and newborn health, and to
increase the credibility of national societies locally
to provide technical support to Ministries of
Health (MoH) and national professional councils.
‘Each project focused on identified needs within
each country and resulted in varied approaches
and targets, ranging from clinical training,
protocol development, and implementation of
clinical audit through to legislative and policy
change.’
Rising to the challenge
Women and children, Uganda
Explaining the challenges (Kenya project)
Laying the groundwork
He continued: ‘The Committee worked with
associations of obstetricians, gynecologists and
midwives in 10 low- and middle-resource
countries between 2006 and 2011, with
contributions from professional associations in
high-resource countries through a structured
north-south mentoring programme.
Pakistan medical camp
‘The countries involved were: Haiti, Kenya,
Kosovo, Moldova, Nigeria, Pakistan, Peru,
Uganda, Ukraine and Uruguay.
‘The main goal - that of contributing to the
reduction of maternal and newborn morbidity and
mortality to help achieve MDGs 4 and 5 – was
complemented by critically important secondary
6
Dr Lalonde explained: ‘From the very start, the
challenges were immense, but the project elicited
tremendous enthusiasm in reacting to the needs
of pregnant women in the countries involved.
‘Some concrete examples of success: the
Uruguay project – how to manage unsafe
abortion in a country with very restrictive laws – is
a model for many countries. The Haiti project
responded to an enormous humanitarian disaster
[a severe earthquake] through making the project
maternity centre one of the few maternities in
Port au Prince able to offer essential obstetrical
care, thus preventing hundreds of maternal
deaths. The Kenya project instituted clinical
audits and mobilised the healthcare professionals
(HCPs) to provide better care. The Pakistan
project recruited and trained local women to
provide essential obstetrical care.
‘Each project was indeed unique and, despite
presenting huge administrative challenges,
succeeded in mobilising HCPs – for many, this
was the first time that there had been a direct
response to the needs of safe motherhood and
newborn care in their countries outside of their
clinical practices.
A significant outcome
‘We are delighted to report that significant and
largely sustainable results were achieved,
particularly in relation to the relatively small-scale
funding available, and this resulted in direct
improvements to maternal and newborn health
outcomes. The capacity of both FIGO and
national professional associations was also
substantially strengthened in project design,
management, and implementation, leading to
opportunities to support international
development efforts in the future.
‘One of the most notable achievements was the
provision of clinical training to more than 2,000
health professionals, including traditional birth
attendants, midwives, doctors, and obstetricians.
‘The SMNH Committee played no small part in
the success of this enterprise – Committee
members in different regions were tasked with
troubleshooting difficulties, therefore providing a
cost-effective solution to problem-solving.’
Dr Lalonde concluded: ‘All programme directors
are scheduled to present their results at a halfday seminar at the FIGO World Congress, and a
booklet will also be produced and made available
on www.figo.org’
Full reports on the project’s activities (including
the individual country reports) are available on
this section of the FIGO website:
http://www.figo.org/projects/newborns
The project in focus
Selected achievements
Haiti ‘Strengthening the health center of Croix des Bouquets’ Primary health clinic transformed into
functioning hospital; ambulance purchased and on-call driver contracted
Kenya ‘Improving quality of prenatal, delivery, and postnatal care through clinical audit’ Update of
clinical audit extended beyond maternity into general surgery
Kosovo ‘Reduction of maternal and newborn mortality’ First set of national standards developed
by a clinical body produced by national association and approved by the MoH
Moldova ‘Beyond the numbers - implementation of new approaches in reviewing perinatal deaths’
National registration of all perinatal deaths
Nigeria ‘Saving mothers and newborns in Edo, Amambra, and Kaduna States’ Magnesium
sulphate supplied to all state hospitals by Kaduna State Government; its cost reduced by
manufacturers
Pakistan ‘Community-based interventions to reduce maternal and perinatal mortality and morbidity
in rural Sindh’ Training local women as midwives; renovations led to functioning operating theatre
Peru ‘Improving obstetric and neonatal emergency care in Morropón Chulucanas Health Network,
Piura’ Emergency Obstetric Care (EOC) and Comprehensive Essential Obstetric Care (CEOC) in
rural mountain area audits
Uganda ‘Reduction of maternal and newborn mortality’ Paradigm shift in professional
organisational thinking led to collaborative working with non-health community staff to achieve
improved health outcomes for rural women
Ukraine ‘EmOC improvement by advances in labor and risk management (ALARM) international
program (AIP)’ Reduction in inappropriate clinical interventions during delivery
Uruguay ‘To protect the life and health of Uruguayan women by reducing unsafe abortions’ Policy
and legislative change; Presidential support for the project; creation of a sexual and reproductive
health department within the MoH (headed by project director)
International Federation of Gynecology and Obstetrics | August 2012
10660:Layout 1
10/8/12
12:44
Page 7
Dr André Lalonde
receives Queen
Elizabeth II Jubilee
medal
Dr Lalonde continues his commitment to
reducing maternal mortality in low-resource
countries and especially the prevention and
treatment of post-partum haemorrhage (PPH).
