Women’s Health in IndiaWomen’s health in India is still vulnerable to several risks such as high maternal mortality rates, lack of preventative care and misinformation about family planning and contraception. Despite this, India has proven itself a pioneer in technological innovation among developing countries and it is putting its new innovations towards improving women’s healthcare. 

Maternal Health and Newborn Development

Although maternal mortality rates in India have declined substantially in the last decade, the number of recorded deaths related to pregnancy complications in the country is still remarkably high. A report by UNICEF estimates that 44,000 women die due to preventable pregnancy-complications in India yearly. These complications often stem from a lack of knowledge and inherently the inability to understand that their baby isn’t developing correctly. This lack of knowledge results in fewer women seeking treatment that could save their lives. To combat this, organizations are developing innovative mobile apps to help women stay proactive and educated about the health of their babies and the status of their pregnancies. 

For example, in 2014, MAMA (Mobile Alliance for Maternal Action), an organization dedicated to women’s maternal health in developing countries, developed a digital service called mMitra. The service sends recordings and SMS messages to new and expectant mothers with crucial information about the early stages of pregnancy and child development within the first year of life. The app, which collected 50,000 subscribers within months of its launch, sends educational content to women in their native languages and at times of their choosing. The app,  mMitra ultimately aims to help women pick up on pregnancy and child development issues early and seek treatment before symptoms escalate or endanger the mother and child. 

Breast Exams and Preventative Care

Mammograms are an essential part of preventative care for women globally. Despite this, it is estimated that over 90 percent of women in the developing world go without this essential screening examination. Particularly, in India, high-costs, unsustainable electricity and lack of properly trained radiologists are major causes for the inaccessibility to mammograms and other procedures like it. More women die of breast cancer in the country than anywhere else in the world (around 70,000 women annually). While these high death rates due to inaccessibility to preventive care are tragic, they’ve inspired innovative medical devices that have revolutionized women’s health in India. 

One such device, known as iBreastExam was invented by computer engineer Mihir Shah. Shah invented the device to ensure that women in even the most rural parts of India could get affordable, accurate breast exams and seek treatments as needed. The battery-operated wireless machine is designed to record variations in breast elasticity and performs full examinations in five minutes, posting and recording results through a mobile app. Not only that, the exams are painless, radiation-free and are extremely affordable at $1 to $4 per exam.

Family Planning and Contraceptive Options

Lack of family planning and knowledge of contraceptive options is another challenge in improving women’s health in India. Many Indian women shy away from modern family planning and contraception due to things like familial expectations, cultural influence and a general fear stemming from misinformation from disreputable resources. Family planning and the use of contraception could reduce India’s high maternal mortality rates. However, without proper education on these matters, it is difficult for young Indian women to make informed decisions about what options are best for them. But, in the midst of India’s technological revolution, an increase in accessibility to mobile devices is steadily transforming the way women are gaining health awareness in India. 

There is a particular mobile app that is playing a huge role in improving women’s health awareness in India. Known as Gyan Jyoti, the mobile app provides credible information through educational films, TV advertisements and expert testimonials from doctors. It also acts as a counseling tool for ASHAS (appointed health counselors). The app allows ASHAS to expand their knowledge of family planning through an e-learning feature, customize their counseling plan according to the needs of clients and monitor and store client activity in order to provide the best information possible. 

Overall, while there are still many challenges in improving women’s health in India, the country has proven itself to be a pioneer in technological innovation. Just as well, it’s proven that transformation is possible by putting its innovations towards women’s health awareness through mobile apps, life-saving hand-held devices, and educational platforms that can be accessed at the click of a button. 

Ashlyn Jensen
Photo: Flickr

 

Contraception Reduces PovertyOverpopulation is a growing concern for both developed and developing countries alike. The rate at which the global population is increasing is alarming. While it took thousands of years to reach the world’s first billion people in 1804, it only took 123 years to add another billion and only 12 for the most recent billion. It is imperative to curb population growth now to prevent the spread of global poverty due to overpopulation. This solution should be as efficient as it is effective. Contraception reduces poverty, and it also ensures a more resourceful future that better meets the needs of the world’s population.

