ICRH Belgium Newsletter
20th of April, 2012
PROJECTS
CERCA project update
The CERCA project consortium organized a four day consortium meeting in Cochabamba, Bolivia, and had its third community advisory board meeting in Belgium.
CERCA stands for Community-Embedded Reproductive health Care for Adolescents in Latin America). This intervention research project, coordinated by ICRH, investigates how to improve teenagers’ sexual and reproductive health in Latin America. The partners involved are South Group (Bolivia), the University of Cuenca (Ecuador), the Amsterdam School for Social Sciences (Netherlands), the University of Kaunas (Lithuania), Centro de investigaciones y estudios de salud (Nicaragua) and the Instituto Centro Americano de la Salud (Nicaragua).
From March 27, all consortium partners met in Bolivia to discuss the ongoing interventions in Ecuador, Bolivia and Nicaragua. The CERCA intervention strategy is specific and innovative as it is focusing simultaneously on different societal levels, actively involving beneficiaries in the development and implementation and considering the complex determinants of human behavior. On the fourth day, the CERCA consortium has been invited by the prefecture of Cochabamba to present the results of the baseline surveys among adolescents in the three countries for an audience of politicians and the public in general. The event has been broadly covered by the Bolivian press.
On the 7th of March individuals and organizations working in the field of Latin America and/or sexual and reproductive health (care) for adolescents participated in the third Community Advisory Board meeting. The following organizations were represented: Sensoa, Plan Belgium, FOS-Socialistische Solidariteit, the Department of Public health and the Department of Family Medicine of the university of Ghent. The results of the surveys among adolescents in the three countries were presented. The participants gave useful input for improving the interventions and the evaluation process.
More information: Peter.decat@ugent.be and SaraA.demeyer@ugent.be
Websites: www.proyectocerca.org and www.icrh.org/projects/cerca-communityembedded-reproductive-health-care-for-adolescents-in-latin-america,
EVENTS
ICRH presents LUMIMA!
On May 10th 2012 ICRH organizes the interactive event LUMIMA, an information and sensitization initiative within the framework of the Belgian Development Days.
LUMIMA starts at 3 p.m. with ‘Think & Taste’, an information market about the Millennium Development Goals 4 & 5 (reducing child mortality and improving maternal health). Various organizations working in the field will be present, as well as the following speakers: Prof Dr Temmerman (Senator and director ICRH), Prof Dr Chia Longman (lecturer genderstudies UGhent and coordinator Ella, knowledge centre gender and ethnicity), Dr Annelies Verdoolaege (Ghent Africa Platform), Fadumo Abdi Nasir (testimony FGM) and Eva de Plecker (MSF midwife). Expositions and videos will be shown and a musical touch will be given by Jim Cole and Sherman. ‘Think & Taste’ is mainly aimed at students and staff of the Association of Ghent University but also other enthusiasts are welcome. At 8 p.m., a big quiz (presented by Lieven Scheire of Neveneffecten) will start, in which the participants can challenge some eminent professors and celebrities among whom Prof Temmerman, Daniel Termont (Mayor of Ghent), Prof Dr Rik Torfs (Canon Law and senator), Tom Coenye (elected ‘the coolest professor of Ghent University 2012’) and Nic Balthazar (director, writer, actor) to have the best knowledge on MD 4 and 5. The winning team is awarded trip to Kenya, including visits to ICRH Kenya projects related to child and maternal health. Place to be: Universiteitsforum, Sint-Pietersnieuwstraat 33, Ghent. For more information, have a look at: www.icrh.org/lumima or contact: JulieG.Deman@ugent.be or SaraA.demeyer@ugent.be
Save the date! 7 May: launch of the ICRH Belgium Activity Report 2011
The 2011 Activity Report will be published within a few weeks and will be presented to the press and the public on 7 May in Ghent.
The launch will take place at in the Faculty Room of the Ghent University Hospital (first floor in between Poli 5 and Poli 6) on 7 May at 4:30 pm. The presentation of the report by ICRH Director Marleen Temmerman will be followed by a reception.
All ICRH contacts, friends and sympathizers are warmly invited to attend this event. Please confirm you participation by sending an e-mail to icrh@ugent.be.