More recently, he led the Committee in
developing FIGO PPH Guidelines.
He is seen below with the Minister of International
Cooperation, Ms Beverley J Oda, at a ceremony
in Ottawa. She complimented Dr Lalonde on his
illustrious career and on how he ‘makes Canada
proud’.
A selection of Dr Lalonde’s
achievements:
Dr Lalonde receiving his medal from the Minister
On 21 June 2012 Dr André Lalonde, Chair of
the FIGO Committee for Safe Motherhood and
Newborn Health, received the Queen Elizabeth
II Jubilee Medal for his contribution to women’s
health in Canada and around the world.
• Leading the ground-breaking multi-disciplinary
Collaborative Primary Maternity Care Project.
This enabled nurses, midwives, family
physicians and obstetricians to work together
effectively to ensure appropriate care.
• Pioneering a worldwide Maternal Risk
Management programme to address maternal
and newborn mortality and morbidity. The
ALARM International programme has been
piloted and used in over 20 low-resource
countries with great success.
• Co-authoring Postpartum Hemorrhage
Today, the definitive textbook on the subject.
• The LaSalle General Hospital in Montreal,
where Dr Lalonde was Head of Obstetrics,
recognised his dedication and named the
obstetric wing the ‘Lalonde Birthing Unit’.
FIGO Chair highlights
importance of new PPH
Guidelines
For many years, Dr Lalonde has been
active in FIGO’s worldwide campaign to
prevent PPH, promoting non-invasive
treatments to prevent this devastating
condition.
He commented: ‘The FIGO Committee for
Safe Motherhood and Newborn Health has
completed a full review of the physiology of
the Third Stage of Labour, and prevention
and management of PPH in low-resource
countries. FIGO’s recently published
Guidelines [available at
http://www.figo.org/publications/PPH_G
uidelines], in the International Journal of
Gynecology & Obstetrics, are not only
evidence-based, but include important
clinical information to help all healthcare
professionals to tackle this huge problem.’
He added: ‘The central recommendation is
that all women should be offered an oxytocic
drug at delivery. It also calls for community
availability of trained personnel in midwifery
care, as well as supply of misoprostol [see
page 9] where oxytocin is not available.
‘In particular, there are discussions on the
cascade of medical and surgical treatment of
PPH, and recommendations on the use of
uterine tamponade and the anti-shock
garment [NSAG].
‘The Guidelines offer a logical approach, and
downloadable schemas that can be
reproduced and used as posters in delivery
rooms.’
He ended: ‘Medical societies should
pressure all governments to supply
necessary drugs and equipment to prevent
and treat PPH, and therefore help to reduce
maternal mortality.’
Global review presents key interventions for RMNCH
The Partnership for Maternal,
Newborn and Child Health (PMNCH),
together with WHO, Aga Khan
University and other partners, have
produced, following consultations with
a broad range of experts, a consensus
document: Essential Interventions,
Commodities and Guidelines for Reproductive, Maternal, Newborn and Child Health (RMNCH).
The document – the product of extensive research and consultation – can be accessed at:
http://www.who.int/pmnch/topics/part_publications/201112_
essential_interventions/en/index1.html
The document provides information on key selected survival interventions that should be made
available to women and children, as well as information on the type of professional health worker
required for their delivery, key commodities required, and corresponding available guidelines.
Its aim is to support policy makers and RMNCH advocates and programme implementers in the
development of guidelines, policies and programmes to improve the health of women and children.
