Throughout the Reproductive Life Course: Opportunities and Challenges for Empowering Girls and Women

Maureen Norton (R) and Katie Taylor (L) of USAID's Bureau for Global Health

A technical meeting, held April 2 & 3 in Washington, DC, brought together US domestic and international reproductive health experts to share program learning across agencies. 

Entitled “Throughout the Reproductive Life Course: Opportunities and Challenges for Empowering Girls and Women,” the invite-only meeting was hosted by the US Agency for International Development (USAID) and the Agency's flagship projects for family planning and reproductive health and maternal and child health—the Evidence to Action (E2A) Project and the Maternal and Child Health Integrated Program (MCHIP), respectively—in partnership with the Health Resources and Services Administration (HRSA).

The agenda focused specifically on HRSA's model of interconceptional care and USAID's approach to integrating family planning into maternal and child health interventions throughout the life cycle in multiple countries. Attendees also examined emerging best practices and experiences in reproductive and interconceptional health care from both domestic and international programs through panels and sessions in six thematic areas:

• Youth
• Using Family Planning to Prevent High-Risk Pregnancies
• Community-Based Services
• Family Planning Integration with Health Services
• Multisectoral FP Links with Non-Health Activities
• Integration of Empowerment or Motivational Components

The program featured remarks from: Robert Clay, Deputy Assistant Administrator, Bureau of Global Health (USAID); Katie Taylor, Deputy Assistant Administrator, Bureau for Global Health (USAID); Dr. Michael Lu, Associate Administrator, Maternal and Child Health Bureau (HRSA); and Dr. Hani Atrash, Division of Healthy Start and Perinatal Services, Maternal and Child Health Bureau (HRSA).

Participants were able to listen and contribute to both plenary and concurrent sessions, and contributed to small working group sessions on each thematic area in order to share lessons learned and draw from the diversity of field experience.

To view the presentations from the two-day meeting, click here. The full program guide can be downloaded here. More information about the call for abstracts that preceded the meeting follows.

__________________________________________________________________________________________________________________________________________________

CALL FOR ABSTRACTS—The United States Agency for International Development (USAID), in partnership with the Health Resources and Services Administration (HRSA), the Maternal and Child Health Integrated Project (MCHIP), and E2A, will convene a two-day global technical meeting, April 2 & 3, 2014 in Washington, DC, to bring together US domestic and international reproductive health experts to share program learning across agencies. Abstracts are being accepted through February 3, 2014 for panel presentations at the meeting (details below). The goals of this two-day meeting are to: 

• disseminate knowledge and identify gaps about effective approaches for empowered decision making throughout the reproductive life course; and 
• explore the use of these findings to strengthen programs, and stimulate new interventions and research opportunities.

Background 

USAID and HRSA are working on similar problems in reproductive health, including adolescent  pregnancies; rapid, repeat pregnancies; and preterm birth. Both agencies are developing tools and models to reach vulnerable, marginalized, low-income populations, especially to help girls and women make healthy decisions over the entire reproductive life course. Both are supporting research and working to mobilize evidence on effective models and approaches. Both seek opportunities to disseminate knowledge and share learning opportunities about what works, what doesn’t work, and why.

Developing Countries

Nearly 90 percent of the estimated 208 million pregnancies in 2008 occurred in the developing world. Worldwide, 86 million pregnancies were unintended (38%); of these, 41 million ended in abortions (22%).[1] In some developing countries, 40% of adolescents are mothers or pregnant with their first child, while 90 percent of adolescent pregnancies occur within marriage. Pregnancies that are less than 24 months from a live birth increase the risk of adverse outcomes for mothers and babies, both in developing countries and the US.[2] In sub-Saharan Africa, more than 40% of pregnancies are spaced less than 24 months after the last birth. Adolescents (15 to 19 years old) and young adults (20 to 24 years) have the highest proportion of rapid, repeat pregnancies among all age groups. Advanced maternal age and high-parity pregnancies also contribute significantly to the high mortality and morbidity rates found in the developing world.  An estimated 222 million women in the developing countries have an unmet need for family planning (FP).