Here are three facts about the relationship between contraception and poverty reduction:

  1. If women who currently lack the means to sexual health information, as well as proper contraception, were allowed access to these reproductive tools, an estimated 35 million abortions and 76,000 maternal deaths would be prevented each year. Given that abortions far exceed the price of standard birth control, these women could instead spend this money to provide for their families and improve their quality of life. Saving women from a premature death from unwanted pregnancy due to a lack of reproductive education and resources is not only beneficial in regard to humanitarian measures, but it also strengthens the economic security of the household.
  2. More people being integrated into the work force, followed by a decrease in the number of dependents, provides a boost to economies worldwide. Populations dense with working-age individuals often live in more developed countries given the surplus of people contributing to the respective economy. Contraception reduces poverty in this sector because adults who either choose not to have children or delay the rate at which they have children have more time and resources to earn better-living potentials when compared to those who must use their income to provide for their families.
  3. While education and international aid offer clear benefits in the fight against poverty, the growth of an excessive population counters these measures. Given the current population’s exponential growth, the economies and civil services of developing countries already lack the capacity or resources to provide for the influx of people to come. The ways in which global poverty is combatted today may no longer be effective in the future if contraception is not accessible.

Family planning means more than just preventing unwanted pregnancies. According to the former executive director of the UN Population Fund, the late Babtunde Osotimehin, “It is a most significant investment to promote human capital development, combat poverty and harness a demographic dividend, thus contributing to equitable and sustainable economic development.” Funding family programming can ensure that contraception reduces poverty, and it will remain effective for generations to come. Additionally, it will help the planet utilize its limited resources more effectively.

Kaitlin Hocker

Photo: Flickr

Youth pregnancies in Côte d’Ivoire declined by an astounding 20 percent since the Zero Pregnancies in School Campaign began in 2013, according to the United Nations Population Fund. This campaign is part of a nationwide plan, supported with technical and financial assistance from UNFPA, to enable young people to make informed decisions about their sexual and reproductive health.

During the 2012-2013 academic year, 5,076 students became pregnant in primary or secondary school, reported the Ivorian Ministry of National and Technical Education. While the teen-age birth rate globally is 50 per 1,000 girls, in Côte d’Ivoire, the number is 125.

The 2013 UNFPA State of World Population report found that 7.3 million girls, 18-years-old and younger, give birth each year in developing countries. This reality is both a health issue as well as a development issue. Many pregnant girls are forced to drop out of school creating downward-spiraling repercussions of limited prospects.

“It is deeply rooted in poverty, gender inequality, violence, child and forced marriage, power imbalances between adolescent girls and their male partners, lack of education, and the failure of systems and institutions to protect their rights,” said Dr. Babatunde Osotimehin, UNFPA Executive Director.

The high birth rates in Côte d’Ivoire undermine the country’s ability to take advantage of a demographic dividend. A demographic dividend is a window of opportunity to hasten economic growth when a population’s age structure shifts from one with fewer people of working age (15 to 65) to one with fewer dependent people (under 14 and over 65).

In response to this situation, the Ivorian Council of Ministers formally adopted the accelerated pregnancies reduction plan on April 2, 2014. The plan is a comprehensive program that integrates sexuality education in Côte d’Ivoire, teaching over several years starting in 4th grade to provide age-appropriate information at each stage.

Based on human rights principles, sexuality education encompasses more than sex education. The fundamental components of the curriculum feature the information about the human body, contraception and sexual and reproductive health. This includes knowledge about sexually-transmitted diseases and the effects of early pregnancy. The curriculum also addresses the issues of child marriage and gender-based violence so that human rights, gender equality and the empowerment of young people is advanced.

The comprehensive program offers other school activities beyond the classroom. Nationally, student clubs are being formed to raise awareness, and an arts and culture festival is planned where students can display their creative endeavors, such as plays, poems, stories and drawings about pregnancy in school. UNFPA has helped the government open a call center that provides free, confidential information. To disseminate information about health and services, various media, such as leaflets, videos, radio announcements and SMS messages will be disseminated.