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]
President-Elect:
Sabaratnam Arulkumaran (UK)
Administrative Director:
Bryan Thomas
Past-President:
Dorothy Shaw (Canada)
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 20 October
2012 for the next issue.
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.
Honorary Secretary:
Ian Fraser (Australia)
President:
Gamal Serour (Egypt)
Chief Executive:
Hamid Rushwan
Vice President:
Takeshi Maruo (Japan)
Honorary Treasurer:
Wolfgang Holzgreve (Switzerland)
International Federation of Gynecology and Obstetrics | August 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.
7
10660:Layout 1
10/8/12
12:44
Page 8
FIGO IN THE FIELD…
Latest from the LOGIC Initiative
Saving the lives of
mothers through
facility-based
Maternal Death
and Near Miss
Reviews in
Ethiopia
The Ethiopian Society of
Obstetricians and Gynecologists
(ESOG) has – through the support of the FIGO
LOGIC Initiative (Leadership in Obstetrics &
Gynaecology for Impact and Change) in Maternal
and Newborn Health (MNH) – been working with
the Ethiopian Government and other partners to
introduce facility-based Maternal Death Reviews
(MDRs) and Near Miss Reviews (NMRs) in eight
public hospitals in Ethiopia. This has been done
as part of national efforts in Ethiopia to achieve
Millennium Development Goal 5 to improve
reproductive and maternal health. The maternal
mortality in Ethiopia is 676 per 100,000 live births
(Ethiopian Demographic Health Survey 2011).
It is possible to prevent most maternal deaths
and disabilities with known and effective
interventions, but this requires the right kind of
information on why women are dying or facing
lifelong disabilities. It is not enough to have
information on the overall levels of maternal
mortality and morbidity – health policy makers
and practitioners need to understand the
underlying factors to be able to prevent future
deaths and disabilities.
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, 20031 p. 33). The
lessons learned from MDRs/NMRs lead to
recommendations for improvements in care to
prevent future deaths and disabilities. It is not a
process for handing out blame or shame, but
exists to identify and learn lessons to help ensure
that mothers are healthy in the future.
ESOG has implemented facility-based MDRs and
NMRs at eight public hospitals in four regions of
Ethiopia (Addis Ababa, Amhara, Oromia and
SNNPR) since 2011. It has successfully been
working with the public health facilities to ensure
staff ownership of the process. The fact that
hospital staff have not been reluctant to report
maternal deaths or near misses, nor have they
feared punitive action, is a credit to the
successful management of the implementation of
MDRs/NMRs by ESOG. The data has been
collected by multi-disciplinary hospital
committees by using structured and standard
MDR/NMR tools. The near-miss definition was
based on validated disease-specific criteria.
ESOG has conducted primary analysis of
facility-based MDR/NMR data between May and
October 2011 from eight hospitals to find out the
causes and circumstances surrounding maternal
mortality and morbidity. During this period there
were 119 maternal deaths and 989 near miss
cases out of a total of 9,712 women giving birth.
This represents a maternal mortality rate of
1318/100,000 live births. 1.2 per cent of the total
facility-based deliveries result in maternal deaths.
The ratio of maternal death to near miss is nearly
1:9.
The leading causes of maternal deaths and near
misses were: preeclampsia/eclampsia (29 per
cent); obstetric haemorrhage (16 per cent); and
uterine rupture (13 per cent). Nearly 52.8 per cent
of deliveries were attended at home and phase I
delay (delay in decision to seek care) contributed
to about 25 per cent of maternal deaths and near
misses in the health facilities.
ESOG has also found that the MDRs/NMRs
provide a good learning experience for staff if the
reviews are done in a participatory manner, using
a team approach. The MDRs/NMRs have
resulted in change in clinical practice within the
health facilities. For example, as a result of the
MDR/NMR process, the hospital at Debre Berhan
has reported many improvements, including
increased use of the partogram from 48 per cent
to 85 per cent; increased and appropriate
administration of magnesium sulphate; and
better adherence to protocols and increased
availability of drugs. The hospital is also working
towards acquiring ambulance transport and
setting up a ‘mini’ blood bank.
The successful implementation of MDRs/NMRs
requires strong partnership between the
Government, including the Federal Ministry of
Health (FMoH) and regional health authorities,
and other partners, including UN agencies and
major bilateral donors. ESOG has throughout this
process been working very closely with the
Ethiopian Government as well as other partners.
