Newsletter November 2009



 ICRH Belgium Newsletter

 November 10, 2009




Once we had  a dream...Once is about 15 years ago and ‘ we’  was a small group of engaged, concerned, enthusiastic young people with a passion to contribute to a better world. Health and access to health care as a human right, especially for vulnerable groups, was the basic paradigm.

ICRH Belgium was created in 1995 by a mixed group of hardworking individuals united by a common goal, and determined to contribute to the new Cairo and Beijing concepts of sexual and  reproductive health and rights. A few years later the concept was taken up in Kenya in the format of a local NGO based in Mombasa, and thus ICRH Kenya was born in 2000. Our main activities include research  and interventions in HIV/AIDS, mother-child health, family planning, microbicides and female barrier methods, sexual and gender-based violence, and harmful traditional practices. Awareness raising and advocacy, policy research and training became high ranking topics on the agenda. ICRH Mozambique was born in 2009 and joint programmes are  underway in South-Africa, Rwanda, Ethiopia, as well as in Latin-America and China, with Universities as well as Ministries and multilateral organisations such as the WHO and UNFPA.  Over 200 people of very diverse backgrounds work for ICRH all over the globe with a common mission and vision. A larger group creates more potential and also more challenges. We therefore need a new overarching structure with clearly defined roles and responsibilities, and a strong overall leadership. Time to move on and to look for better structures to work together and to communicate within and outside the ICRH family. That is why we  have set up ICRH Global.

 As one of the founders of ICRH I am extremely happy and proud and grateful to  everyone who made this possible , and I am looking forward to continue working with and for all these wonderful people.

Prof. dr. Marleen Temmerman, Chair.


“ICRH Global”: the new ICRH umbrella organization

The ICRH family currently consists of three separate organizations. A new not-for-profit organization, “ICRH Global” has been established to enhance coordination and communication between the different ICRHs.

Next to ICRH Belgium, which is part of the Ghent University, there is also ICRH Kenya, based in Mombasa and ICRH Mozambique, based in Maputo. In order to formalize the relationship and to enhance communication and cooperation between these organizations, the not-for-profit organization ‘ICRH Global’ has been established. The Board of Directors consists of representatives from the three ICRHs and from Ghent University. The chair is prof. dr. Marleen Temmerman. Non-voting membership of ICRH Global is open to any person or organization interested in the broad field of reproductive health and rights.

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First results of the YOLAMI project in China

YOLAMI (Young Labor Migrants in Chinese Cities) is an operational research project, coordinated by ICRH and funded by the EU (FP6), that addresses barriers to health care for Chinese laborers who migrated from rural areas to cities.

 In a first phase, a survey at worksites assessed  the needs of 4867 migrant women concerning their sexual and reproductive health. The results of the survey are analyzed and prepared for publication. Our main conclusions are that migrant women are a  vulnerable population concerning sexual and reproductive health. Sexually active migrants have an unsafe contraceptive behaviour, resulting in high percentages of unplanned pregnancies  (up to 18% over 6 months) and abortions (up to 15% over 1 year). We found that unsafe contraceptive behaviour was associated with reduced access to health services, existing taboos on sexuality and limited knowledge on sexual and reproductive health. Migrants who are unmarried, lowly educated and not covered by health insurance were found to be the most vulnerable.  Based on those conclusions intervention strategies have been developed and subsequently implemented in 29 worksites.  Results from the impact of those interventions are expected in the beginning of 2010.

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CERCA: Community-embedded Reproductive Health Care for Adolescents in Latin America

ICRH gained a FP 7 tender (European Union) for a research project related to strategies for improving reproductive health in Ecuador, Bolivia and Nicaragua.

 The CERCA (Community-embedded Reproductive Health care for Adolescents in Latin America) project has been approved for funding and will be launched  from March 2010. Over a four year period, a consortium of three European and four Latin American research institutions, coordinated by ICRH, will develop and test innovative strategies targeted at adolescents in Ecuador, Bolivia and Nicaragua. A strong emphasis will be put on the use of the new media (Internet and mobile phone text messages) to reach adolescents for empowering actions. Local and national policy makers will be continuously involved in the research project as part of the project strategy to bridge the gap between health research and health policies. Community-participatory action research will be the main methodology for the development of the intervention strategy. The impact of the interventions will be evaluated through a randomized control and a quasi experimental study.

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Understanding the impact of migration on forced marriage

A new ICRH project on forced and child marriage, funded by VLIR-UOS, has recently started.

The four-year project is entitled "Girls and women forced into marriage: understanding the impact of migration on Kenyan and Moroccan communities". It will study the impact of context on the occurrence of forced/early marriage in Kenya and Morocco, and among immigrants with a similar background in Belgium and the UK. In general, the project examines to what extent migration has an influence on perceptions and decision-making processes of forced/early marriage.

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Survey among patients in Nicaraguan health centres

At the International Conference on Communication in Healthcare (5-6 October 2009, Miami), Elena Vargas, a graduating medical student in Nicaragua, presented the results of investigations carried out in Nicaragua within the framework of an ICRH project.