Much of the needed education involves demystifying contraception and pregnancy. Amina, a pregnant student, revealed: “I did not take contraceptives because my mom told me that it might make me sterile.” Some girls are also told that not getting pregnant by age 15 or 16, “is a problem,” remarked Clarissa, 22.

The Zero Pregnancies in School Campaign was launched in Bondoukou, the most affected area in Côte d’Ivoire. Students in the region brought banners to the event with such messages as “Zero pregnancy in school, I endorse it,” “You don’t get a child pregnant” and “I am a child. A child doesn’t bear a child. A child goes to school to succeed.”

The government is making even further changes. Laws have been introduced that increase penalties for the sexual abuse of minors. Most significantly, this includes sanctions against teachers who abuse their students. Girls are often pressured into sex with teachers in order to get good grades.

Additionally, the government is planning to build better housing for the 10,000 to 15,000 students in cities that must board. This will enable the young students to have proper housing where boys and girls do not have to share a room.

The government also no longer expels girls when they are pregnant, and girls are returning to school after giving birth. Amina told UNFPA, “My mom takes care of my baby when I come to school.” Clarissa’s mom also takes care of her son. Clarissa explained to UNFPA that she still has her dreams: “I lost a school year,” but “I want to become a teacher.”

Janet Quinn

Sources: UNFPA, UNFPA, Demographic Dividend, UNFPA
Photo: WCARO

Innovation_Countdown_2030

As many under-developed countries begin to enter the global market, the struggles their people face are becoming increasingly apparent. Luckily, an amazing NGO called Innovation Countdown 2030 is seeking to fund ideas today that may save the developing world tomorrow.

Innovation Countdown 2030 (IC2030) is a NGO that is mainly focused on advancing global health. In collaboration with PATH, one of the leading innovators in global health, IC2030 has created “a platform to identify, evaluate, and showcase high-impact technologies and interventions that can transform global health by 2030.” The ideas that they have supported include technologies that will add vitamins to rice, long-lasting injectable contraceptives, and devices that can help newborn baby’s breathe better. All of these ideas were the result of massive crowd-sourcing efforts and will inevitably help the world towards reaching the United Nations Sustainable Development Goals (SDGs). People from all over the world submitted their ideas and a panel of expert’s selected 30 innovations which they believed could feasibly change the world in the next 15 years.

For years, innovation has been focused on development. From new types of tractors all the way to robot vacuums, technology development has been focused on developing a better life for those living in developed countries. As the years have gone by, people have become increasingly aware of how reliant we are on one another and the importance of bringing up the developing world in order to benefit the whole world. We are living in a time where children still die from completely treatable diseases and malnourishment, but what if there was a way to provide a sustainable form of nourishment, and a reliable place of medicine? What if people no longer had to worry about basic survival and could instead focus on innovation of their own? This is the philosophy behind many development and global health NGOs, presumably including IC2030, and is one that can only lead to a more prosperous global community.

Much of IC2030’s work focuses on pregnant women and their newborn babies as in line with the SDGs. One invention in particular, a uterine balloon tampon, is predicted to save the lives of over 150,000 pregnant women. The idea was developed in the United States in Massachusetts General Hospital and essentially utilizes water pressure to prevent hemorrhaging in a mother who have just given birth. This device is made out of a simple condom and a catheter and can be filled with water to create pressure. It is low-cost and highly effective, making it an ideal candidate for IC2030’s top 30 devices.

Several of the innovations included on IC2030’s list have already been utilized in more rural areas of Africa and have already begun to save lives. The organization is being led by PATH and has received funding from the Bill & Melinda Gates Foundation, the U.S. Agency for International Development, as well as the Norwegian Agency for Development Cooperation.

Hopefully this organization gains more support, but so far it has succeeded in carrying out its goal of saving lives and promoting innovation throughout the world.

Sumita Tellakat

Sources: IC2030, NPR
Photo: NPR

sayana_press
Safe and effective contraception is one of poverty’s biggest enemies. In fact, it can prevent up to 33 percent of maternal deaths through things like unsafe abortions (which lead to the death of over 50,000 women annually) and too many consecutive pregnancies, which can lead to harm for both mother and child.