Mothers’ Night
On the 15th of May, ‘Moedernacht’ (Mothers’ Night) will take place in Ghent.
Every year, 350,000 women die as a consequence of complications during pregnancy or delivery. These are almost 1,000 women per day. At Moedernacht, the problem of maternal mortality is targeted. A debate will be held with Marleen Temmerman (ICRH-Ghent Unviersity), Goedele Liekens (UNFPA Goodwill ambassador), Severine Caluwaerts (MSF), Joseph Vyankandondera (ICRH) and Alma De Walsche (MO*). Sara Van Boxtael (Radio 1) will moderate the panel discussion. The Belgian-Congolese singers of Radio Candip will take care of the musical entertainment. The event, organized by Sensoa and Vooruit, will start at 8pm in the theatre hall of Vooruit, Sint-Pietersnieuwstraat, Ghent. Entrance is free.
More information: www.elkemamatelt.be
ICRH PEOPLE
Adriane Martin Hilber
On 17 of April, Adriane Martin Hilber successfully defended her PhD dissertation entitled ’women’s health, hygiene and HIV in Sub-Saharan Africa: The role of vaginal practices’.
Researchers studying HIV vaccines and vaginal microbicides have long suspected that relative variations in vaginal health play an important role in HIV rates. These differences might be linked to reproductive tract infections or behaviours that increase inflammation, lesions or change the vaginal flora. It is difficult to determine how important vaginal factors are in increasing a woman’s risk for HIV acquisition because of the many other factors also influence HIV transmissibility.
Adriane Hilber used qualitative and quantitative research methods to investigate vaginal practices used by women in sub-Saharan Africa, and to determine whether their use increases women’s risk of acquiring HIV infection. The results of country studies in Mozambique and South Africa have shown that vaginal practices are more varied and diverse than previously thought and some practices such as intravaginal cleansing are extremely common. An aggregate systematic review and an individual patient data meta-analysis showed that some practices are clearly not benign; indeed women’s use of some practices to address sexual or reproductive health concerns through self-treatment or increased hygiene practices may in fact be placing them at greater risk. Results however between studies are inconsistent leaving the critical question about harm of some practices unanswered. A meta-ethnography gave insight that practices are an important source of power for women to control their relationships and health indicating that changing practices will require appreciation of the role they play in women’s life. As new HIV prevention technologies become available, it will be critical for programmes to develop introduction strategies that take into account women’s vaginal practice preferences whether they be for health, sexual or hygiene purposes.
The PhD supervisor was prof dr Marleen Temmerman, director of ICRH/Ghent University. Co-supervisors were prof dr N. Low, Institute of Social and Preventive Medicine, University of Bern,Switzerland, and prof Terence Hull, Australian Demographic and Social Research Institute, Australian National University.
The dissertation can be downloaded at http://www.icrh.org/files/Adriane%20Martin%20Hilber%20PhD%20Thesis.pdf
PUBLICATIONS
Prevention with positives
Sexual behavior of HIV-positive adults not accessing HIV treatment in Mombasa, Kenya: Defining their prevention needs
HIV spread continues at high rates from infected persons to their sexual partners. In 2009, an estimated 2.6 million new infections occurred globally. People living with HIV (PLHIV) receiving treatment are in contact with health workers and therefore exposed to prevention messages. By contrast, PLHIV not receiving ART often fall outside the ambit of prevention programs. There is little information on their sexual risk behaviors. This study in Mombasa Kenya therefore explored sexual behaviors of PLHIV not receiving any HIV treatment.
Using modified targeted snowball sampling, 698 PLHIV were recruited through community health workers and HIV-positive peer counselors. Of the 59.2% sexually-active PLHIV, 24.5% reported multiple sexual partners. Of all sexual partners, 10.2% were HIV negative, while 74.5% were of unknown HIV status. Overall, unprotected sex occurred in 52% of sexual partnerships; notably with 32% of HIV-negative partners and 54% of partners of unknown HIV status in the last 6 months. Multivariate analysis, controlling for intra-client clustering, showed non-disclosure of HIV status; experiencing moderate levels of perceived stigma; and believing condoms reduce sexual pleasure were independently associated with unsafe sex. Unsafe sex was also higher in those using contraceptive methods other than condoms; or no method, compared to condom users.
