Countdown to Rome 2012

Dear ColleaguesSince last October, FIGO has been activelyscaling up its efforts in preparation for its WorldCongress in Rome (7-12 October 2012), andcontinuing to play a major role in global efforts toaccelerate the achievement of the health-relatedMillennium Development Goals (MDGs).

Congress plans coming to fruitionThe various Congress Committees, together withthe FIGO Secretariat, have been working hard tofinalise arrangements. Professor William Dunlop,Chair of the Scientific Programme Committee,has put together an outstanding programmewhich meets the needs of all levels, from basicmaternal and newborn health through to ‘cuttingedge’ knowledge in our field. The President’sSession will incorporate a stimulating debatebetween the presidents of various professionalorganisations and heads of several UNorganisations, with active audience participation.There will be new landmarks, including hands-on

Pre-Congress courses, sessions organised bymember societies, regional federations andsubspecialty societies and committees, and livesurgery transmission from several countries.

Please note that the Congress ‘EarlyRegistration’ fee deadline has been extended to15 April 2012. Additionally, FIGO has alwaysendeavored to provide special assistance tocolleagues from lower-resource countries, so adecision has been taken to offer to delegatesfrom countries classified as ‘low-incomeeconomies’ and ‘lower-middle-incomeeconomies’ (by The World Bank), that aremembers of FIGO, the opportunity to register at aspecially reduced ‘Early Registration’ fee of €600– a substantial saving of €150 on the standard‘Early Registration’ fee of €750. A full list of thecountries and territories to which this offerapplies is available on www.figo2012.org Wehope that this will encourage attendance from thecountries concerned.

Keeping the focus on educationand trainingFIGO’s education and training programme ismaking excellent progress with more emphasison hands-on training: the FIGO Committee forCapacity Building in Education and Training –chaired by Professor Luis Cabero-Roura – hasheld high profile workshops and sessions innational and regional conferences over the pastfew months.

The Committee for Reproductive Medicine –chaired by Professor David Adamson – held an

excellent hands-on workshop – ‘Basic andAdvanced Clinical and Laboratory TrainingCourse in Infertility, including ART, forDeveloping Countries’ – in Cairo, December2011, in collaboration with the InternationalIslamic Center for Population Studies andResearch, Al Azhar University and ICMART, withsupport from ESHRE. This fruitful event wasattended by participants from Egypt, Qatar andNigeria. Subsequent evaluation revealed thecandidates’ great satisfaction, with mostattendees signing up for more training,according to their needs. I would like to thankIBSA international for its support of thesevaluable activities.

In ternat iona l Federat ion of Gynecology and Obstet r ics | March 2012 1

Latest on FIGO’s 2012 World Congress in Rome | Interview with CEO of FistulaFoundation | WSRR Committee news | Spotlight on our Mozambique members

continued on page 2

Professor Serour (centre) at the FLASOG Congress (September 2011)

FLASOG Congress (September 2011)

International Federation ofGynecology and ObstetricsF

FIIGGO

OFIGO

INSIDE:

communications@figo.orgwww.figo.org March 2012

‘Basic and Advanced Clinical and Laboratory TrainingCourse in Infertility, including ART, for DevelopingCountries’, Cairo (December 2011)

An attendee, Dr Chris Agboghoroma, SecretaryGeneral of the Society of Gynaecology andObstetrics of Nigeria (SOGON), discussed withme strengthening collaboration with FIGO, andthe plans to launch the African Federation ofObstetrics and Gynecology at FIGO’s RomeCongress.

The first FIGO training centre for MinimallyInvasive Surgery – in Soba Hospital, KhartoumUniversity, Sudan – held its first course from 28February-1 March 2012; another centre in theUkraine will start its first course in March 2012. Iwould like to thank Olympus SurgicalTechnologies Europe for its staunch support ofthis programme.

Following the success of recent ERC-RCOG andFIGO workshops on the prevention andtreatment of post-partum haemorrhage, held inEgypt during 2011, I am pleased to report thatsimilar workshops have taken place from 28February-1 March in Cairo and Alexandria.

FIGO and global partners –furthering urgent action on theMDGsLast October, the FIGO leadership participated inthe second FIGO LOGIC (Leadership inObstetrics and Gynecology for Impact andChange) Initiative Annual Review Meeting inMumbai, where discussions were held withrepresentatives from the Bill & Melinda GatesFoundation, chairs of the country projects andthe evaluation team on the current successesand challenges of this major project. There hasbeen tremendous progress, aided by a newproject team, increased enthusiasm from countrydirectors, close monitoring by FIGO leadershipand the establishment of a special TechnicalAdvisory Group.

In November, I represented FIGO at the‘International Conference on Family Planning’ inSenegal. The President of Senegal, four AfricanFirst Ladies, UNFPA’s Executive Director and topUN and NGO representatives were in attendance.I delivered a presentation in the opening plenarysession on ‘Family Planning’s Dividends forGlobal and National Health’, highlighting the roleof FIGO as an important professionalorganisation. I also participated in the‘Postabortion Family Planning: What’s Working inAfrica’ workshop organised by USAID andRESPOND, delivering a presentation on‘Postabortion Family Planning: ProfessionalAssociations Support Universal Access’, andparticipating in the panel discussion on policyand scale up.

I also attended the Postabortion Care (PAC)Consortium organised by Pathfinder International,EngenderHealth and the Population Council,highlighting FIGO’s role with particular referenceto its own statements on family planning. I briefedparticipants on the FIGO Misoprostol for Post-Partum Haemorrhage in Low-Resource SettingsInitiative, and the FIGO guidelines on the use ofmisoprostol in various gynecological andobstetric conditions, including postabortion care.In May, FIGO will again collaborate with thePopulation Council on a consultation on theunmet needs of family planning and the provisionof long-acting effective contraception.

Early 2012 took me to Geneva, participating in aspecial WHO Infertility Global Research andGuidance Meeting, as well as attending itsExecutive Board meeting.

FIGO recently joined forces to condemn themedicalisation of Female Genital Mutilation (FGM)in one Asian country, and I also sent a letter to itsMinister of Health drawing attention to FIGO’sethical guidelines on FGM, as well as theInternational Islamic Center for PopulationStudies and Research Al Azhar Universityguidelines in the international book: ‘Children inIslam. Their Care, Development and Protection’,developed in collaboration with UNICEF.

Countdown to Rome 2012Continued from page 1

Strengthening relationshipsI recently participated in many national societyand regional federation meetings – mycommitments ranged from giving presentations,chairing discussions and workshops, andmeeting with key representatives to discusscollaborative efforts.

Events included:

– Congress of the Federation of Latin AmericanSocieties of Gynecology and Obstetrics(FLASOG), September 2011 A highlight was aproductive breakfast meeting with Presidentsfrom FLASOG member societies

– XXII Asian and Oceanic Congress ofObstetrics and Gynecology (AOCOG 2011),September 2011 I met representatives of themember societies on the Asia & OceaniaFederation of Obstetrics & Gynaecology(AOFOG) Council to discuss regional activities

– 87th National Congress of SIGO and NationalAOGOI Congress, September 2011 Thismeeting enabled me to convey sincere thanksto our Italian colleagues for hosting the FIGO2012 Congress, and to call for generally closercollaboration with all Italian obstetricians andgynecologists and their various associations

– XII All-Russian Scientific Forum, Moscow,September 2011 I encouraged the RussianSociety of Obstetricians and Gynaecologiststo have a session at FIGO’s Rome Congress

– International Annual Congress of theLebanese Society of Obstetrics & Gynecology,November 2011 This provided a valuableopportunity to discuss collaborative interestswith the General Secretary of the ArabAssociation of Obstetrics and GynaecologySocieties

– Saudi Arabia Ob/Gyn Conference (SAOGC)and ACOG Congress, Riyadh, January 2012I encouraged the Saudi Society to have asession at FIGO’s Rome Congress, and alsodiscussed support for the global MNCHprogramme

Faith-based organisations (FBOs) –accelerating the achievement of thehealth-related MDGsFIGO is well aware of the major role that FBOscan play in this regard – for example, more than50 per cent of healthcare in Africa is beingprovided by such organisations. We recognise

In ternat iona l Federat ion of Gynecology and Obstet r ics | March 20122

The FIGO President at a meeting of religious leaders(IICPSR-UNFPA, December 2011)

2011 International Conference on Family Planning, Dakar,Senegal (December 2011)

that there have been some obstacles that havebeen a barrier to the adoption of some policies,mostly related to the lack of credible informationsurrounding population problems, reproductiveand sexual health and gender issues. Incollaboration with UNFPA and UNICEF a numberof workshops and ‘training of the trainers’workshops for Imams, religious leaders andpolicy makers in Afghanistan and Egypt wereheld in December 2011. These workshopsdispelled misconception among religious leadersconcerning population policies, and helped themrevise and modify their religious addresses to themasses in the most remote areas of theircountries. These activities have been evaluatedby an independent body and their effectivenesshas been proved.