Incorporating facility-based MDRs/NMRs into the
routine national maternal health programme is
key in finding out the causes and circumstances
surrounding maternal deaths and near misses, so
that improvements in care can be implemented thereby preventing future deaths and disabilities.
The FMoH is currently working to standardise the
ESOG-initiated MDR/NMR tools and practice
with the aim to incorporate this into the routine
national programmes.
This article was prepared with the assistance of
Dr Yirgu Gebrehiwot, ESOG President, Birukkidus
Tekleselassie, Project Manager, FIGO-LOGIC
Initiative in MNH, and Selamawit Kifle, ESOG
General Manager.
1 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.
MDR Workshop, Addis Ababa, 23 June 2012: L–R (left hand
table): Dr Segun Adeoye, Dr Fred Achem, Dr Chris
Agboghoroma; L–R (right-hand table): includes Professor
Robert Leke, Dr Philip Nana, Dr Jolly Beyeza and Dr Daniel
Murokora
FIGO LOGIC support for MDRs and NMRs
FIGO LOGIC, funded by the Bill & Melinda Gates Foundation, is working with eight FIGO
Member Associations (MAs), internationally renowned Maternal Death Review (MDR) experts,
and other partners to influence and improve the use of maternal death notification systems
and/or MDRs in eight countries in Africa (Burkina Faso, Cameroon, Ethiopia, Mozambique,
Nigeria and Uganda) and South Asia (India and Nepal).
The FIGO MAs taking part in the FIGO LOGIC Initiative in Maternal and Newborn Health (MNH) are
working closely with Ministries of Health, relevant health authorities, hospital management in
selected hospitals as well as other partners such as multilateral institutions to implement MDRs,
and in some cases Near Miss Reviews (NMRs) and Maternal and Perinatal Death Reviews
(MPDRs).
The aim is to implement MDRs/NMRs in line with international standards and as outlined in the
World Health Organization publication: ‘Beyond the Numbers – Reviewing maternal deaths and
complications to make pregnancy safer’ (2004).
FIGO LOGIC is working towards contributing to nationally, sustainable MDR/NMR processes over
the longer-term with the aim of helping to improve maternal health services and preventing future
maternal deaths and disabilities.
Gynecologists and obstetricians, together with other health care professionals, have an important
role to play in improving MNH policy and clinical practice, including through the implementation of
findings and recommendations coming out of MDR and NMR processes.
The following FIGO MAs are participating in the FIGO LOGIC Initiative in Maternal and
Newborn Health: Société des Gynécologues et Obstétriciens du Burkina Faso (SOGOB);
Society of Gynaecologists and Obstetricians of Cameroon (SOGOC); Ethiopian Society of
Obstetricians and Gynecologists (ESOG); The Federation of Obstetric and Gynaecological
Societies of India (FOGSI); Associação Moçambicana de Obstetras e Ginecologistas
(AMOG); Nepal Society of Obstetricians and Gynaecologists (NESOG); Society of
Gynaecology and Obstetrics of Nigeria (SOGON); Association of Obstetricians and
Gynaecologists of Uganda (AOGU).
8
David Taylor, FIGO LOGIC Project Director
Dr Yirgu Gebrehiwot, ESOG President
Birukkidus Tekleselassie, Project Manager (ESOG),
FIGO-LOGIC Initiative in MNH
International Federation of Gynecology and Obstetrics | August 2012
10660:Layout 1
10/8/12
12:44
Page 9
Misoprostol and PPH:
high profile at Rome 2012
– an update on the
Misoprostol for PostPartum Haemorrhage
(PPH) in Low Resource
Settings Initiative
In October 2012 Rome will provide the setting
for FIGO’s XX World Congress of Gynecology
and Obstetrics, an important triennial event
attracting leading experts in women’s health
and rights from around the world. The Scientific
Programme includes two FIGO-sponsored
expert panel sessions, scheduled for the
morning of Wednesday 10 October 2012, that
will focus on the prevention and treatment of
PPH with misoprostol.
