‘Working together towards thecommon goal of improving sexualand reproductive health’– new FIGO President in global rallying call

In ternat iona l Federat ion of Gynecology and Obstet r ics | December 2012 1

FIGO welcomes new President | UNFPA Chief highlights MDG challenge |Launch of African Federation of Obstetrics and Gynaecology (AFOG)

| ‘Why Did Mrs X Die, Retold’ premiere

continued on page 2

International Federation ofGynecology and ObstetricsFFIIGGOOFIGO

CONGRESSSPECIAL ISSUE

communications@figo.orgwww.figo.org December 2012

Dear ColleaguesI would like to thank Professor Gamal Serourfor the tremendous job he has done in leadingFIGO over the past three years. To the FIGOmembership and the national societies, I ammost grateful to you for having the trust in meand providing the mandate for me to be FIGOPresident. The Officers and the ExecutiveBoard members have worked extremely wellwith the Chief Executive, the AdministrativeDirector, the staff, and with the nationalsocieties over the last several decades. Theyhave brought FIGO to its current position,which is recognised globally. On behalf of FIGOI would like to acknowledge our colleagues andthe people of Italy who have welcomed us. I

should fail in my duty if I did not also thank mywife, Gayatri, and my children, Shankari,Nishkantha, and Kailash.

My theme over the next three years is not a newone; it is to ‘continue to work together’ during theperiod 2012 to 2015. FIGO will continue to buildon the good work completed so far and will workon the Millennium Development Goals (MDGs)and reproductive health issues.

There are several issues of concern: maternalhealth (ie morbidity and mortality), preterm births,stillbirths, subfertility, cancer, domestic violence,female genital mutilation, fistula, and sexual andreproductive health. In addition to carrying outactivities in these areas, I will focus on maternalmortality, stillbirth, unmet need for familyplanning, and safe abortion care. FIGO will alsocontinue with some emphasis on HIV/AIDS, andits other activities will continue. These activitiescannot be conducted by FIGO alone and we willwork in collaboration with a number of nationalorganisations and governments.

The essential partners that have helped FIGOover the years include the World HealthOrganization (WHO), the Partnership forMaternal, Newborn and Child Health, FamilyHealth International (FHI), the InternationalConfederation of Midwives (ICM), theInternational Paediatric Association (IPA), theInternational Confederation of Nurses (ICN), theInternational Planned Parenthood Federation(IPPF), EngenderHealth, and Gynuity; in additionto donors such as USAID, UKAID, the Bill and

Melinda Gates Foundation, an anonymous donor,Ford Foundation, and others. I am extremelygrateful to them and look forward to theircontinued support. There are others such asUNFPA, the World Bank, UNICEF, and industrypartnership that are essential for FIGO tofunction. I would like to thank the staff of FIGOand its partner organisations for helping us tocome this far.

Principles that govern successThere are five principles behind recent successstories.1. Governments have to make saving mothersa national priority and strengthen theexisting coalition.

2. Focus should be given to selected issuesrather than trying to target too manyactivities.

3. Ownership at the grass-roots level must bestrengthened.

4. Continuous innovation and maximisation ofavailable resources.

5. Accountability by measuring outcomes tostrive for continued improvement.

Whatever the projects, FIGO will need to abideby these five principles if we are to succeed.Whether we are going to provide safe abortioncare, reduce stillbirths, or provide contraception,we must get the support of government. Weneed to innovate as to how best we canimplement contraception, provide the ownershipto the women, provide the needed care, and beaccountable.

Strengthen existing coalitionsHere we can learn from the FIGO LOGIC project,the aim of which is to strengthen the nationalsocieties. The project has been able to link aprofessional society with the government andestablish a good working relationship withMinistries of Health. The project will continue untilOctober 2013. FIGO will try to encompass other

Professor Sir Sabaratnam Arulkumaran, FIGO President

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New FIGO President in global rallying callContinued from page 1

In ternat iona l Federat ion of Gynecology and Obstet r ics | December 20122

societies to build a South–South collaboration.Focus will be given to items that are mostneeded in a particular country, such asreductions in deaths from haemorrhage, unsafeabortion, or hypertensive disorders. During myterm of office, I want to concentrate on how bestto resolve unmet need for family planning (MDG5b). Voluntary family spacing with postpartumfamily planning programmes including long-acting reversible contraceptives might be the keyfor mothers attending for delivery at a healthfacility. We should take that opportunity andprovide whatever contraceptive method isdesired.