FIGO is currently engaged in preliminarynegotiations with various UN organisations tostrengthen the role of FBOs.

China to greet Executive Board in 2012The next FIGO Executive Board meeting will beheld in Beijing, in May, and arrangements are welladvanced. In addition, two educational andtraining workshops will be held in Beijing andChengdu. I would like to offer sincere thanks tothe Chinese Society of Obstetrics andGynecology for hosting these events.

I wish you a prosperous 2012, full of happinessand joy.

Best wishes

FIGO President Gamal Serour

Religious leaders (December 2011)

CHIEF EXECUTIVE’S OVERVIEW

In ternat iona l Federat ion of Gynecology and Obstet r ics | March 2012 3

Congress 2012 ‘open for business’Dear ColleaguesWarm greetings for 2012!

A new year brings with it new challenges and ourfocus for 2012 is very obvious – our forthcomingWorld Congress in Rome! Planning, organising,and finalising continues apace, and we hope thatas many of you as possible will join us for thishigh profile and hugely important global event. Ifyou have not done so already, please visitwww.figo2012.org for comprehensiveinformation on every aspect.We are pleased toreport that our ‘Early Registration’ fee deadlinehas now been extended to 15 April 2012 – Iurge you to book early to avoid disappointment!Please turn to page 11 for more details, and putthe dates 7-12 October 2012 firmly in yourdiaries.

UN puts women’s and children’shealth centre-stageIn September 2011, I attended the UN GeneralAssembly in New York – where a special sessionwas held to discuss the UN Secretary General’sGlobal Strategy for Women’s and Children’sHealth – and a special meeting of the GlobalLeaders Council for Reproductive Health. Asalways, my visit to this vibrant city proved avaluable opportunity to touch base with UNFPAand EngenderHealth, both collaborative partnersof FIGO on fistula and Adolescent Sexual andReproductive Health (ASRH) activities.

In October, I travelled to Maputo to discussmatters in relation to the formation of the AfricanFederation of Obstetrics and Gynecology(AFOG). Participants included the WHO’s office inAfrica, the Presidents of ECSAOGS, SAGO andour Mozambique member society, and arepresentative from the Nigerian Society(SOGON). There was firm agreement to establisha regional Federation for Africa, and the meetingpinpointed the necessary steps to be taken –most importantly, the finalisation of itsConstitution. As we go to press, arrangementsare in hand for a special launch meeting to beheld during our World Congress.

Our LOGIC Initiative Annual Review Meeting inMumbai (see page six) was a great success,drawing together the many strands of this far-reaching project. We are most grateful to the

Professor Rushwan at LOGIC’s Annual Review Meeting(October 2011)

Professor Rushwan presenting at the ICM meeting(January 2012)

MDG focus in run-up to 2015Shortly afterwards, I attended a special Boardmeeting in Paris of the Partnership for Maternal,Newborn and Child Health (PMNCH), thepurpose of which was to approve its 2012workplan and to reach alignment on key issues.The main aim is to co-ordinate efforts towardsstrengthening the UN Secretary General’s GlobalStrategy for Women’s and Children’s Health(mentioned earlier), as it is essential that globalpartners continue to strive towards theachievement of MDGs 4 and 5. It was agreedthat healthcare professional organisations –including FIGO – will play a major role in trainingand in the dissemination of essential interventionpackages.

Seizing initiative – new talks withACOG and the RCOGAt the end of October, a high-level meeting ofrepresentatives from the American College ofObstetricians and Gynaecologists (ACOG), theUK’s Royal Society of Obstetricians andGynaecologists (RCOG) and FIGO was held toexplore collaborations and partnerships fordramatically accelerating progress in preventingmaternal and newborn deaths globally. Theoutcomes were: a better understanding of howthe College, FIGO and the RCOG arecontributing to current and planned globalinitiatives for maternal and newborn health; anassessment of possibilities for ACOG to support

the current and planned efforts of FIGO and theRCOG; an assessment of possibilities forcollaboration on new activities of sharedinterests; and a provisional plan for movingforward. I look forward to updating you on this indue course.

FIGO and post-partum haemorrhage– valuable work on guidelinesIn November, a special Technical ConsultationMeeting, organised by FIGO, on FIGO Guidelineson Misoprostol for the Prevention and Treatmentof Post-Partum Haemorrhage (PPH), provided uswith the opportunity to meet with experts fromthe WHO, the Universities Liverpool andStanford, the International Confederation ofMidwives (ICM), FIGO’s Committee for SafeMotherhood and Newborn Health and GynuityHealth Projects. It was decided that there wassufficient consensus in key areas to moveforward with the development of Guidelines.Please see the latest updates on FIGO’smisoprostol initiative on page seven.

In December, I was invited to Yokohama, Japan,to present on FIGO’s global role at a special FIGOworkshop held during the 56th Annual Meeting ofthe Japan Society for Reproductive Medicine. Itwas an excellent opportunity to touch base withour Japanese friends on many pertinent issues,and to meet also with Professor Takeshi Maruo,FIGO’s Vice-President.

2012 has started as briskly as 2011 ended, andso far has taken me to Rome (World Congressmeeting), Geneva (WHO’s 130th Session of theExecutive Board), the Hague (a Multi-StakeholderMidwife Education Providers Meeting, organisedby the ICM), and Varanasi, India (55th All IndiaCongress of Obstetrics and Gynaecology). Thenext few months will be fast-moving, as weprepare for our annual Executive Board meetingin Beijing, China, among other important FIGOcommitments.

My best wishes for the hard work ahead as weapproach Congress 2012.

FIGO Chief ExecutiveHamid Rushwan

Professor Rushwan in Yokahama (December 2011)Front row: Yorino Sato PhD, Mrs Maruo, Mrs Hsueh,Dr Okutsu, Dr Nanba; back row: Seido Takae, Dr Ishizuka,Professor Rushwan, Dr Hsueh, Dr Kawamura, Dr Yoshioka

Young people high on agenda at AICOG 2012Chief Executive Hamid Rushwan was a guest speaker on‘Adolescent Sexual and Reproductive Health (ASRH): theGlobal Issues’ at a workshop hosted by the AdolescentHealth Committee of the Federation of Obstetric andGynaecological Societies of India (FOGSI). The event –held during January’s All India Congress of Obstetrics andGynaecology (AICOG), Varanasi – was organised byChairperson Dr Roza Olyai.

‘These issues are vital to address,’ said Professor Rushwan. ‘Promoting healthy practices andtaking steps to better protect young people from risks is critical to the future of countries’ healthand social infrastructures and the prevention of problems in adulthood. This excellent workshopprovided a clear overview of the challenges facing health professional organisations.’

