ICRH Belgium Newsletter
20th of January, 2012
PROJECTS
Communication skills of health professionals
ICRH obtained VLIR-UOS funding for a short term project about to the promotion of communication skills of health professionals in Cuenca (Ecuador) and Cochabamba (Bolivia).
The topic ‘provider-patient communication’ is relatively underrepresented in training and research of academic institutions in Latin-America. The present ‘south initiative’ will take advantage of the experiences of a previous VLIR-UOS funded project in Nicaragua to introduce the topic in Ecuador and Bolivia. Achieving a change in practice is a long lasting process that requires awareness and readiness to action at different levels. The ICRH project aims to take a first step for this process by 1) identifying, motivating and training pioneers, 2) supplying tools and background information, 3) implementing training activities, 4) carrying out research, 5) disseminating results and experiences and 6) creating a supportive network initiating training and research activities in provider-communication. Similar to previous activities in Nicaragua, medical consultations will be videotaped. The videos will be scored and analyzed using the Calgary Cambridge assessment scale. Partners are Universidad National Autónoma de Nicaragua, The Faculty of Medicine of the University of Cuenca, South Group (Cochabamba), Hogeschool West-Vlaanderen (Department of nursery), Ghent University (International Centre for Reproductive health and the department of General practice and primary health care).
More information: peter.decat@ugent.be
Female genital mutilation in Europe
ICRH obtained a study of the European Institute for Gender Equality (EIGE) to map the current situation and trends of female genital mutilation in 27 EU member states and Croatia.
The aim of the study is to assess and analyze the current situation of female genital mutilation in all 27 member states of the European Union and Croatia, in particular with regard to:
- current policies and policy developments on FGM at EU level and at national level
- existing prevalence data
- current actors and their activities with regard to prevention of FGM, clinical care for women with FGM, protection and prosecution.
Finally, the study will provide recommendations on data collection on FGM in the EU.
The study is led by ICRH and Yellow Window, in collaboration with national researchers in the 28 countries and the University of Tilburg. The study runs from December 1 2011 to November 30 2012.
More information: els.leye@ugent.be
Registration of female genital mutilation in Belgium
ICRH will conduct a study on registrations of FGM in Belgian hospitals.
Following the national action plan on partner violence 2010-2014, the Federal Department Public Health was requested to guarantee the registration of FGM by professionals that are confronted with female genital mutilation. This task was assigned to ICRH, in partnership with UMC Saint Pierre in Brussels. The study will assess the current registration system. Based on this assessment, a concept for an improved registration system will be developed and piloted in hospitals, after which it will be finalized. The study will run from January 1 to September 30 2012.
More information: els.leye@ugent.be
Addressing Interpersonal Violence (IPV) in a Hospital Setting
The Federal Governmental Agency of Public Health and the Minister of Public Health evaluated the project conducted in 2011 and decided to provide further funding for 2012.
The Federal Governmental Agency of Public Health and the Minister of Public Health evaluated the project conducted in 2011 and decided to provide further funding for 2012. This decision is in line with the national strategy of enhancing the skills of health workers when dealing with patients in in interpersonal violence situations.
Thus far, for health workers in hospitals this consisted of providing three pathways: 1) basic trainings of 3 hours to 18 hospitals in Belgium (10 Dutch speaking and 8 French speaking ones) per year;
2) an advanced training course of 24 hours on different modules provided to 18 hospitals that participated in the basic training at an earlier stage; 3) assistance in and coaching of hospitals who completed the advanced training in the development of their hospital specific protocols on at least child and elderly abuse and maltreatment, intimate partner violence and sexual abuse.
As funding for 2012 is limited, the Agency chose to invest on two of the three pathways, being: the advanced training and protocol coaching to the 18 hospitals that participated in the basic trainings in 2011. We do however lobby for the reinvestment in a broader strategy including basic trainings for new hospitals as well as further guidance and coaching of hospitals in the implementation process of their violence protocols. ICRH is the coordinator of the national project and is also responsible for the trainings and guidance of the Dutch-speaking hospitals.