PANEL 1 – Misoprostol for the Prevention
and Treatment of Post-Partum
Haemorrhage: The Clinical Evidence &
International Recommendations
Session Moderator: Zarko Alfirevic
(University of Liverpool)
Name of Presenter and Title of Presentation
1. Sir Sabaratnam Arulkumaran (FIGO) – The
Global Challenge of PPH and New FIGO
Guidelines on the Prevention and
Treatment of PPH with Misoprostol
2. Metin A Gülmezoglu (WHO) – The World
Health Organization Recommendations on
PPH
3. Wilfrido León (Hospital Gineco-Obstétrico
Isidro Ayora) – Sublingual Misoprostol for
Treatment of PPH: Dose and Side Effects
4. Rasha Dabash (Gynuity Health Projects) –
Programmatic Implications of Current
Strategies and New Approaches to
Integrating Misoprostol for PPH
Management
5. Beverly Winikoff (Gynuity Health Projects)
– Why Misoprostol Matters
PANEL 2 – Misoprostol for the Prevention
and Treatment of Post-Partum
Haemorrhage: Innovative Country
Approaches in Low-Resource Settings
Session Moderator: Jeffrey Smith (Jhpiego)
Name of Presenter and Title of Presentation
1. Jennifer Blum (Gynuity Health Projects) –
Misoprostol: A Proven Technology for
Prevention and Treatment of PPH –
Overview of the Clinical Evidence
2. Swaraj Rajbhandari (Senior Public Health
Specialist) – Scale-up of Misoprostol for
PPH Prevention at the Country Level:
Nepal
3. Andrew Weeks (University of Liverpool) –
Community-Based Use of Misoprostol for
PPH Prevention: Snapshot from a Pilot
Study in Uganda Documenting SelfAdministration of Misoprostol in a Home
Delivery Setting
4. Susan Mukasa (Population Services
International / PACE-Uganda) –
Community-Based Distribution Models for
Rolling Out Misoprostol for PPH
Prevention: Experience and Lessons
Learned from Uganda and Tanzania
5. Shafiq Mirzazada (Aga Khan Health
Services, Afghanistan) – Misoprostol for
the Treatment of PPH Following its Use for
Prevention (Afghanistan & Pakistan)
FIGO symposium success at RCOG Congress
A FIGO Symposium
attracted over 300
delegates who had
gathered in Sarawak,
Malaysia, in June
2012, to take part
in the 10th Royal
College of
Obstetricians and
Gynaecologists’
(RCOG)International
Scientific Congress.
FIGO’s Chief
Executive, Professor
L–R: Holly Anger (USA); Clare Waite (UK); Professor Hamid Rushwan (UK); Professor
Emad Darwish (Egypt); Dr Alka Barua (India); Swaraj Rajbhandari (Nepal); and Dr Nadeem Hamid Rushwan,
Zuberi (Pakistan)
moderated the
Symposium, which focused on the evidence around the prevention and treatment of
post-partum haemorrhage with misoprostol.
Dr Nadeem Zuberi (Aga Khan University, Pakistan) opened by reviewing studies on the efficacy and
safety of 600mcg oral misoprostol to prevent PPH in community-based settings, including when
administered by trained traditional birth attendants during home deliveries in Pakistan (Mobeen et
al. 2010). Professor Emad Darwish (University of Alexandria, Egypt) followed by discussing two
large multi-site studies that review the efficacy of misoprostol 800mcg sublingual compared to 40
IU IV oxytocin for treatment of PPH in hospitals where oxytocin prophylaxis is provided during the
third stage of labour and in others where it is not provided (Winikoff et al. 2010; Blum et al. 2010).
Dr Alka Barua (Public Health Consultant, India) continued by presenting an analysis of a pilot study
that sought to understand better the relationship between misoprostol dose and occurrence of
elevated body temperature (≥40°C), using a lower dose of sublingual misoprostol for the treatment
of PPH, among one population in Ecuador where an unexpectedly high rate of fever had previously
been recorded (Durocher et al. 2010). Holly Anger (Gynuity Health Projects, USA) looked at
alternative strategies for managing PPH, focusing her presentation on a ‘secondary prevention’
study currently underway that bridges PPH prevention and treatment strategies, whereby a safe
and effective treatment dose of misoprostol (800 mcg sublingual) is selectively administered to
women, such as those who bleed 350 mL (less than accepted definitions of PPH). ‘Secondary
prevention’ would medicate fewer women, could improve acceptability, may be more cost-effective
compared to universal prophylaxis, and may alleviate fears of delayed time to transfer associated
with a treatment-only approach.