Professor Rushwan was accompanied by FIGOPresident-Elect Professor SabaratnamArulkumaran, who participated in a specialsession focusing on Indian ASRH issues. Dr P KShah, FOGSI President, inaugurated theworkshop.

FOGSI’s Committee will be organising workshopsand Continuing Medical Education (CME)throughout 2012 in 24 FOGSI societies, whichwill include a Public Forum. It will also inauguratethe Young Women’s Club in each FOGSI society.The overall aim is to sensitise gynecologists andthe general public on ASRH issues.

Federation of Obstetric and GynaecologicalSocieties of India (FOGSI) for their generoussupport of this event.

Dr Olyai; Professor Rushwan; Dr Shah; ProfessorArulkumaran; Lord Naren Patel; Dr Purandare

Kate Grant is the CEOof the FistulaFoundation, based inthe heart of SiliconValley, San Jose,California. TheFoundation is thelargest charity focusedglobally on thetreatment of obstetricfistula, funding fistulaprogrammes at 38sites in 15 countries.

Kate joined the Foundation as its first ChiefExecutive in 2005 and has led the board andstaff team that have expanded the Foundationfrom supporting one institution in one country,Ethiopia, to its current global reach. TheFoundation raises funds from donors in theUnited States, Europe and Asia and does notaccept funds from any government; itadvances its mission by forming closepartnerships with doctors and hospitals indeveloping countries, funding their provision offistula treatment. Collaboration is at the centreof its work.

Before joining the Foundation, Ms Grant heldseveral senior positions, including Deputy Chiefof Staff at USAID in the Clinton Administration.She’s lived and worked in Tanzania andSenegal, and travels frequently to consult withpartners in the field. Ms Grant brings to hercurrent role a long-term commitment toadvancing the reproductive health of womenthat began as a volunteer for PlannedParenthood two decades ago, and led her toearning a MPA from the Woodrow WilsonSchool at Princeton University. She is acontributor to the Huffington Post, writing onmaternal health and motherhood.

Kate, how did your relationship withFIGO evolve?The single biggest obstacle to treating the greatbacklog of fistula patients in Africa and Asia is alack of trained fistula surgeons. FIGO, incollaboration with UNFPA, stepped forward toaddress this critical deficiency. I’ve certainly beenan admirer of the important work done by FIGOglobally, and, over the last year, I’ve beenhonoured to become acquainted with FIGO’sChief Executive, Professor Hamid Rushwan, andLord Naren Patel, the Chair of the FIGOCommittee for Fistula, and to learn more aboutFIGO’s pioneering work on fistula treatment.FIGO’s new Global Competency-Based FistulaSurgery Training Manual and the new FellowshipTraining Programme are critical steps in helpingincrease the quantity of fistula surgeons, whileensuring high quality clinical training.

I was delighted that our Foundation could provideinitial funding for the FIGO Fistula FellowshipProgramme.

mentoring for new fistula surgeons. Toparaphrase Humphrey Bogart from the classicfilm Casablanca, I hope this is just the beginningof a beautiful partnership between FIGO and theFistula Foundation! We want the programme tothrive and expand. Dr Suzy Elneil, who wrote theManual and serves on the FIGO Committee forFistula, joined the Foundation’s Board ofDirectors this January. We are going to benefitgreatly from her expertise, helping solidify ourpartnership with FIGO. FIGO’s leadership – inensuring more surgeons receive high qualitycompetency-based training – will result in manymore women, suffering needlessly from obstetricfistula, getting treatment that will change theirlives. That’s why I’m so thrilled to be working withFIGO and supporting this important programme.

What do you find most satisfying/challenging about your work?I am inspired by the dedication of the surgeonswe support and the courageous fistula patientsthey treat – women who have suffered more thanany woman should have to suffer simply for tryingto bring a child into the world. It is immenselyrewarding to work in partnership with others whoI respect so greatly to bring care to women withsuch profound need. In many ways, fistulatreatment is still in a nascent stage, and thechallenge of getting treatment for all women whoneed it is both daunting and motivating.

Visit www.fistulafoundation.org/whatisfistula/faqs.html(Source: www.fistulafoundation.org)• Fistula used to be present in the US andEurope, but was largely eliminated in the latterpart of the 19th century and early 20th centurywith improved obstetric care in general and theuse of c-sections in particular to relieveobstructed labour.

• The World Health Organization estimates theremay be as many as 50,000-100,000 newcases of fistula each year, yet the globaltreatment capacity is less than 20,000 cases ayear. There is a large unmet need for treatment.Fistula is most prevalent in sub-Saharan Africaand Asia.

• The root causes of fistula are grinding povertyand the low status of women and girls. Indeveloping countries, the poverty andmalnutrition in children contributes to thecondition of stunting, where the girl skeleton,and therefore pelvis as well, do not fully mature.This stunted condition can contribute toobstructed labour, and therefore fistula.

• Fistula is both preventable and treatable. Forinstance, the Addis Ababa Fistula Hospital hastreated over 35,000 women over 33 years.Their cure rate is over 90 per cent. Fistula canbe prevented if labouring women are providedwith adequate emergency obstetric care whencomplications arise.

The Fistula Foundation: in focus• The Foundation funds 38 facilities in 15 countries• It has invested $1.1 million in new hospitalsand equipment between 2009-11

• It has managed $11 million in worldwide grantsfor fistula projects between 2006-11

• It made 3,416 fistula surgeries possiblebetween 2009-11

• It runs patient recruitment campaigns in 12countries

• It has trained 44 surgeons in fistula repair and144 nurses and anaesthetists

Chair of FIGO Working Group receives 2011Allan Rosenfield Award for Lifetime Contributionsto International Family Planning

Dr Anibal Faúndes – Professor of Obstetrics at the State University ofCampinas, Sao Paulo, Brazil, and Chair of the FIGO Working Group forthe Prevention of Unsafe Abortion – has been awarded the 2011 AllanRosenfield Award for Lifetime Contributions to International FamilyPlanning at the North American Forum on Family Planning (held late lastyear in Washington, DC).

The Allan Rosenfield Award for Lifetime Contributions to InternationalFamily Planning was created in 2007 to pay tribute to the authority anddedication of its first recipient, the Society of Family Planning’s (SFP)founding board member Dr Allan Rosenfield. It is an award ‘given yearlyto individuals who have made invaluable contributions to internationalfamily planning through their research, writing, teaching, institutional

leadership, and/or policy contributions. The recipient of this award will have contributed to thehealth of women worldwide through activity in the field of family planning and will havedemonstrated commitment to the importance of women in society, their equal treatment, and theirright to autonomy in reproductive decision-making. In doing so, the awardee will have enhancedthe lives of men and women now and in the future.’

FIGO President Professor Gamal Serour said: ‘This is highly deserved, prestigious recognition for ascientist who has contributed enormously to our profession and who has cordially served FIGO formany years. His contributions and dedicated efforts to save the lives of women and newborns andimprove the quality of their lives, particularly in low-resource countries, have been outstanding.

‘The FIGO leadership and staff are immensely proud of his achievements, and are grateful for hiscontinuing unfailing dedication and expertise.’

For more information, visit: www.societyfp.org/about/default.asp andwww.societyfp.org/about/awardees/faundes.asp

PEOPLE

In ternat iona l Federat ion of Gynecology and Obstet r ics | March 20124

Q and A with Kate Grant, MPA, BS

Kate Grant

How do you see your work withFIGO progressing in the future?The FIGO Fistula Manual and Fellowship TrainingProgramme are truly visionary, providingcompetency-based training and ongoing

Dr Anibal Faúndes

Fistula Foundation Board of Directors

www.fistulafoundation.orgThe Fistula Foundation website –www.fistulafoundation.org – provides a wealthof information on this grave women’s healthissue, including the latest facts and figures.

