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Officers' update, June 2015

Professor Lesley Regan, RCOG Vice President Strategic Development, writes...

By the end of 2015, our world will have witnessed the death of another 300,000 pregnant women. Since the vast majority of these deaths are preventable with cheap drugs and simple interventions, we are forced to conclude that these girls and women continue to die because no one in their society cares enough to save their lives.

At the RCOG, we do care and I believe that the new Leading Safe Choices initiative has the potential to bring about transformational change, not only for the women we seek to serve but for our College too.

We know that there are 222 million women in the world who have no access to family planning. We also know that providing these women with the choice to use effective contraception and space their babies by 18-24 months, results in a dramatic reduction in unplanned pregnancies, unsafe abortions and a massive increase in infant survival.

Thanks to significant funding received by an international donor who wishes to remain anonymous, the RCOG has been given the opportunity to make a real difference to the quality of postpartum family planning and comprehensive abortion and post abortion care offered to women in South Africa and Tanzania.

Leading Safe Choices

Leading Safe Choices is an opportunity to confront two major issues that have persistently hindered progress in women’s health: contraception and abortion.

Globally, 1 in 6 of all maternal deaths stem from unsafe abortions, all of which could be prevented if all women were able to access effective, affordable contraception to plan and space their pregnancies. The World Health Organization (WHO) has estimated that this simple intervention would in turn result in maternal deaths falling by 66% and newborn deaths by 75%.

As a profession we must tackle the root causes underlying why women die – namely that they often have little control over whether and when they become pregnant. As professionals we need to find ways to address these controversial issues in order to improve women’s healthcare.

Our strategy

The 3 year pilot programme runs from January 2015 to December 2017 in selected facilities in South Africa and Tanzania and we are working alongside colleagues in these two countries to develop and implement the programme. Together with them, we will be training healthcare professionals to offer and provide long acting reversible contraceptives (LARCs) immediately postpartum so that women who struggle to access family planning services are able to space their children and avoid unintended pregnancies.

We will also be training health care professionals to improve women’s access to safe abortion and post abortion care to the full extent of the local law. This is vital to ensure that not only do women have access to safe services, where they are treated with respect and dignity but that providers feel equipped, motivated and supported to deliver those services too.

A key part of our strategy will be to develop a system that measures and recognizes the skills and competence of these dedicated providers of reproductive health services. By establishing a locally owned certification process we aim to enhance the pride and self esteem of these professionals and raise their standing and respect amongst their peers.

Having demonstrated the feasibility and sustainability of our programme, we hope to scale up our activities across South Africa and Tanzania, before expanding to other countries in the region.

Measuring our success

In the short term, the success of Leading Safe Choices will be measured by an increase in the number of providers able and willing to provide high quality postpartum family planning and comprehensive abortion and post abortion care services.

Our long term success will be evident when the countries we are partnering with no longer need our input because a sustainable system to deliver high quality reproductive health care has been firmly established.

The RCOG has never embarked on an overseas project of this magnitude before. I am determined to make this a successful programme that results in the donor choosing to fund us for many more years to come.

Changing hearts and minds

We have come a long way already in developing Best Practice Papers and Training Manuals and are now engaging the in-country teams to deliver the programme. I am grateful to all the Fellows and Members who have contributed their expertise so generously to this initiative. I am delighted that we have been able to attract such a talented team who are so passionate about the cause.

This initiative is not rocket science, it is very simple medicine, but it requires a step change in the way that we think about reproductive healthcare. Leading Safe Choices should make ALL of us, wherever we work, think about how we can do a better job and how we value women in our society.

I consider this initiative to be quite simply the most exciting and potentially transformational programme that I have ever been involved in during the 35 years I have been a practicing doctor. I am proud to be able to share it with you.