United States

Although the preponderance of reproductive health-related mortality and morbidity is found in developing countries, the US has a relatively high rate of unintended pregnancies, adolescent pregnancies, and preterm births. In the United States, 49% of pregnancies are unintended (unwanted or mistimed).[3] The rate of unintended pregnancy among poor women (those with incomes at or below the federal poverty level) in 2006 was more than five times the rate among women at the highest income level. A 2013 study, conducted in the US, found that 35% of the pregnancies in the sample assessed were conceived less than 18 months of a previous birth, and that pregnancies occurring after a short interval were more likely to be unintended.[4] Advanced maternal age pregnancies were found to be growing in number in the US among all ethnic groups and represented about 14 percent of all pregnancies.[5]  Domestic agencies have developed tools and approaches that international organizations can incorporate into their programs.

Abstract Submission Details

Individual abstracts are being accepted for panel presentations, as well as abstracts for preformed panel that highlight healthy decision-making throughout the reproductive life course, including on any of the following topics:  

1. Using Family Planning to Prevent High-Risk Pregnancies. This includes adolescent pregnancies; rapid, repeat pregnancies; postpartum or post miscarriage/induced abortion; advanced maternal age pregnancies; and high-parity pregnancies. 
2. Influencing Short Intervals and Fertility Intentions. Successes or challenges of community-based programs and activities to influence interpregnancy length and/or intendedness of conceptions, including improved couple communication and joint/respectful decision making. 
3. Youth. This could include addressing positive youth development, self-esteem, goal-setting, reaching first-time parents, HIV prevention, engaging boys, preventing child marriage, or responding to the needs of married adolescents.
4. Family Planning Integration with Health Services. Integrating FP with other health services (e.g., maternal health [antenatal, safe delivery, postpartum care], nutrition services, child health and immunization services, addressing postpartum depression, gender-based violence, or reproductive coercion).
5. Family Planning Links with Non-Health Activities. FP linkages with non-health activities (e.g., life skills, literacy, microcredit, income generation, education promotion [keeping girls in school], and skills needed for productive employment).
6. Empowerment or Motivational Components Integrated, or holistic FP-MNCH services that include empowerment or motivational components (through use of reproductive life planning and other innovations to overcome barriers to empowerment). 

Abstracts must be evidence-based (quantitative or qualitative), with substantive content of no more than 300 words. We encourage colleagues from both the international and domestic spheres to share their work! Individual and preformed panel abstracts will be accepted through February 3, 2014.

Please submit all abstracts to Salwa Bitar at [email protected]. 

Abstract Submission Form

Title:

Presenter:

Job Title:

Affiliation:

Theme (select one):  FP and High Risk Pregnancy,  Youth,  Community-Based Services,  FP Integration with other Health Services,  Empowerment Components,  Multi-Sectoral Approach–FP Integration with Non-Health Services 

Geographic Focus of Work: USA or International

The following sections must total no more than 300 words.

Background:

Methods:

Implementation Challenges/Barriers:

Results and Conclusions:

[1] Guttmacher Institute, "Unplanned Pregnancy Common Worldwide: Neither Legal Status of Abortion nor Health Risk Deters Women from Terminating Pregnancies—Four in 10 Pregnancies Unplanned—Half of Which End in Abortion," accessed www.guttmacher.org/media/nr/abortww_nr.html.

[2] Rutstein SO. Further Evidence of the Effects of Preceding Birth Intervals on Neonatal, Infant, and Under-Five-Years Mortality and Nutritional Status in Developing Countries: Evidence from the Demographic and Health Surveys DHS Working Papers (Calverton, MD: Macro International, Demographic and Health Research Division, 2008).

[3] Guttmacher Institute, "Facts on Unintended Pregnancy in the United States, Guttmacher Fact Sheet," October 2013, accessed http://www.guttmacher.org/pubs/FB-Unintended-Pregnancy-US.html.

[4] Gemmil A, Lindberg LD, "Short interpregnancy intervals in the US," Obstetric Gynecology, Jul 2013, 122 (1):64-71.

[5] RG Resta, "Changing demographics of advanced maternal age (AMA) and the impact on the predicted incidence of Down syndrome in the US: implications for prenatal screening and genetic counseling," American Journal of Medicine, Feb 2005, 31-6.

RELATED NEWS