Conclusions: High-risk sexual behaviors are common among PLHIV not accessing treatment services, raising the risk of HIV transmission to discordant partners. This population can be identified and reached in the community. Prevention programs need to urgently bring this population into the ambit of prevention and care services. Moreover, beginning HIV treatment earlier might assist in bringing this group into contact with providers and HIV prevention services, and in reducing risk behaviors.
Sexual behavior of HIV-positive adults not accessing HIV treatment in Mombasa,
Kenya: Defining their prevention needs. Avina Sarna, Stanley Luchters, Melissa Pickett, Matthew Chersich, Jerry Okal, Scott Geibel, Nzioki Kingola, Marleen Temmerman. AIDS Research and Therapy 2012, 9:9 doi:10.1186/1742-6405-9-9.
A call for a family planning surge
Family planning is receiving insufficient attention, in spite of its considerable potential impacts on public health, environmental sustainability and social and economic development.
In 1994, the International Conference on Population and Development (ICPD) held in Cairo, Egypt, laid out in its Programme of Action an impressive and ambitious set of goals for improving sexual and reproductive health and rights all over the world, by the target date of 2015. One of these goals was the provision of universal access to a full range of safe and reliable family -planning methods. However, notwithstanding increases in budgets for family planning during the years
following the ICPD, there has been an alarming neglect from the international community for the topic since the year 2000. As a result, the progress made during the second half of the nineties slowed down considerably between 2000 and 2010; in a sense, one could say that ten
years were almost wasted! This is astonishing, the more since meeting the need for family planning would have beneficial impacts on public health, environmental sustainability and social and economic development. In this paper, the authors explore these impacts and urge for a strong renewed commitment of the global community in the form of a global family planning decade.
A call for a family planning surge. M. Temmerman, D. Van Braeckel, O. Degomme. FVV in ObGyn, 2012, 4 (1): 25-29.
Violence is silent rape
Sexual and gender-based violence in refugees, asylum seekers and undocumented migrants in Belgium and the Netherlands
Although women, young people and refugees are vulnerable to sexual and gender-based violence (SGBV) worldwide, little evidence exists concerning SGBV against refugees in Europe. Using community-based participatory research, 223 in-depth interviews were conducted with refugees, asylum seekers and undocumented migrants in Belgium and the Netherlands. Responses were analysed using framework analysis. The majority of the respondents were either personally victimised or knew of a close peer being victimised since their arrival in the European Union. A total of 332 experiences of SGBV were reported, mostly afflicted on them by (ex-)partners or asylum professionals. More than half of the reported violent experiences comprised sexual violence, including rape and sexual exploitation. Results suggest that refugees, asylum seekers and undocumented migrants in Belgium and the Netherlands are extremely vulnerable to violence and, specifically, to sexual violence. Future SGBV preventive measures should consist of rights-based, desirable and participatory
interventions, focusing on several socio-ecological levels concurrently.
Hidden violence is silent rape: sexual and gender-based violence in refugees, asylum seekers and
undocumented migrants in Belgium and the Netherland. Ines Keygnaert, Nicole Vettenburg & Marleen Temmerman (2012). Culture, Health & Sexuality: An International Journal for Research, Intervention and Care, DOI:10.1080/13691058.2012.671961.
NICK project newsletter
The project ‘Nutritional Improvement for children in urban Chile and Kenya’ (NICK) has published its first newsletter.
The NICK project seeks to address the following central research question: Can child malnutrition amongst families living in poverty in informal settlements and slums in Mombasa and Valparaíso be reduced through broadening community and stakeholder participation and strengthening local political accountability for nutrition? In a first phase, literature reviews and situational analyses have been carried out by the core research team and used to inform the Participatory Action Research (PAR). The PAR groups will follow three six- monthly cycles of planning, action, reflection and re-planning in order to design, trial and improve a range of small scale community-based interventions to reduce child malnutrition.
The first NICK newsletter reports on project progress and contains preliminary results of the baseline survey.
More information: http://www.ioe.ac.uk/study/departments/hsse/56520.html