COMMITTEE NEWS

In ternat iona l Federat ion of Gynecology and Obstet r ics | March 2012 5

Integrating Human Rights and Women’s Health – an educational approachA project of the FIGO Committee for Women’s Sexual and Reproductive Rights (WSRR)By Professor Lesley Regan, Committee Chair

This exciting projecthas the potential totransform women’shealthcare globally byensuring that a clearunderstanding ofwomen’s sexual andreproductive rightsbecomes an integralpart of the coreeducational trainingprogramme delivered

to undergraduate medical students throughoutthe world. The goal is to educate future doctorsto practice in such a way that Women’s Rightsand Reproductive Healthcare becomeinseparable.

Human rights as main focusMillions of women and children suffer illness orinjury every year because their fundamentalhuman rights have been denied. In 2012 weexpect that nearly 500,000 women will die inchildbirth and 80 per cent of these deaths will beavoidable within the fiscal resources of thesocieties in which they live – no-one caresenough to ensure that their human rights areprotected.

Our Committee is developing a generic medicalschool curriculum that is designed to integratethe teaching of women’s health and humanrights, and which will produce a framework thateach medical school will be able to adapt to itslocal and national standards, health policies, lawsand conventions. This will help to ensure thatevery graduate doctor has the necessary clinicaland communicative skills and knowledge base tohelp women protect their sexual and reproductiverights. Doctors educated in this approach aremore likely to deliver quality healthcare, advocateeffectively for patient rights and participate in thedevelopment of healthcare systems that integrateavailable technologies with quality processes andrespect for human rights.

The Committee’s historyThe Committee was founded in 2001 under theleadership of Dorothy Shaw. During her FIGOpresidential term (2006–2009), Dr Shaw workedtirelessly to raise the profile of reproductive rightsand women’s health. When the Committee met in2008, under the chairmanship of Dr Kamini Rao,FIGO had already agreed to produce a bookletthat could be used by medical students to raiseawareness of reproductive rights issues and toclarify the terminology in use.

Following FIGO’s 2009 Congress, I was invited tochair the Committee in its next developmentalstage: the design of the curriculum.

The project in progressIn March 2010 the new Committee working party(four ob/gyn clinicians, a medical educator and areproductive rights lawyer) met to determine howbest to produce the curriculum. An outlinedocument was drafted describing 10 universalhuman rights and the healthcare competenciesthat are necessary to ensure them in the courseof daily medical practice. Each statement ofrights would be accompanied by a case study orexemplar, references to relevant medical, ethicaland legal literature and followed by a list ofspecific discussion questions that would guidethe student and teacher to consider localpractices, laws and governance.

It was recognised that guidelines for thecurriculum’s teachers would need to beproduced, along with recommendations for

dissemination and implementation in medicalschools globally.

In May 2011 the list of 10 human rights andhealthcare competencies was finalised. A finaldocument was produced alongside plans and adissemination timetable, and these werepresented to the FIGO Executive Board in June2011, and further approved.

Following on, draft outlines for case studies toillustrate the human rights and competencieschecklist were proposed by the Committee. Aworkshop was held in January 2012 to reviewand complete the editing for eight of the 10clinical case studies, which now include the casenarrative, questions specific to each andreferences.

We have deliberately weighted the referencesmore heavily towards human rights standards onthe assumption that medical teachers and theirstudents have more ready access to texts andreferences describing the health conditions thanthey do human rights literature. There is acommon theme to the questions beginning withthe medical dilemma and the threat to rights,then progressing to explore the complexities ofthe relationship of health and rights for the casescenario and for the general healthcare systemwhich is in place locally for that student andteacher.

We have now completed the last two cases andreference materials and will start designing theformat of the teaching materials guide andcurriculum assessment tools. Every opportunitywill now be taken to disseminate the project inthe form of presentations and interactiveworkshops.

FIGO World Congress, Rome 2012 –the next stepsA plenary session, ‘Integrating Human Rights andHealth – introducing the FIGO project totransform women’s healthcare’, scheduled forMonday 8 October 2012, aims to attract globalleaders in women’s health and human rights,representatives of ob/gyn specialist societies,and education and ethics teachers.

The Committee will demonstrate how thechecklist of human rights can be applied to anindividual case study and so easily incorporatedinto daily teaching on women’s reproductivehealth. This will be followed by a panel discussionwith audience participation. Attendees will beinvited to use the educational materials availableon www.figo.org and to register for aninteractive Workshop to be held the next day, 9October 2012 – ‘Integrating Human Rights andWomen’s Health into your educational and clinicalpractice’ – designed for leaders from nationalsocieties and training colleges.

We hope to recruit a cadre of future trainers whowill help us disseminate the project globally, andwe will actively encourage feedback to help refine

our materials. Do join us at the FIGO plenary andWorkshop sessions, and encourage yourcolleagues to attend.

The way aheadThis transformational project is still evolving, andaims to move women's health and reproductiveneeds from a marginal position in most curriculato more mainstream thinking. We aim to turn thetables on traditional approaches and ensure that,in the future, sexual and reproductive healthcareteaching and practice has a central focus basedon human rights principles.

The main questions1. What is the nature of the health care

problem?2. What is the threat to human rights

posed by the scenario?3. How does the health care system

support or infringe human rights?4. What are the local regulations

governing delivery of care?5. How can the health care system be

improved to respect human rights andensure health care?

Integrated Human Rightsand Women’s Health:Checklist to DetermineCompetencies for ClinicalPracticePhysicians must be able to apply theprinciples of human rights to the dailypractice of women’s health care.

1. Right to life: Everyone has the right tolife.

2. Health: Everyone has the right to thehighest attainable standard of physicaland mental health.

3. Privacy: Everyone has the right torespect for privacy in the field of healthcare.

4. Confidentiality: Everyone has the rightto confidentiality in relation toinformation on health care and healthstatus.

5. Autonomy and decision-making:Everyone has the right to autonomousdecision-making in matters concerningtheir health.

6. Information. Everyone has the right toreceive and impart information relatedto their health.

7. Non-discrimination: No one shall besubject to discrimination on anygrounds in the course of receivinghealth care.

8. Right to decide number and spacing ofchildren: Everyone has the right todecide freely and responsibly on thenumber and spacing of children and tohave access to the information,education and means to enable themto exercise these rights.

9. Freedom from inhumane and degradingtreatment: Everyone has the right to befree from torture or cruel, inhuman ordegrading treatment or punishment inthe field of health care.

10. Benefit from scientific progress:Everyone has the right to enjoy thebenefits of scientific progress and itsapplications.

Professor Lesley Regan

The Committee (January 2012)L-R: Professor PC Ho – Hong Kong (OBGYN); ProfessorLesley Regan – London (WSRR Chair, OBGYN ); Dr DianeMagrane – Philadelphia USA (Medical Educator, OBGYN);Professor Anibal Faúndes – Brazil (OBGYN, Contraceptionand Safe Abortion care expert); Ms Adriana Lamackova –London (Reproductive Rights lawyer); Dr Stephen Munjanja– Zimbabwe (OBGYN, Domestic Violence expert)

In ternat iona l Federat ion of Gynecology and Obstet r ics | March 20126

Setting the agenda for 2012 –LOGIC looks ahead

FIGO IN THE FIELD…

The FIGO LOGIC (Leadership in Obstetrics andGynecology for Impact and Change) Initiative inMaternal and Newborn Health (MNH) – fundedby the Bill & Melinda Gates Foundation – heldits Annual Review Meeting in Mumbai, India,from 12-13 October 2011.

LOGIC’s aim, over five years, is to help enablemember associations (MAs) in eight low-resourceAfrican and Asian countries to play a catalytic rolein making positive changes in policy and practiceand improve maternal and newborn healthservices for under-served populations. Thecountries involved are Burkina Faso, Cameroon,Ethiopia, India, Mozambique, Nepal, Nigeria andUganda.

The meeting was hosted by the Federation ofObstetric and Gynaecological Societies of India(FOGSI). Representatives of FIGO LOGIC MAsfrom the participating countries and high-levelrepresentatives from FIGO and other partnerswere in attendance.