Flemish and Nicaraguan students conducted a survey among patients in three Nicaraguan health centres, researching feelings, emotions and expectations before consultation and perceptions after consultations.  Nicaraguan patients spend a long time waiting for the consultation (38% waits over two hours). Although most patients’ expectations were fulfilled after consultation, shared-decision making appears to be a neglected aspect in primary care in Nicaragua. This study  forms part of the research project “Quality Sexual and Reproductive Health Delivery in Primary Health Services, carried out by ICRH, the department of family Medicine UGhent and UNAN (Universidad Autónoma de Nicaragua) and is financed by VLIR-UOS.

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Bridging the gap between knowing and doing in maternal and prenatal care

In June 2009, a new health care intervention research project,  entitled QUALMAT and funded by the EU (FP7),  kicked off with an international meeting in Ouagadougou.

“Knowing is not enough, we must apply; Wanting to do, is not enough, we must do it” (J.W. v. Goethe).

QUALMAT stands for ‘the quality of maternal and prenatal care: bridging the know-do gap’. The odds that a sub-Saharan African mother will die from complications of pregnancy and childbirth are 1 in 16 compared to 1 in 3 800 in industrialized countries. In addition to a lack of financial and human resources in developing countries, health care is endangered by quality deficiencies caused by low staff motivation. The QUALMAT project wants to increase health care staff motivation through a commonly agreed upon performance-based incentive scheme. In addition a computer-assisted clinical decision support system (CDSS) will be developed and tested, which will help providers to comply with established standards of care.

The study findings will allow a stronger understanding of the important factors of staff motivation and facilitate adequate management for the improvement of maternal and neonatal health care.

The QUALMAT project is funded by the European Commission under the Seventh Framework Program. The project is coordinated by the University of Heidelberg and the research will be conducted in three Sub-Saharan African countries: Burkina Faso, Ghana and Tanzania, with an intervention and a control district in each country.

ICRH is in charge of the development and the implementation of adequate tools and systems for the monitoring and evaluation of the quality of pre-natal and maternal care in resource-poor settings.

The QUALMAT consortium includes the following 6 partner institutions:

  • Heidelberg University, Department of Tropical Hygiene and Public Health and Department of Internal Medicine VI, Germany
  • International Centre for Reproductive Health, Ghent University, Belgium
  • Centre de Recherche en Santé de Nouna, Burkina Faso
  • Navrongo Health Research Centre, Ghana
  • Karolinska Institutet, Division of International Health and Division of Clinical Pharmacology,  Sweden
  • Muhimbili University of Health and Allied Sciences, Tanzania.

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Why is law enforcement on FGM in Europe so difficult?

The ICRH project "Towards an improved enforcement of FGM legislation in Europe: dissemination of lessons learned and capacity building of actors in legal and para-legal field" ran from June 2007 to June 2009.

The project, financed by the European Commission Daphne Programme, aimed to enhance implementation of criminal and child protection laws on FGM in the EU. Questionnaires were sent to all EU countries to update the review of the criminal and child protection laws on FGM. 

Project partners from Belgium, France, Spain, Sweden and UK collaborated to organize workshops to build the capacities in FGM law enforcement for professionals from various sectors: child protection officers, social workers, health professionals, etc.

Project results, including practical recommendations on improving the implementation of FGM-legislation, are published in the final report and will be made available on the ICRH website.

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Novel biomarkers to measure safety of microbicides

To avoid unexpected safety problems, a broader range of more reliable safety markers needs to be identified. This project will study a variety of African female target populations in four African settings, including special population groups (such as adolescent, pregnant women and high frequency users).

Biomarkers will be characterized in perspective to inflammation, epithelial integrity, immune activation and antimicrobial activity in the cervicovaginal environment. This study is a multidisciplinary project bringing together clinicians, laboratory scientists, and scientific experts from both sub-Saharan African and European countries. Cutting edge laboratory techniques are essential to investigate the composition of the normal cervicovaginal milieu and accompanying safety biomarkers.

The expected outcome is the introduction of these biomarkers in the next generation of microbicide safety trials, more precisely to gain insight in the baseline situation of the cervicovaginal flora.

Partners are ICRH Kenya, Projet Ubuzima Rwanda, MITU/NIMR Tanzania, RHRU South Africa, ITM, Ghent University, AMC-CPCD, LSHTM and MRC. This study is funded by EDCTP with Belgian and UK cofunding.

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Global Responsibilities for Global Health Rights Conference

From 19 to 21 October 2009, public health specialists from all over the world discussed the way forward to establish global health systems on a conference co-organized by ICRH Belgium.

The conference aimed to move from concepts to practice by bringing together leading academics and practitioners in the field of global health and human rights. Three issues were addressed: clarifying the conceptual frameworks associated with ‘right to health’ and ‘global social protection’, understanding global responsibilities of both low- and high income countries and of the international community, and overcoming the obstacles associated with putting these concepts into practice. Closing remarks were made by Jeffrey Sachs and Mary Robinson.

The conference was an initiative of the Hélène De Beir Foundation, in collaboration with 8 other organizations, including ICRH Belgium.

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