Focus on a few selected issuesSafe abortion careGlobally, it is estimated that there are 210 millionpregnancies and 40 million abortions, half ofwhich are unsafe. About 70,000 women die as aresult of septic abortion and five million areadmitted with complications. We have to work onthe principles of primary, secondary, and tertiaryprevention by making contraceptives andemergency contraception available, by makingabortion a safe procedure, and by providingpostabortion contraception. We should worktoward reducing the vast majority of unsafeabortions occurring in low-resource countries. Atthe FIGO Pre-Congress Workshop, sixrecommendations were made as to how best toprovide safe abortion permitted by law. Thisinformation will be disseminated to FIGO’snational societies.

ContraceptionA total of 222 million women have an unmet needfor contraception. Contraception can help toreduce 10% of child mortality and 30%–50% ofabortion. The Pre-Congress Workshop produceda strategy detailing how we can make this workthrough the national societies. The Resolutionthat was passed by the General Assembly will beposted on the FIGO website. There are certainstrategies that we will implement. We would liketo include family planning in general nurse andmidwifery training. We will engage generalpractitioners and primary care providers. We shalldevelop a standard FIGO model curriculum forfamily planning and will engage the nationalsocieties to disseminate this information. We willwork to facilitate task shifting; for example inIndia, abortion is legal but the number of facilitiesand providers are not enough and women seekabortion from providers who are not qualified.

Strengthening communityownership: ‘Maternity ecosystem’Strengthening ownership at the grass-roots levelis vital. What can we do to mobilise women,

families, and the community? The charity‘Women and Children First’ has been workingwith several local organisations in countries tomobilise the community to come together everyfew weeks. This has been shown to be effectivein reducing child and maternal mortality andmorbidity. FIGO hopes to participate to see howwe can activate the community along with thenational and regional societies to make theimpact even stronger.

Community mobilisation is part of the ‘maternityecosystem.’ Key issues concern healthcaredelivery, availability, acceptability, affordability, andappropriateness. The issues involved are thehospital or health facility, the community or thehome, and the financial and physical barriers. Weneed to prioritise the services we want tostrengthen; for example, contraceptive servicesor abortion services or emergency obstetric care.We need to have a dialogue to see how thesebarriers can be overcome by strengthening thenational societies. In Sri Lanka, where I comefrom, having community midwives provideprenatal and postnatal care and contraceptionhas worked effectively. These successful modelsneed to be exploited and FIGO will explore theseissues with ICM.

Continuous innovation andmaximising resourcesThe fourth principle of success is to continuallyinnovate to maximise available resources. InMozambique, training of surgical assistants toperform caesarean deliveries has beensuccessful. There are other good examples. Wehave to maximise available resources and devisedifferent ways of working. For example, offeringpostpartum and postabortion contraception is agreat opportunity or situation that has to be usedmaximally and effectively.

AccountabilityThe final principle is accountability. We have tomeasure what we are doing and the outcomes. Ifwe cannot measure, we cannot improve on whatwe do. FIGO will measure the outcomes of theprojects it undertakes and disseminate theinformation in a useful way.

Working in partnershipAs mentioned, there are a number of tasks andFIGO cannot do it alone. We need the help ofadvocacy groups such as the White RibbonAlliance, policy makers like WHO, facilitators suchas the Partnership for Maternal, Newborn andChild Health; we need advisors and technicalsupport, such as JPHEIGO; we need the help ofdonors – the Bill and Melinda Gates Foundation,USAID, UKAID – and we need nongovernmental

organisations for help with training. We must alsobuild public/private partnership within countries.Most of all we have to work with our fellowprofessional organisations – midwifery, nursing,paediatric, and anaesthetic organisations.