As Joy Phumami, Co-chair of the World Health Organization’s Independent Expert Review Group, says, “delaying pregnancy and spacing births enables more young women to complete school, prevents death and disability among many young women and their children, and contributes to economic development.”

It seems like common sense when stated so plainly. However, worldwide, over 200 million women lack access to contraception.

Factors inhibiting access to and use of birth control include everything from lack of education, to lack of proximal availability, to lack of medical professionals available to administer the drugs.

Sayana Press, an injectable form of birth control, provides three months of contraceptive protection and is so simple that the possibility of self-administration is currently being researched. If achieved, this would allow for long-lasting contraception without the need for patients to enter a clinical setting. One study conducted over 12 months showed that 95 percent of women found self-injection to be a convenient option.

Even in its current state, Sayana Press is easy to administer, and doing so requires very little training. Because it lasts for three months at a time, women do not have to meet up with healthcare professionals so frequently that it is a major inconvenience.

How does it work? The popular birth control drug Depo-Provera is delivered using the Uniject injection system, a prefilled, single-dose, disposable, and compact device. Depo-Provera is widely known to be effective, and more than 88 million Uniject systems have been used since 2000 for such purposes as administering the Hepatitis B vaccine to newborns.

Thanks to the innovation and potential of the product, the Sayana Press was showcased in the Innovation Countdown 2030 Report, an initiative led by PATH to increase awareness and investment in technologies designed to improve global health.

PATH, a nonprofit that works to improve global health and save lives, does its work with a focus on accelerating innovation, making the efficiency and effectiveness of the Sayana Press a prime example of a product warranting their support.

PATH’s Sayana Press Pilot Introduction Project, an initiative that began in 2014 and will last until 2016, has brought the product to five countries in Africa and South Asia. If the results are successful, the product will likely be adopted more widely.

Because family planning is so important in the fight against global poverty, the more options there are, and the more widely available they are to those who need them, the better. Sayana Press is being called one of the most exciting innovations in global health today. Part of its beauty lies in its simplicity: a disposable piece of plastic that has the potential to save millions of lives.

Emily Dieckman

Sources: IC2030, NPR, Science Direct, Path 1, Path 2, Path 3, WHO
Photo: Path

reproductive_health

Only governments can ensure that Universal Health Coverage (UHC) is achieved within their nations. While it is widely regarded to be making strides with reproductive health services, it is important to take note of the following changes to ensure so that new era of services can emerge:

1. Domestic Financing
The Universal Health Coverage goal allows everyone access to health services regardless of financial hardship. Pursuing this goal often leads to dramatic health financing reforms, but the key is to give rise to national insurance initiatives that allow health budgets to be spent on strategic purchasing of health services, rather than on keeping the doors open at public facilities alone.

2. Cost-effective Service Package
Few services are as cost-effective for both health and economic development as contraception. Thus, contraception must be prioritized for universal access. It would be imperative to place importance on measurable health outcomes, or possibly the Sustainable Development Goals.

3. Making UHC Work in the Low-Level Private Sector
Lower-level private facilities, which are often a lifeline to communities, should not be forgotten in public financing reforms. This will prevent a wider spread of coverage to communities that need the types of services that accompany the lower-level private facilities.

4. Advocating Financing by Doing
In countries that have not taken strides with the UHC, organizations can still contribute to progress through proof-of-concept financial projects like large-scale voucher programs to remove financial barriers. All types of health providers (faith-based, for-profit or public) need to be quality-assured for the services they offer.

5. Disrupting the Status Quo
Youth, women, tech-savvy entrepreneurs, health workers, civil society and the private sector will all be the influencers to drive change within family panning over the next 15 years. It is important to welcome new voices to the debates and meetings of importance. Frankness will be key to change, by dropping euphemisms and vague terms there will less trickery and more discussion of the topics that need to be discussed. Even the term “family planning” was created to avoid the associated taboo of the world’s abortion and contraception.

Investment in the health, education and rights of young people, and the alignment of related policies, is critical as it enables productivity and economic growth and the better spread and knowledge of reproductive health services is key to that.