The countries presented on key achievements,challenges and lessons learned in 2011,including those in relation to organisationalcapacity development, implementation ofMaternal Death Reviews (MDRs), and policyinfluencing and advocacy.

Professor David Taylor, Project Director,explained: ‘This meeting prioritised three criticalobjectives: to review the progress of projectactivities in 2010/11; to share the experiences of,and the lessons learned from, 2010/11; and todevelop and agree final 2011/12 workplans.’

Engaging; influencing;innovatingImproving maternal and newbornhealth policyMost FIGO LOGIC MAs are engaging in policyinfluencing and advocacy activities with the aimof improving MNH policy. The MAs are liaising

and/or developing relationships with keystakeholders such as Parliamentarians and otherhealth professional organisations, and areengaging with the media on MNH issues.

Improving maternal health practicethrough MDRsThe majority of MAs are now implementing MDRsin selected hospitals in their respective countries.The aim is to improve the quality of maternalhealth care by collecting relevant data on thecauses of maternal deaths, and in some casesnear-misses, so that future deaths andmorbidities can be prevented.

Organisational capacitydevelopmentSeveral of the MAs have made significantprogress in developing strategic plans and

developing their overall organisational capacity toimplement projects in 2011. Successfulworkshops were held on Basic FinancialManagement for NGOs, Project ManagementSkills, and Advocacy. Many of the MAs receivedsupport from the Society of Obstetricians andGynaecologists of Canada (SOGC) to help themdevelop strategic and operational plans.

The year in focusThe meeting discussed plans for LOGIC in 2012.The MAs will continue to focus on strengtheningtheir organisational capacity to implement MNHprojects and to secure additional funding for suchactivities. The improvement of MNH clinicalpractice, including the implementation of MDRsand MNH policy, will continue to be a majortheme in 2012.

In summary, Professor David Taylor commented:‘The LOGIC meeting was, once again, invaluablefor all parties, and set the scene for a confidentmove into 2012 activities. I would also like toextend my very sincere thanks to FOGSI for itsorganisational help with this meeting, and itsrobust support of all aspects of our work.’

TAG – looking forward to2012LOGIC’s Technical Advisory Group (TAG) –comprised of global experts from fields such aspublic health, advocacy, and midwifery – met on14 October in Mumbai to discuss a wide-rangingagenda of issues, including the development ofan electronic toolbox to help strengthen theorganisational capacity of health professionalorganisations; the future implementation ofMDRs; and plans for disseminating the Initiative’ssuccesses and lessons learned to key externalaudiences.

New addition to LOGICThe LOGIC team wasdelighted to welcomeCharlene Bruneau tothe role of LOGICAdministrative Officer inlate 2011.

Charlene joined FIGOfrom the Department ofHealth in the UK, whereshe worked as aPersonal Assistant andadministrator for the

International Clinical Lead for Maternal Health,supporting her on the Confidential Enquiries intoMaternal Deaths; as well as an administrator forthe Maternity and Newborn team and senior civilservants, overseeing key administrative andsecretarial support.

She also has over 15 years’ experience ofworking in the UK’s NHS, including accident andemergency departments and the ‘out-of-hours’GP service.

Charlene said: ‘I have really enjoyed myexperiences so far with the LOGIC team – I amlooking forward to the challenges and providing apositive contribution in our efforts to ensure theproject’s continued success.’

Professor David Taylor said: ‘Charlene made asignificant contribution to the success of our2011 Annual Meeting, and we are lookingforward to working with her as we approach abusy year for the team, in the run-up to theRome World Congress in October 2012.’

Meeting participants L–R: FIGO President-Elect Professor SabaratnamArulkumaran; Chairperson Adolescent Health Committee,FOGSI, Dr Roza Olyai; FOGSI President Dr P K Shah; FIGOChief Executive Hamid Rushwan; LOGIC Project DirectorProfessor David Taylor

The LOGIC team meets with the Bill & Melinda GatesFoundation and the Society of Gynecologists andObstetricians of Cameroon (SOGOC)

Professor Gwyneth Lewis (right) and Professor DorothyShaw engage with a Working Group on Maternal DeathReviews

Charlene Bruneau

President Gamal Serour (right) in discussion with FOGSIPast-President Dr C N Purandare

Global experts refine newPPH guidelinesA new set of FIGO guidelines on misoprostol forPPH prevention and treatment are underdevelopment, and will be ready in time for theFIGO World Congress in October 2012.

In recognition of the paucity of up-to-date andevidence-based guidelines on the use ofmisoprostol for PPH care, the guidelines willreflect the current best available research,addressing important areas such asrecommended dosages and routes ofadministration, contraindications, precautions,course of treatment, and side effects.

The decision to develop simple and conciseguidelines, which will be available in French andSpanish translation, was taken following atechnical consultation meeting convened byFIGO to assess the evidence and to ascertainwhether there was sufficient group consensus inkey areas. The meeting, held in New York(November 2011), was attended by an invitedgroup of experts from FIGO’s Committee for SafeMotherhood and Newborn Health, Gynuity HealthProjects, the International Confederation ofMidwives (ICM), the World Health Organization,the Universities of Liverpool and Stanford, andFIGO.

In accordance with standard practice, the draftguidelines will undergo a process of internal andexternal consultation before final endorsement atthe next FIGO Executive Board meeting in May.FIGO will work towards securing a joint statementon PPH with other authoritative internationalbodies. FIGO’s formal position regarding the useof misoprostol for PPH care was last outlined inNovember 2006 in a joint statement with the ICM– FIGO and ICM Joint Statement: Prevention andTreatment of PPH. New Advances for LowResource Settings.

Advocacy key focus at regionalconferencesAs part of an ongoing initiative to increase accessto evidence-based clinical and operationalresearch to a global audience of obstetriciansand gynecologists, FIGO continues to sponsorexpert panel sessions on the use of misoprostolfor PPH care at regional conferences.

In January 2012, FIGO’s President-Elect,Professor Sabaratnam Arulkumaran, chaired asession at the All India Congress of Obstetricsand Gynaecology in Varanasi, India, where expertspeakers presented on the role of misoprostol atdifferent levels of the health system in India;analysed clinical indicators of post-partumhaemorrhage; and introduced new community-based research in India and Egypt comparing theeffectiveness of two strategies at the communitylevel: the implementation of universal prophylaxis(600mcg oral misoprostol) versus the secondaryprevention service delivery model (whereby onlywomen who bleed 350 mL following deliverywould receive 800mcg sublingual misoprostol).

In February 2012, during the Royal Society ofMorocco’s 30th annual meeting in Casablanca,Dr Mohamed Cherine, El Galaa Teaching Hospital(Cairo), presented evidence from two double-

blinded randomised non-inferiority trials on theefficacy of misoprostol 800mcg sublingualcompared to 40 IU IV oxytocin for treatment ofPPH in hospitals where oxytocin prophylaxis is

provided during thethird stage of labourand in others where itis not provided.

Further sessionsare planned for theRoyal College ofObstetricians andGynaecologists’ 10thInternational ScientificMeeting (Malaysia,June 2012), and theMexico Society’s 63rdCongress (Guadalajara,August 2012).

‘The Product Problem: Pathways forMaking Misoprostol Available forPostpartum Hemorrhage’A report summarising a meeting to discusspathways for making misoprostol more widelyavailable for PPH indications is available online atthe Gynuity Health Projects website:www.gynuity.org/resources/info/pathways-for-making-misoprostol-available-for-postpartum-hemorrhage-en/ Some 50international experts from the programmatic,policy and pharmaceutical arenas gathered inNew York in March 2011 to discuss productregulation, the importance of quality products,registration, procurement, and the developmentof effective service delivery and programmaticmodels.