More information: Ines.keygnaert@ugent.be or ansofie.vanparys@ugent.be
EVENTS
ICRH Mozambique registered as National Research Institute
On December 1, 2011, the Minister of Sciences and Technology of Mozambique officially recognized ICRH Mozambique as a National Research Institute, authorized to undertake scientific research activities on questions related to biomedicine and social sciences
ICRH Mozambique was formally established at the end of 2009 as an autonomous NGO, the articles of association were published in the Boletim Da República of February 26, 2010. In the course of 2010 and 2011, ICRH Mozambique has gradually developed its organizational and logistic structure and has invested a lot of effort in submitting project proposals in order to achieve a sufficient critical mass in terms of project portfolio and funding to secure its future as an independent organization. These efforts turn out to have been quite successful: the project volume and the number of staff have grown steadily. ICRH Mozambique has currently two offices: one in Tete and one in Maputo. The recognition as a National Research Institute by the Mozambican authorities is a significant milestone in the development of the organisation.
More information: Beatrice Crahay icrh.coord@tdm.co.mz
GAPSYM 2011
On December 2nd 2011 the Ghent Africa Platform (GAP) organized its fifth annual symposium.
The symposium theme was “multidisciplinary approaches to the African city”. With half of the world population living in urban centers, urbanization has become one of the mayor challenges of this century. The fastest urban growth is taking place in sub-Sahara Africa. In this context, development programs have increasingly shifted their focus from the rural to the urban setting. The African city has become the scene of extensive anthropological literature, socio-political analyses and economic studies. Several well-known speakers, as Abdou Salam Fall (Université Cheikh Anta Diop), Jim Brennan (University of Illinois) and Paul Hebinck (Wageningen University) addressed a varied public from all disciplines. ICRH was present with three delegates. Marleen Temmerman, president of GAP opened the conference.
The Ghent Africa Platform (GAP) is an umbrella organisation of actors belonging to the Ghent University Association, who focus on the African continent and the African Diaspora. GAP as a platform offers a forum within which they can intensify mutual contacts, get to know and discuss their collective, interdisciplinary interests and possibly turn this into joint research, publications and/or the implementation of these within the scope of development aid.
More information: Dominique.Godfroid@UGent.be
Women for Peace 2011
Marleen Temmerman and Els Leye received the honorary title of “Women for Peace 2011”.
This title is provided by the Platform 1325. This Belgian Platform was created in September 2009 by the National Women’s Council. The Belgian Platform 1325 wants to monitor the Belgian National Action Plan for the implementation of UN-Security council Resolution 1325 (NAP 1325). Through the campaign “Women for Peace”, the Platform seeks to inform and sensitize the general public on the importance of the UN Resolution 1325. This Resolution draws attention to the particular impact of war on women and stresses the role of women in the peace building process.
Be-cause Health seminar
Will our generation close the gap? Comprehensive and Innovative strategies to address social determinants of health.
The seventh annual seminar of Be-cause Health took place on 15 and 16 December 2011 at the Belgian Technical Cooperation in Brussels and addressed the social determinants of health in different ways. The seminar presented the global picture on SDH and was structured according to the three principles of action (“tracks”) referred to in the WHO 2008 publication of the Commission on Social Determinants of Health: [1] conditions of life, better services for the people; [2] power relations and resources; and [3] monitoring, research and advocacy. The objectives of the seminar were to raise awareness amongst the stakeholders in international cooperation and to clarify the challenges.
Birgit Kerstens, together with Prof. Yvo Nuyens, coordinated the four sessions of track 3 which dealt with identification of the critical issues and problems in monitoring and research, provided some examples and good practices of monitoring and research at country level and discussed how data and research on social determinants can be better integrated into policy, practice and action. Kristien Michielsen and Dirk Van Braeckel were actively involved in the first session of track 1 on the social determinants of adolescent’s sexual health with as main themes sexual education at school and teenage pregnancies in Latin America. One of the invited speakers was Dr. Bernardo Vega, Professor in Gynaecology at the Department of Medical Sciences at the University of Cuenca in Ecuador and partner in the CERCA project, which is lead by ICRH (Dr. Peter Decat and Sara De Meyer). This project has conducted surveys among adolescents in Bolivia, Ecuador and Nicaragua and Prof. Vega presented the preliminary results. The challenges identified during the presentations of the keynote speakers and related discussions with the audience and the recommendations on how to bridge the worlds of research and policy were highlighted in a final plenary session.