– Alysha Biemolt

Sources: AllAfrica, Impatient Optimists, World Bank
Photo: myScience.org

Contraception

For all the immense scientific progress made over the past decade, methods of contraception, particularly for women in the developing world, has stagnated. It is estimated that in 2013, only $65 million was used for contraception research and development for middle and low income women in developing countries, compared to $580 million used for tuberculosis and $549 million for malaria. Clearly, R&D in these areas is of primary importance, but improvements in birth control technology will make it more affordable and accessible for women in developing countries.

This technology is in huge demand—the Bill & Melinda Gates Foundation estimated that there are 200 million women in developing countries who want family planning services but have none available to them. Access to birth control would prevent an estimated 72 million unintended pregnancies and 70,000 maternal deaths annually. It would also put the power in the hands of women to decide when to start families and how big they will be. Preventing unintended pregnancy will help women who cannot financially support more children, or those who have insecure food resources.

One reason that contraceptive technology has gone largely underdeveloped in the past is that there is very little communication amongst those in the field: private corporations, university labs and investors. Beyond financial restraints that may prevent a company from advancing a new solution down the pharmaceutical pipeline, some corporations may lack certain innovations that allow them to develop a drug all the way to completion. Even further, a lack of communication within the medical community limits knowledge on the market for this kind of medicine, discouraging investors from funding technological endeavors.

Unification among private corporations, academia, donors and nongovernmental organizations is essential to leveraging funds, technology and information that will help progress access to birth control for women in developing nations. Family Health International 360 has recently partnered with private companies, university laboratories, and international medical research centers to expand development on two types of technology: the long-term injection and biodegradable implant. In doing so, FHI 360 has also linked up with research centers that had not previously applied their work to contraceptive development and also connected nonprofit funding organizations with private companies.

Another advancement spurred by the Bill & Melinda Gates Foundation is the Contraceptive Technology Innovation Exchange, a website that houses information on over 170 in-development or recently developed contraceptive technologies. Founders hope this kind of information will lead to increased funding for medical innovation and partnerships between groups. This will improve the accessibility of contraceptive technologies and expand the market for them internationally. Such a database will spur the growth of the industry for contraceptives.

Progress at home, whether through medical research, food technology and investment, spurs growth all over the world. When corporations, organizations and academic groups work together for a common cause, they can improve innovations that will benefit people all over the world.

Jenny Wheeler

Sources: Impatient Optimists, Contraceptive Technology Innovation Exchange
Photo: Pacific Standard Magazine

vaginal_ringThe World Health Organization has included the progesterone contraceptive vaginal ring (CVR) on its 2015 Essential Medicines List.

Developed by the Population Council, this contraception method is unique because it is safe and effective for lactating women after they have given birth. It can be used as early as four weeks after childbirth for up to one year in order to space out potential future births.

Birth spacing is important for the health of mother and child. Maternal death and other health complications are more likely to arise with short intervals between births. In addition, family planning can help parents to plan finances related to family expansion. Family planning is critical to poverty reduction. When families do not have the knowledge or ability to space births, particularly in developing countries, they may also lack the resources to support these children.

The vaginal ring is 98.5 percent effective in preventing pregnancy with proper use. The ring can be inserted and removed by the mother. This translates to less doctor visits, which are known to strain family resources, such as time and money, in developing countries.

The ring releases progesterone, but does not interfere with breast milk production. In this way, it is unlike oral contraceptives, which contain estrogen and cannot be used by lactating women.

This method is currently used in Bolivia, Chile, Dominican Republic, Ecuador, El Salvador, Guatemala, Panama, and Peru. Currently, studies in India and Sub-Saharan Africa are underway in order to determine if it could be effective in these regions as well.

The inclusion of this method on the list from the World Health Organization’s list suggests that it is likely to be more accessible to communities in the near future. The CVR is effective, safe, and inexpensive. Medical services can be difficult to reach in developing countries, but the CVR places very few demands on doctors.

The Population Council is currently developing another vaginal ring that will not have to be replaced every 3 months. It would last for one year. This would make this contraceptive method even more appropriate for the developing world.