ConclusionBy doing what we plan to do, not only will wetackle MDG 5 but we will also tackle MDG 1,which is poverty. If a woman effectively usescontraception and is not going to have a baby fortwo or three years, she will have time to work andearn money. She will have time to look after thebaby and the child for primary education (MDG2); she will take the children to school and oncethey are educated, they can become equalpartners with men (MDG 3). She will also take thechildren for vaccinations and resolve any childhealth problems (MDG 4). If she has five childrenin five years, she will not be able to accomplishthis. Hence, it is crucial that we advise aboutfamily spacing to achieve MDGs 1 to 5. TacklingMDG 5 will resolve many underlying issues. MDG5 can be tackled to a great extent byconcentrating on contraception and safe abortioncare.

I would like to finish with two quotes. The first isfrom Professor Thoraya Obaid, former ExecutiveDirector of UNFPA, who said: ‘It keeps startlingme that at the beginning of the 21st century, at atime when we can explore the depths of the seaand build an international space station, we havenot been able to make childbirth safe for allwomen around the world. This is one of thegreatest social deficiencies of our time.’ This is afact and this tragedy is happening every year. Thereason for this tragedy was spelt out many yearsago by Professor Mahmoud Fathalla, a PastPresident of FIGO, who said: ‘Women are notdying because of diseases we cannot treat. Theyare dying because societies have yet to make thedecision that their lives are worth saving.’

We have to spend time and money to derive themaximal impact. I want everyone here to committo make this a personal priority. Ensure you canmake a compelling case for change and getinspired by others’ success. With inspiration,commitment and collaboration we can save morelives.

My very best wishes.

Professor Sir Sabaratnam ArulkumaranFIGO President (2012–2015)This is an edited extract from the inaugural address given byProfessor Sir Sabaratnam Arulkumaran at the XX FIGO WorldCongress, Rome, Italy, 12 October, 2012.

The full text will be available in the March issue of IJGO: Int JGynecol Obstet 2013;120(3):XX–XX.

The new FIGO President and Immediate Past-President, with Past Presidents: S Arulkumaran, G Serour, M Fathalla, D Shaw, S Sheth, A Acosta, J Sciarra

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CHIEF EXECUTIVE’S OVERVIEW

In ternat iona l Federat ion of Gynecology and Obstet r ics | December 2012 3

Dear ColleaguesOur Congress in Rome is over, and I would like toextend my sincere thanks to everyone who madeit such a success. The feedback we havereceived from delegates has been superb. FIGOattracted 8,000 visitors from over 170 countries –a tremendous attendance. Our ScientificProgramme was commended for its exceptionalbreadth and the calibre of its speakers. The eventwas a wonderful opportunity to touch base withour existing global colleagues, and also to meetmany new ones for the first time – I am pleasedto report that many fresh developments havearisen for FIGO in the weeks following theCongress, and we greatly look forward toconsolidating new ideas and strategies withglobal collaborators.

The Congress gave aplatform to many voices,but I am especially pleasedand proud that the remakeof the World HealthOrganization’s iconic 1980sfilm ‘Why Did Mrs X Die?’took place at our OpeningCeremony. It was indeed anhonour to welcomeProfessor Mahmoud

Fathalla, a pioneer in the Safe Motherhoodmovement, and a former FIGO President, to theproceedings – without his involvement andvaluable input this project could not have beenachieved. Special thanks must of course go toProfessor Gwyneth Lewis and Amy Gadney, ofHands On for Mothers and Babies(www.handsonformothersandbabies.org) fortheir dedication and commitment to thisenterprise, from conception to final delivery!

Another ‘first’ for the Congress was the launch ofthe new African Federation of Obstetrics andGynecology (AFOG), a Federation that has takenmany years to materialise for our Africancolleagues. Under the able leadership of its newlyelected President, Dr Yirgu Gebrehiwot (Presidentof the Ethiopian Society of Obstetricians &Gynecologists – ESOG), the Federation will holdits first Officers’ meeting in Brazzaville, February2013, hosted by WHO. I look forward toreporting on its progress.