ICRH PEOPLE
CHEN Qiu-ju and LI Jin-ke
Dr CHEN Qiu-ju and Dr. LI Jin-ke joined ICRH as a post-doc researcher in December 2011 under the LOTUS program.
Prior to joining ICRH, Dr. Chen Qiu-ju worked as an associate professor of Shanghai Institute of Planned Parenthood Research in China where her research mainly focused on family planning and new contraceptive technologies. Chen holds a Ph.D degree in Gynecology and Obstetrics from Shanghai Jiaotong University (2007). She has participated in several clinical trials on the developing of new contraceptive and medical abortion regimens . She has published her research results in international scientific journals. Her research at ICRH will focus on the evaluation of family planning services for women seeking abortion, by a systematic review under the supervision of Prof. Marleen Temmerman and Dr. Wei-Hong Zhang.
More information: chenqiuju2865@hotmail.com;
Before joining ICRH, Dr. Li Jin-ke was a young physician in the Department of Obstetrics and Gynecology, West China Second Hospital. He obtained his Ph.D in June 2008 at Sichuan University, China. His work focused on cervical cancer development. Since 2008, Dr Li has been involved in researches of gynecologic diseases, especially women carcinomas. His research was funded by National Scientific Foundation of Chinese government in the year 2010. Until now, he has published over 5 international papers in high impact journals. Dr. Jinke Li will be working in ICRH for 6 months under the supervision of Dr. Wei-Hong Zhang and Prof. Marleen Temmerman. His postdoc research will focus on Chinese family planning policy as well as its practices and implications.
More information: leonljk@126.com
Peter J.T.Wangwe
Peter Wangwe is staying at ICRH Belgium to prepare his PhD research.
Peter is an obstetrician working with the Muhimbili University of Health and Allied Sciences (Tanzania) as a lecturer and clinician for the Muhimbili National Hospital. He was attached to IWK Hospital in Dalhousie for 6 months in Fetal Maternal Medicine in the management of high risk obstetrics. Since one year, he has been working with Qualmat (Quality of Prenatal and Maternal Care – an FP7 project coordinated by Heidelberg University and with ICRH Belgium as a consortium member) as field supervisor in data collection. At ICRH, Peter will work together with his supervisor on his PhD proposal. During his stay he will also work together with Qualmat members on some of the issues which were raised during data collection.
More information: Peter Wangwe, drwangwe@yahoo.com
Stéphanie De Maesschalck’s PhD
On January 10, Stéphanie De Maesschalck defended her dissertation entitled “Cultural and linguistic diversity in the consultation room”, on the emotional communication between primary care physicians and ethnic minority patients.
For this thesis, consultations of primary care physicians working in areas of Ghent with a high percentage of minority inhabitants were recorded, and both the patients and the physicians were interviewed. The focus was on emotional communication, because emotions (such as worry, anxiety,...) are quite often playing an important role in patients' reasons to consult a physician. Results of the study showed that patients' language proficiency of the language spoken during the consultation was a very determining factor in talking about emotions, rather than patients' cultural values and background. Working with interpreters seemed to enhance patients' emotional expressivity. Further, physicians' attitudes towards working with minority patients played a role in how they respond to patients' emotions.
Another interesting finding was that, although some of the participating physicians (the ones working in community health centers) were entitled to use professional interpreters, they almost never make use of these services. In our data, physicians always used informal interpreters (such as family members, children, acquaintances,...), although literature is warning about the many risks in using informal interpreters. Physicians' experiences in working with interpreters were asked for in semi-structured interviews.
PUBLICATIONS
Age-disparate relationships and implications for STI transmission.
This study aimed to estimate the prevalence of age-disparate (AD) relationships among young black and colored adults in Cape Town (South Africa) and determine socio-demographic predictors and individual and relationship characteristics of women in these relationships.