In the future, we may even see vaginal rings that can protect against HIV and other sexually transmitted diseases, in addition to its contraceptive function. This exciting new technology has the potential to address many of the global health problems our world faces today.

Iliana Lang

Sources: WHO, Population Council, Impatient Optimists
Photo: Impatient Optimists

FP2020

Access to contraception is a basic human right to which too few of us around the world have access. The 2012 FP2020 Summit in London, which brought together the U.K. government, the Bill and Melinda Gates Foundation and over 20 national governments, agreed to help knock down the economic, political and cultural barriers that prevent women from having a say in how and when they have children. FP2020 is committed to providing access to contraception and educating women on safe and cost-effective methods of birth control. It is working to provide universal availability to voluntary contraceptive materials and services. Through promoting transparency and neutrality in government efforts to establish these resources, the Summit tracks data to ensure that the most at-risk, underprivileged women and girls are reached by their efforts.

To help provide materials and information to these women, the countries have pledged a combined $2.6 billion in funding. Its goal is to increase access to birth control and other contraceptives to 120 million women by 2020. To accomplish this goal, the Summit plans to:

  •  Track progress on fulfilling financial and political commitments through the U.N. Secretary General’s Every Women Every Child program
  • Report on the progress of individual countries toward the FP2020 goals
  • Identify obstacles standing in the way of Summit goals and propose solutions to them
  • Confirm contraceptive materials are distributed evenly and accepted voluntarily; ensure that there is no force in giving out and taking the materials
  • Publish annual updates on the progress of the Summit in individual countries

The predicted number of women at a reproductive age is 250 million, globally. Thus, the Summit commitments require innovation, such as technological development. One such invention is CycleBeads, a phone app that helps a woman track her menstrual cycle to plan for or prevent pregnancy. Developed by the Institute for Reproductive Health and iHub research, CycleBeads is available through both an online and text-based service and is based off the Standard Days Method for family planning that has been in use in the United States for decades. This invention has started in Nairobi, Kenya and will aid in the fulfillment of the FP2020 goals.

Marie Stopes International, an organization that attended the Summit, has recently pledged to provide contraceptives to 12 million women by 2020, reaching 10 percent of the population outlined by the FP2020 goal. Through partnerships and advocacy, Marie Stopes has already reached 3 million women in Sub-Saharan Africa. Through technological innovation and commitment by governments and organizations, the FP2020 goals, although lofty, can become reality.

– Jenna Wheeler

Sources: Impatient Optimists 1, Impatient Optimists 2, Family Planning 2020,
Photo: Family Planning 2020

girls in Malawi
The United States Agency for International Development will spend between $4.5 million and $10.4 million to encourage girls in Malawi to use birth control.

This plan intends to prevent pregnancy and STDs, especially HIV.

Part of USAID’s “Girls’ Empowerment through Education and Health Activity” plan, this grant will endow sexual and reproductive health and family planning education for young girls in Malawi. It seeks to combat the lack of HIV and sexual and reproductive health education and services.

The grant explains that “sexual acts that resulted in a pregnancy also place girls at risk for leaving school and/or contracting HIV.” Females, especially young girls, are disproportionately affected by HIV compared to men. In 2010, the HIV occurrence rate for girls between the ages of 15 and 19 was 4.2 percent as opposed to 1.3 percent for males.

The grant calls for more resources to teach about sexual reproductive health, HIV and family planning. USAID has stated it is important for young women to know correct information about these topics.

However, the 2010 Malawi Demographic and Health Survey exposed that even though there has been an increase in the use of modern family planning in Malawi, the HIV rate has remained.

Access to birth control and other methods does not appear to be a problem for women in Malawi.  However, Malawi ranks tenth in the world for the number living with HIV/AIDS, and ninth worldwide for the number of fatalities from HIV/AIDS.

The grant also aims to improve literacy skills for girls and access to schooling. The grant states that this will lead to more achievement for girls in school.

This initiative in Malawi is one more step in encouraging Family Planning 2020’s aim to provide 120 million more women and girls with contraceptives by 2020.

Colleen Moore

Sources: CNS News, Life Site
Photo: USAID