Moving from evidence to practice:IJGO special communication(doi:10.1016/j.ijgo.2011.10.005)

The January 2012 issue of FIGO’s officialpublication, the International Journal ofGynecology & Obstetrics (IJGO), featured aspecial communication addressing the challengesto evidence-based use of misoprostol and thestrategies for expanding access to evidence-based care. The article, jointly authored by AnnStarrs (Family Care International) and BeverlyWinikoff (Gynuity Health Projects), is also availableonline to IJGO subscribers and non-subscribersat: www.sciencedirect.com/science/article/pii/S0020729211005030

FIGO taking the lead onpost-partum haemorrhageprevention and treatment– an update on the Misoprostol for Post-Partum Haemorrhage inLow Resource Settings Initiative

7

Dr M B Bellad at AICOG

Professor SabaratnamArulkumaran

Internat iona l Federat ion of Gynecology and Obstet r ics | March 2012

Abstract‘Clinical and operational evidence indicatesthat misoprostol is a safe and effectivetechnology for addressing postpartumhemorrhage, a major cause of maternaldeath. This research has not yet beentranslated into effective policies, programs,and practice in many parts of the world.Efforts to expand evidence-based use ofmisoprostol are often complicated bymisoprostol's range of indications, insufficientavailability, a lack of evidence-basedguidelines and provider training, andmisconceptions about the drug. The medicaland health policy communities need to worktogether to translate research findings intochanges in policy, knowledge, and clinicalpractice so that we can deliver on theworld's promise to improve maternal health.’

In ternat iona l Federat ion of Gynecology and Obstet r ics | March 20128

The challenge of fistulaObstetrical fistula remains a common anddemeaning affliction of young women in thedeveloping world, in part due to the lack ofsufficiently trained medical personnel. Trainingmedical professionals in fistula repair can becostly and time-consuming, and many who havesuccessfully completed a training programmelose confidence over time and do not continuerepairing fistula.

The most significant advance in the training offistula repair is the recent publication of FIGO’s

‘Global Competency-BasedFistula Surgery TrainingManual’, which, forthe first time, hasestablished astandardisededucationalcurriculum.Implementationof this manual isa formidable

challenge and willrequire a multi-

modal training initiative.

A technological solutionSimulation technologies have revolutionised theeducation of surgical trainees across thedeveloped world. These tools have yet to beutilised meaningfully in the developing world andmay benefit the implementation of the manual atcertified fistula training centres.

In this effort, the FIGO Committee for Fistula hasrequested the assistance of the US-based non-profit organisation Children’s SurgeryInternational* and medical software companyRed Llama, Inc. to develop and deploy asimulation trainer that would communicate thekey elements of this curriculum in an interactivevideo format. The final product is intended to runon the surgical trainee’s own personal computerand provide a preparatory course withassessments of knowledge before a studentbegins a hands-on training programme at acertified fistula centre.

Five master fistula surgeons from the FIGOCommittee for Fistula have been appointed to theauthoring and editorial board of this uniqueproject: Professor Serigne Gueye, Dr KeesWaaldijk, Dr Mulu Muleta, Dr Andrew Browningand Dr Suzy Elneil.

The benefits of the interactiveapproachIt is believed that such an interactive videotraining programme would uniquely engagefistula trainees and allow them the opportunity tofully rehearse the steps of the procedure beforepracticing on a woman and potentially making aserious error. Utilising this tool, it is hoped thatmany more surgeons could be trained efficientlyand safely at certified centres. In addition, uponreturning to the trainee’s home hospital, thisvideo trainer may provide a useful refresher andbuild confidence in those who may considerabandoning their newly acquired skills.

The manual curriculum is divided into ‘standard’,‘advanced’ and ‘expert’ levels. The intendedaudience for this video trainer project will bepracticing surgeons who are entering at the‘standard’ level of fistula repair and plan to attenda training programme at a fistula training centre.

The trainer’s core software engine will be based

on video recordings of a master fistula surgeon’sactual cases and will be uniquely interactive,requiring input from the trainee in order toproceed through the entire training course. It willalso provide virtual mentorship and a runningnarrative throughout the programme, as well asan assessment of the surgical trainee’sknowledge base via a comprehensive testing andscoring system.

The project in detailIn the production of this programme, an entirefistula repair will be video recorded using highdefinition endoscopic camera equipment.Afterwards, the footage of the procedure will bebroken down and the key images/video clipsorganised into a series of logical steps. A team ofsoftware engineers will then generate live ‘hotspots’ within the video picture frame to highlightthe relevant anatomic locations in the surgicalfield. In the final product, the trainee will berequired to choose the correct instrument froman animated Mayo stand using their computer’smouse and place the instrument at the correctpoint of action (‘hot spot’) within the surgical field.Incorrect choices will be recorded as an error andidentify an area that may require more focusedtraining.

Once the correct choice is made, the video willprogress with running commentary of thatspecific step. Step-by-step, the student willprogress in this fashion until completion of anentire fistula repair. At important intervals, quizzesand tests of pre-op assessment, patientpositioning, instrument management, anatomy,post-op management and awareness ofcomplications will appear in order to verify thatthe core principles are being imparted to thetrainee.

Upon completion of the trainer, a print-out of thestudent’s score is provided to identify areasneeding additional attention. It is hoped that thisassessment will allow master trainers at certifiedtraining centres to focus their educational effortson the areas needing most attention.

Next steps: production andimplementationPhase I (development) of the project has beencompleted, including an initial on-location filmshoot in Dakar, Senegal at Grand Yoff General

Hospital with Professor Serigne Gueye, in whichnumerous fistula repairs were video recordedfrom start to finish using high definitionendoscopic cameras and video equipmentprovided by Stryker Corporation.

Phase II (production) involves the laborious andhighly technical effort of separating the video of afistula repair into individual steps, applying theinteractive anatomic ‘hot spots’, and integratingcurricula from the manual. Upon completion ofPhase II (which will take approximately eightmonths), a deliverable product will be available inthe form of a standard DVD that runs on apersonal computer.

Phase III (implementation) involves the distributionand implementation of the project, including avalidation study and language translation.

We will report on further progress with thisproject very shortly – we are confident that ourvideo trainer will prove an invaluable, trulyground-breaking tool in the fight against fistula.

New interactive video trainer setto revolutionise fistula repair

Surgery in progress

Screenshot of video trainer(administering spinal anaesthesia)

*This article was prepared with theassistance of Peter Melchert MD, who is aPaediatric/Internal Medicine Hospitalist atAbbott Northwestern Hospital, Children’sHospitals and Clinics of Minnesota. Since2004, he has been on the board ofChildren’s Surgery International(www.childrenssurgeryintl.org), ahumanitarian organisation that provides freesurgical services to enhance the lives ofunderprivileged children, and serves as itsMedical Director.

FIGO’s multi-faceted SMN Initiative came to fullconclusion in 2011. In this last feature, wepresent the highlights of its work in Haiti andKenya

Haiti – ‘Setting up basic and comprehensiveemergency obstetric care in a health centrein the district of Croix-des-Bouquets’(conclusion: 30 June 2011)

Setting the sceneHaiti is the poorest country in the WesternHemisphere: 70 per cent of its seven millionpeople live on less than one dollar a day, and ithas the highest rate of maternal mortality in theregion – 670 deaths per 100,000 live births. TheSociété Haitienne d’Obstétrique et deGynécologie (SHOG) recognised an ongoing needto provide quality and accessible obstetric care.

Work in actionIn collaboration with other local partners such asthe Ministry of Health (MOH) and the Associationdes Infirmières et Sages-Femmes d'Haïti (AISFH),SHOG worked to improve the physicalinfrastructure and the availability of health careprofessions in the maternity ward within a publichealth centre located at Croix-des-Bouquets, 20kilometres from Port-au-Prince.