A secondary analysis of the Cape Area Panel Study ( N _ 1960) data was conducted. Descriptive statistics were used to quantify the age-mixing pattern and logistic regression was used to identify significant socio-demographic and behavioral correlates of AD relationships. Prevalence of AD relationships was high in both black (36%) and colored (28%) women. The average age difference between male respondents and their partners increased with age. Young, black women who spent fewer nights under the same roof in one week, had a deceased parent, and were not currently attending classes were more likely to be in an AD relationship. Reports of sexually-transmitted infection (STI) symptoms in the last month and unprotected sex were more common among women in AD relationships.
The authors conclude that AD relationships are common among young women in Cape Town. Home and family stability is preventative of young women engaging in AD relationships. Therefore, holistic, societal interventions may reduce AD relationships, which are a risk factor for STIs.
Age-disparate relationships and implications for STI transmission among young adults in Cape Town, South Africa. Roxanne Beauclair , Reshma Kassanjee , Marleen Temmerman , Alex Welte and Wim Delva. The European Journal of Contraception and Reproductive Health Care, February 2012; 17: 30–39.
Caesarean section
Limiting the Caesarean Section rate in low risk pregnancies is key to lowering the trend of increased abdominal deliveries: an observational study.
As the rate of Caesarean sections (CS) continues to rise in Western countries, it is important to analyze the reasons for this trend and to unravel the underlying motives to perform CS. This research aims to assess the incidence and trend of CS in a population-based birth register in order to identify patient groups with an increasing risk for CS. Data from the Flemish birth register 'Study Centre for Perinatal Epidemiology' (SPE) were used for this historic control comparison. Caesarean sections from the year 2000 (N = 10540) were compared with those from the year 2008 (N = 14016). By means of the Robson classification, births by Caesarean section were ordered in 10 groups according to mother - and delivery characteristics. Over a period of eight years, the CS rise is most prominent in women with previous sections and in nulliparous women with a term cephalic in spontaneous labor. The proportion of inductions of labor decreases in favor of elective CS, while the ongoing inductions of labor more often end in non-elective CS. The authors conclude that, in order to turn back the current CS trend, we should focus on lowrisk primiparae. Avoiding unnecessary abdominal deliveries in this group will also have a long - term effect, in that the number of repeat CS will be reduced in the future. For the purpose of selfevaluation, peer discussion on the necessity of CS, as well as accurate registration of the main indication for CS are recommended.
Limiting the Caesarean Section rate in low risk pregnancies is key to lowering the trend of increased abdominal deliveries: an observational study. Delbaere I, Cammu H, Martens E, Tency I, Martens G, Temmerman M. BMC Pregnancy Childbirth. 2012 Jan 9;12(1):3. [Epub ahead of print]
Vaginal microflora
Longitudinal Study of the Dynamics of Vaginal Microflora during Two Consecutive Menstrual Cycles.
Although the vaginal microflora (VMF) has been well studied, information on the fluctuation of the different bacterial species throughout the menstrual cycle and the information on events preceding the presence of disturbed VMF is still very limited. Documenting the dynamics of the VMF during the menstrual cycle might provide better insights. In this study, we assessed the presence of different Lactobacillus species in relation to the BV associated species during the menstrual cycle, assessed the influence of the menstrual cycle on the different categories of vaginal microflora and assessed possible causes, such as menstruation and sexual intercourse, of VMF disturbance. To our knowledge, this is the first longitudinal study in which swabs and Gram stains were available for each day of two consecutive menstrual cycles, whereby 8 grades of VMF were distinguished by Gram stain analysis, and whereby the swabs were cultured every 7(th) day and identification of the bacterial isolates was carried out with a molecular technique.
Longitudinal study of the dynamics of vaginal microflora during two consecutive menstrual cycles.Santiago GL, Cools P, Verstraelen H, Trog M, Missine G, El Aila N, Verhelst R, Tency I, Claeys G, Temmerman M, Vaneechoutte M. PLoS One. 2011;6(11):e28180. Epub 2011 Nov 30.