The Symposium was rounded off by a presentation from Swaraj Rajbhandari (Senior Public
Health Specialist, Nepal) who discussed a government-approved expansion programme of
community-based distribution of misoprostol for PPH prevention across 28 districts of Nepal,
and reviewed the findings from a pilot study, conducted in the Banke district, which established
that misoprostol distribution, given to pregnant women to self-administer at the time of their
delivery as a prophylaxis, can be successfully implemented under government health services in
a low-resource and geographically challenging setting (Rajbhandari et al. 2010).
United Nations High-Level
Commission on Life-Saving
Commodities for Women
and Children
A report, UN Commission on Life Saving
Commodities for Women and Children: Country
Case Studies, developed by the Maternal
Health Task Force was made public in May
2012.
It focuses on three maternal health commodities
– oxytocin, misoprostol and magnesium sulphate
– in six countries that carry a high burden of
maternal mortality: Bangladesh, India, Ethiopia,
Nigeria, Tanzania, and Uganda.
It highlights barriers to access as well as
innovations and best practices for expanding the
availability of the three agents in low resource
countries, and was completed on behalf of the
UN Commission on Life-Saving Commodities,
launched in March 2012 to increase access to 13
life-saving medicines and health supplies for the
world’s most vulnerable people.
The Commission will issue its recommendations
at the UN General Assembly in September 2012.
International Federation of Gynecology and Obstetrics | August 2012
Misoprostol: What does
FIGO recommend?
PPH Prevention: FIGO
recommends a single dose of
600mcg misoprostol administered
orally immediately after delivery of
the newborn and after it is
established that there are no
additional babies in utero.
PPH Treatment: FIGO
recommends a single dose of
800mcg misoprostol, administered
sublingually immediately after PPH
is diagnosed and if 40 IU IV
oxytocin is not immediately available
(irrespective of the prophylactic
measures).
Extracts from FIGO Guidelines that focus on the
prevention and treatment of post-partum
haemorrhage with misoprostol, scheduled for
publication in 2012
9
10660:Layout 1
10/8/12
12:44
Page 10
FIGO puts finishing touches
to World Congress 2012!
www.figo2012.org
After three years of intensive preparations,
FIGO’s World Congress finally opens for
business on 7 October 2012!
Professor Hamid Rushwan, FIGO’s Chief
Executive, commented: ‘Visitors will be treated to
a superlative Scientific Programme, ably
overseen by Professor William Dunlop, Chair of
the FIGO 2012 Scientific Programme
Committee.’
He added: ‘The programme explores current
developments in the areas of Maternal and Fetal
Medicine, Reproductive Medicine, Gynecological
Oncology, Urogynecology and Sexual and
Reproductive Health, as well as the very critical
practical implications of providing healthcare to
women in high- and low-resource settings. The
Programme Committee comprises
representatives of international subspecialty
organisations and also the Chairs of FIGO’s
Committees and Working Groups to ensure upto-the minute information on current global
developments.
‘Over 1700 abstracts have been accepted for
oral or poster presentation – as a result of this
tremendous global interest, the Congress is on
track to provide a major opportunity for the
exchange of ideas between all cadres of
healthcare professionals and other stakeholders
across the world.’
Programme highlights include
• LIVE SURGERY SESSIONS – transmitted from
European hospitals
• NEW CLINICAL GUIDELINES – presented by
representatives of FIGO, WHO and other global
NGOs
• SPECIAL SESSIONS ON INDIVIDUAL
COUNTRIES’ EXPERIENCES – presented by
national and international ob/gyn societies
A Scientific Programme
is now online: visit http://www.figo2012.org/
scientific-programme/ for a full overview.
FIGO eases travel to Rome
Congress
FIGO has made plans to ease the travel of
participants from the city to the Congress venue
(Fiera di Roma) and back. On registration,
participants will receive a free travel card for use on
public transport to be utilised throughout the
Congress, which will be included in their delegate
packs. Please access this link for full details of how
to travel to the venue: http://www.figo2012.org/
public-transportation/ (a Rome metro and city
railways map).
Opening and Closing
Ceremonies
Sunday 7 October 2012
The official inauguration of the XX FIGO World
Congress will take place at Fiera di Roma on
Sunday 7 October 2012 (6.00–7.30pm). A
reception will be held in the same location after
the Ceremony.