Achieving the goalsBefore the project, the centre at Croix-des-Bouquets offered only antenatal and postnatalcare on an outpatient basis. Initially SHOG wassuccessful in converting an outpatient unit into amaternity centre, offering basic emergencyobstetric and newborn care with referral forcaesarean and blood transfusion to a nearbyhospital.

After Haiti’s catastrophic earthquake, the projectdirector, with the support of Canadiancounterparts, was able to obtain funds in order toincrease the level of maternity services so thatwomen would have caesarean sections availableto them, if required. As a result of improvementsmade through this project, 24-hour care is nowbeing provided with the availability of basicemergency obstetric care and caesarean section.Blood transfusions are available on-site duringoffice hours and women are referred to anothercentre outside of these times.

Although the SMN Initiative has been completed,the MacArthur Foundation (www.macfound.org)is now funding the project. The Society ofObstetricians and Gynaecologists of Canada(SOGC) continues to support the project throughthe management of the MacArthur Fund, as wellas continually searching for future funds to keepthe maternity unit running.

was directed to improve the supply of maternityservices, and KOGS provided in-depth training inthis method of audit. To increase the demand forservices, all sites reached out to civil society, andworked with it to distribute messages aboutemergency preparedness, encouraging deliverywith a skilled attendant and safe motherhood.

The project provided a forum for health careproviders to reflect on their working environmentand to identify areas to improve care to womenduring the child-bearing year. Each site took ondifferent tasks relevant to its findings: eg thedevelopment and implementation of standardsand protocols; in-service training in emergencyobstetric care; and community sensitisation. Inaddition, some sites used project money toacquire essential equipment and supplies for theimprovement of the delivery of obstetric care egsphygmomanometers, urine sticks, stethoscopesand partographs.

Achieving the goalsThe project was successful in strengthening thetechnical capacity of health professionals toconduct objective criterion-based clinical audit.This was achieved through recruiting juniormembers of the society to provide support to theteams in the creation of measurement tools andin the evaluation of criteria.

At the project’s conclusion, it was discovered thatcommunication between referral levels hadgreatly improved. Staff members haveexperienced increased and improvedcommunication with referral centres throughholding training sessions about the project, andsharing standards and protocols.

Kenya – ‘Improving the quality of maternaland perinatal health care services in fourhealth facilities’ (conclusion: 31 August2011)

Setting the sceneWith a maternal mortality ratio of 530 deaths per100,000 live births, the Kenya Obstetrical andGynaecological Society (KOGS) wanted toimprove the quality of maternal and newbornhealth services. Building on its experience ofcriterion-based clinical audit in a previous projectcalled ‘The Know-How Project’, the Societydecided to implement this quality assurancemethod to four health facilities – in three hospitals(Kenyatta National Hospital and PumwaniMaternity Hospital in Nairobi, and Moi Teachingand Referral Hospital in Eldoret), and in onesmaller health centre (Sabatia Health Centre,Kakamega, Western Kenya).

Work in actionKOGS’ aim was to improve the supply of andincrease the demand for maternal health care.The main activity of criterion-based clinical audits

Successes from the Saving Mothersand Newborns (SMN) InitiativeBy Moya Crangle, Project Manager, SMN Initiative

In ternat iona l Federat ion of Gynecology and Obstet r ics | March 2012 9

FIGO IN THE FIELD…

FIGO HouseWaterloo Court10 Theed StreetLondon SE1 8ST, UKTel: +44 20 7928 1166Fax: +44 20 7928 7099Email: figo@figo.org

The International Federation of Gynecology andObstetrics is a UK Registered Charity (No 1113263;Company No 5498067) registered in England andWales. The Registered Office is shown above.

President:Gamal Serour (Egypt)

President-Elect:Sabaratnam Arulkumaran (UK)

Past-President:Dorothy Shaw (Canada)

Vice President:Takeshi Maruo (Japan)

Honorary Secretary:Ian Fraser (Australia)

Honorary Treasurer:Wolfgang Holzgreve (Switzerland)

Chief Executive:Hamid Rushwan

Administrative Director:Bryan Thomas

Readers are invited to send all comments, articles andreports (by email to communications@figo.org or ondisk) to the FIGO Secretariat no later than 31 May2012 for the next issue.

The views expressed in articles in the FIGO Newsletterare those of the authors and do not necessarily reflectthe official viewpoint of FIGO.

Produced and edited by the FIGO Secretariat © FIGO2012.

International Federation of Gynecology and Obstetrics

First caesarean delivery at Croix-des-Bouquets (Dr LauréAdrien, Project Director)

Joyce Oduor (Project Manager), right, delivers supplies forKenyatta National Hospital

Improved facilities

Project staff (Dr Lauré Adrien, Project Director, is centre)

Training at Moi Teaching and Referral Hospital

AMOG’s history andorganisational profile

The MozambicanAssociation ofObstetricians andGynaecologists (AMOG)was created in July2006. It currentlycomprises 50 members,both associate andhonorary. Its nationalsecretariat isestablished in Maputoand staffed by threeemployees, two full-timeand one part-time.

AMOG is a private, scientific, non-profitorganisation with social interest established forthe purpose of bringing together, andrepresenting, medical professionals withspecialisation in obstetrics and gynecology inMozambique.

The association was accepted as a full memberof FIGO during the FIGO World Congress in CapeTown, South Africa, in October 2009.

Mission StatementAMOG’s mission is to promote excellence in thepractice of obstetrics and gynecology throughactions related to education, advocacy andresearch.

Vision StatementAMOG envisions a country where all women andadolescents achieve the highest possiblestandards of sexual and reproductive health andrights through the best practices of obstetricsand gynecology providers.

Values/beliefsAMOG’s values are those of the highest ethicalstandards, professionalism, transparency,integrity and leadership.

InitiativesSince its establishment, the association has beeninvolved in a number of initiatives that seek toimprove the sexual and reproductive health andrights of Mozambican women and adolescents.These include:• Collaborations with the Ministry of Health(MOH) for the development of reference/clinicalmanuals related to family planning, emergencyobstetrical care, ante-natal and post-partum

care, screening of cervical cancer andcomprehensive abortion care;

• A partnership with Venture StrategiesInnovation (VSI) related to the use ofmisoprostol for the prevention and treatment ofpost-partum haemorrhage and themanagement of spontaneous abortion;

• Collaborations with FIGO to address the issueof unsafe abortion in Mozambique and, morerecently, strengthening the organisationalcapacity of the association to assume greaterleadership in the field of maternal and newbornhealth;

• Collaboration with DKT International forin-service training related to long-term familyplanning methods (IUD and implants)

Through these initiatives, AMOG has ledoperational research in the prevention of post-partum haemorrhage and the treatment ofincomplete abortion with the use of misoprostol.It has conducted a situational analysis followedby the development and implementation of a planof action related to the prevention of unsafeabortion; and it has also conducted training onpost-abortion care, prevention and treatment ofpost-partum haemorrhage and family planning.

Additionally, AMOG is involved in ContinuingMedical Education (CME) through its annualscientific meeting, which is open to externalstakeholders, and also through its members informal education at the local Faculty of Medicine.

Working with FIGOWith the support of the FIGO LOGIC Initiative(Leadership in Obstetrics and Gynecology forImpact and Change), AMOG is currently involvedin piloting tools related to maternal mortalityaudits in three main referral hospitals in MaputoCity. It has also initiated advocacy work withparliamentarians and the media for the purposeof addressing the issue of unsafe abortion.

Looking forwardIn August 2011, the association prepared itsStrategic Plan and Plan of Action with thesupport of the Society of Obstetricians andGynaecologists of Canada (SOGC) and the FIGOLOGIC Initiative. This Strategic Plan, togetherwith a Code of Ethics, was approved at AMOG’sannual meeting – held in October 2011, Maputo– during the East, Central and Southern AfricanAssociation of Obstetrical and GynaecologySocieties’ (ECSAOGS) Conference, which it alsohosted.