Friday, 12 October 2012
The Closing Ceremony will take place at Fiera di
Roma on Friday 12 October 2012
(12.30–1.30pm). The Ceremony will mark the
close of the Congress and inauguration of the
incoming FIGO President Professor Sir
Sabaratnam Arulkumaran.
Vancouver, Canada will be presented as the host
city of the XXI FIGO Congress in 2015.
Register before 31 August 2012 to take advantage of ‘regular registration’!
Tipology
Congress
Congress
Congress
Pre-Congress courses
Pre-Congress courses
Pre-Congress courses
Pre-Congress courses
Pre-Congress courses
Pre-Congress courses
Pre-Congress courses
Registration fee
Euro
Category
To 31 Aug 2012
From 01 Sept 2012 to 15 Sept 2012
From 06 Oct 2012 onward
Course 1: Basic course on ultrasound
Course 2: Diabetes and pregnancy in low-resource countries
Course 3: Postpartum haemorrhage
Course 4: Basic course on endoscopy
Course 5: Basic course on colposcopy
Course 6: The FIGO Fertility Tool Box™
Course 7: The Global Obstetrics Network (GONet)
850
950
950
100
100
100
100
100
100
100
regular registration
late registration
on site registration
regular registration
regular registration
regular registration
regular registration
regular registration
regular registration
regular registration
FIGO joins the Reproductive Health Supplies Coalition
FIGO is delighted to announce that it has
recently become a member of the
Reproductive Health Supplies Coalition, ‘a
global partnership of public, private, and
non-governmental organisations dedicated to
ensuring that all people in low- and middleincome countries can access and use
affordable, high-quality supplies to ensure
their better reproductive health’.
10
The Coalition brings together multilateral and
bilateral organisations, private foundations,
governments, civil society, and private-sector
representatives that play critical roles in providing
contraceptives and other reproductive health
supplies.
John P Skibiak, Director, Coalition Secretariat,
commented: ‘It’s an honour and privilege to
welcome FIGO on board the Coalition’s
membership. FIGO is
built on the power of
partnership, just as
the Coalition is; its
work for the wellbeing
of women dovetails
perfectly with our
own commitment
to provide all women
with a choice of
safe, modern
contraception. I look
forward to a long and
John P Skibiak
productive relationship with our newest – and
200th – member.’
For detailed information on the
Coalition’s work, please visit:
http://www.rhsupplies.org/about-us.html
International Federation of Gynecology and Obstetrics | August 2012
10660:Layout 1
10/8/12
12:44
Page 11
Are you missing out on key articles?
International Journal of
Gynecology
& Obstetrics
2012 subscriptions are just $80
for members of FIGO national societies!
See www.ijgo.org/pricing
for more information and to subscribe online
This journal publishes articles on all aspects of
basic and clinical research in the fields of obstetrics
and gynecology and related subjects, with special
emphasis on matters of worldwide interest.
The Journal is the official publication
of the International Federation of
Gynecology and Obstetrics (FIGO).
It features:
Editorials t Articles t Case Reports t Brief
Communications t International Calendar t
SOGC Clinical Practice Guidelines t Review
Articles t and sections on, Contemporary Issues
in Women’s Health; Averting Maternal Death and
Disability; and Surgery and Technology.
International Journal of Gynecology & Obstetrics also:
t IBT POMJOF submission at http://ees.elsevier.com/ijg
t *NQBDU 'BDUPS OPX t QVCMJTIFT JTTVFT B ZFBS
t IBT IJHI JOUFSOBUJPOBM WJTJCJMJUZ o 0WFS BSUJDMFT EPXOMPBET JO
4DJFODF%JSFDU JO o 5IBUT BMNPTU POF B NJOVUF
t "OE NPSF UIBO QBHFT WJFXT PO www.ijgo.org
Remember 2012 subscriptions are just $80 for members of FIGO national societies.
See www.ijgo.org/pricing to subscribe online
10660:Layout 1
10/8/12
12:44
Page 12
Organised by
7th - 12th October 2012
fiera di Roma
Rome, Italy
INTERNATIONAL FEDERATION OF
GYNECOLOGY & OBSTETRICS
www.figo2012.org