The conference was well attended by over 100

In ternat iona l Federat ion of Gynecology and Obstet r ics | March 201210

President Dr Nafissa BiqueOsman

Associação Moçambicana de Obstetras e Ginecologistas (AMOG)www.amogmz.org

participants, including senior officials from FIGO,who all delivered excellent lectures: PresidentProfessor Gamal Serour; Chief ExecutiveProfessor Hamid Rushwan; Past PresidentProfessor Dorothy Shaw; and Chair of the FIGOCommittee for Safe Motherhood and NewbornHealth Professor André Lalonde.

After this conference, AMOG’s President,Secretary General and Honorary Treasurerattended the FIGO LOGIC Initiative’s AnnualReview Meeting in Mumbai.

ECSAOGS Opening Ceremony

The Honourable Minister of Health delivering his speech atthe Opening Ceremony

AMOG’s President with the FIGO President and ChiefExecutive

SPOTLIGHT ON FIGO MEMBER ASSOCIATIONS

In the diary

7-12 October 2012FIGO World Congress (Rome, Italy)www.figo2012.org

12-14 April 2012The 36th Annual Symposium of the American Society of BreastDisease (Dallas, USA)www.asbd.org/education/symposium.cfm13-15 April 2012The 64th Annual Congress of the Japan Society of Obstetricsand Gynecology (JSOG) (Kobe, Japan)www.jsog.or.jp/english/annual%20congress/schedule.html20-22 April 2012IVF-Worldwide Live Congress: In Vitro Fertilisation ClinicsEmbracing the Digital Age (Berlin, Germany)www.comtecmed.com/ivf-live/201230 April-2 May 20125th Geneva Conference – Chronic Diseases: Person- andPeople-Centered Perspectives (Geneva, Switzerland)www.personcenteredmedicine.org/events.php3-6 May 2012The World Congress on Building Consensus in Gynecology,Infertility and Perinatology (BCGIP): Controversies in Obstetrics,Gynecology and Infertility (COGI) (Barcelona, Spain)www.bcgip.com/2012/Default.aspxFIGO accepts no responsibility for the accuracy of the external event information.Inclusion of any event does not necessarily mean that FIGO either endorses orsupports it.

9-12 May 201222nd European Congress of Obstetrics and Gynaecology(Tallinn, Estonia)www.ebcog2012.erpmusic.com17-20 May 2012CPP 2012 – The 2nd International Congress on CardiacProblems in Pregnancy (Berlin, Germany)www.cppcongress.com25-27 May 2012University Obstetrics & Gynaecology Congress 2012(Singapore)www.obgyn2012.com5-8 June 201210th RCOG International Scientific Congress (Kuching,Malaysia)www.rcog2012.com7-9 June 201211th European Meeting Days of the French Society ofGynecology (Paris, France)www.sfgparis2012.com/?lg=en20-23 June 201212th Congress of the European Society of Contraception andReproductive Health (Athens, Greece)www.escrh.eu/events/esc-events/12th-esc-congress

In October 2011, AMOG signed a Memorandumof Understanding (MOU) with the Ministry ofHealth, which will strengthen relations with theGovernment by officially recognising theassociation as an important and valued partner innational efforts to accelerate progress towardsMillennium Development Goals (MDGs) 4 and 5:to reduce child mortality and to improve maternalhealth.

For further information on AMOG’s activities, visitwww.amogmz.org

In ternat iona l Federat ion of Gynecology and Obstet r ics | March 2012 11

ALL EYES ON ROME 2012www.figo2012.org

‘As the FIGO WorldCongress – at the Fieradi Roma – draws evernearer, we would like toremind our valuablemember associations,partners, globalassociates andcollaborativestakeholders thatregistration is open forbusiness!’ said Chief

Executive Hamid Rushwan.

‘We outline core information below, but pleasevisit www.figo2012.org for a comprehensivereview of the Scientific Programme and alllogistics.

‘Our “Week-at-a-glance” below provides you witha broad overview of how the Congress isstructured, to enable you to better plan yourvisit.’

Delegate Registration Fee includes:

• Opening Ceremony and Reception

• Closing Ceremony

• FIGO Evening for All

• Access to all sessions and the Exhibition Hall

• Tea/coffee breaks

• Delegate bag and Congress literature

Special fee introduced forlow-resource countriesA special early registration fee for delegates fromlow-resource countries whose national societiesare members of FIGO has been introduced.Please visit www.figo2012.org/lrc/ andwww.figo2012.org/registration/ for the list ofcountries and registration details.

‘Innovative andinformative’… introducingthe 2012 ScientificProgrammeProfessor William Dunlop

‘The FIGO Congress inRome promises to beinformative, innovativeand interesting. Themost importantinternationalorganisations inobstetrics andgynecology have beenconsulted and all havesuggested up-to-date

topics and expert speakers in their areas ofspecial interest. There will be new and excitingpresentations in each subspecialty area(Gynecological Oncology, Maternal and FoetalMedicine, Reproductive Medicine, Sexual andReproductive Health and Urogynecology).Problems relevant to work in low-resourcesettings will be discussed in each of these areasand will also be separately featured. Topicsspecific to FIGO will include the roles ofprofessional societies in providing leadership andin capacity building, new classifications fortumour staging and for uterine bleeding andinternational educational initiatives.

‘A new and valuable feature of this Congress willbe the transmission of live surgery from severalEuropean centres. In addition, there will beimportant keynote lectures, symposia, oralcommunications, poster displays, videos andspecial sessions sponsored by internationalorganisations. The programme should include

topics of interest to every obstetrician andgynecologist. I hope that you will be able toattend.’

– Professor William Dunlop, Chair of the FIGO2012 Scientific Programme Committee

Reflections on Congress2009 in Cape TownProfessor Gerhard Lindeque‘Delegates registered for this high profile

Congress from far andwide, with Cape Towngraciously hostingmore than 8,000attendees.

‘The expectations ofmost were to attendthe varied ContinuousEducation lectures andresearch sessions, toexplore a famous city

and to meet and network with old and newfriends.

‘The academic programme was extensive,modern and did not disappoint. All Congressactivities were exceptionally well attended anddelegates were superbly entertained. The friendlyspirit and collegiality ensured a peaceful andproductive event.

‘Does this not encourage you to register for FIGO2012 in Rome? The same ingredients will bepresent at this highly anticipated Congress, andthe famous city has much to offer. A mostexciting FIGO 2012 awaits you.’

– Professor Gerhard Lindeque, Member of theCongress Organising Committee (SouthAfrica) and Chair of the Local OrganisingCommittee

Extended deadline for registration now available!Register before 15 April 2012 and save up to EUR 100 on the regular registration fee!

Tipology Registration fee Euro Category

Congress Payment within 15 Apr 2012 600 early registration low-resource countriesCongress Payment within 15 Apr 2012 750 early registrationCongress From 16 Apr 2012 to 31 Aug 2012 850 regular registrationCongress From 01 Sept 2012 to 15 Sept 2012 950 late registrationCongress From 06 Oct 2012 onward 950 on site registrationPre-Congress courses Course 1: Basic course on ultrasound 100 regular registrationPre-Congress courses Course 2: Diabetes and pregnancy in low-resource countries 100 regular registrationPre-Congress courses Course 3: Postpartum haemorrhage 100 regular registrationPre-Congress courses Course 4: Basic course on endoscopy 100 regular registrationPre-Congress courses Course 5: Basic course on colposcopy 100 regular registrationPre-Congress courses Course 6: The FIGO Fertility Tool Box™:

Infertility Diagnosis and Treatment in Low Resource Settings 100 regular registrationPre-Congress courses: Course 7: The Global Obstetrics Network (GONet):

Designing a Clinical Trial in Obstetrics 100 regular registration

www.figo2012.org

7th - 12th October 2012

fiera di Roma

Rome, Italy

Organised by

INTERNATIONAL FEDERATION OFGYNECOLOGY & OBSTETRICS