I am particularly pleased that FIGO was able toprovide a significant number of Fellowships toprofessionals from low- and middle-resourcecountries, thanks to the generosity ofcollaborators the United States Agency forInternational Development (USAID) and MarieStopes International (MSI). I know that many who

Health Systems Research, Beijing, China (31October–3 November), where I was asked by DrMubashar Sheikh, Executive Director of theGlobal Health Workforce, to represent FIGO in apanel session entitled: ‘Skills mix to achieveuniversal health coverage: a global systematicreview and country case studies on roles andimpact of mid-level health workers’. Thisdiscussed issues relating to task-shifting/sharingto tackle the massive shortage of health careworkers.

In early November, I was invited to Paris by theInternational Menopause Society to participate inan ‘International Workshop for the developmentof a Global Consensus on HRT’. Later in themonth I represented FIGO at the 60thAnniversary of the IPPF which was celebrated inJohannesburg, South Africa. I wish tocongratulate the IPPF on its years of commitmentto sexual and reproductive healthcare and rights.Its work in these all-important fields is unrivalled,and it commands enormous respect fromcollaborating organisations across the world.

Activities in early 2013 will include attending theLOGIC Initiative’s Technical Advisory Group (TAG)January meeting in Arusha, Tanzania, followed bypresenting at the Second International Congresson Women’s Health and Unsafe AbortionIWAC2013) in Bangkok, Thailand.

The 2013 FIGO diary is already filling up withmany collaborative activities, and I look forwardto reporting on them in due course. In themeantime, I wish to thank you all for your greatsupport of FIGO at the end of what has been anexceptionally busy and challenging year. I amlooking forward to working closely with our newPresident, Professor Sir SabaratnamArulkumaran, Officers and Executive Board. Inaturally extend my sincere thanks to Past-President Professor Gamal Serour for his superboverseeing of FIGO over the past three years,and to the outgoing Officers and Executive Boardmembers who have made immense contributionsto the promotion of FIGO’s work.

I wish you and your families a peaceful Christmasand New Year break.

My very best wishes.

Professor Hamid RushwanFIGO Chief Executive

participated were immensely grateful for theopportunity to sharpen their professionaleducation, and take back home with them muchneeded new knowledge on the latestdevelopments in the field of obstetrics andgynecology.

As experience has proved, three years is not along time in the field of event planning, and it willcertainly not be long before the next Congress isupon us – Vancouver 2015 promises to beequally exciting, and work has already begun inearnest. We are greatly looking forward toprogressing the planning of Congress activitieswith Dr Jennifer Blake, the new Chief ExecutiveOfficer of the Society of Obstetricians andGynaecologists of Canada (SOGC), one ofFIGO’s highly valued collaborators.

Travels have been brisk of late. Just beforeRome, I was invited by the International PlannedParenthood Federation (IPPF) to participate in a‘High Level Expert Consultation on Islam andWomen’s Health’ in Kuala Lumpur, Malaysia(22–24 September). The range of challengesimpacting young women and girls in particularacross our Muslim-populated countries issignificant, and the conference focused on theprogress made in countries and regions basedon international, regional and country initiatives –including the UN Secretary General’s ‘GlobalStrategy for Women and Children’s Health’ – andalso on identifying challenges, gaps and barriersand possible solutions to help acceleratewomen’s health in Muslim-populated countries.The meeting came out with the Kuala LumpurDeclaration, which made excellentrecommendations for the promotion of women’shealth and rights in Muslim communities.

Directly after the Congress, I attended the 13thExecutive Board Meeting of the Partnership forMaternal, Newborn and Child Health (PMNCH) inAbuja, Nigeria (15–20 October). The meetingdiscussed reports and workplans for 2013. I alsoattended the Second Global Symposium on

FIGO HouseWaterloo Court, 10 Theed StreetLondon SE1 8ST, UKTel: +44 20 7928 1166Fax: +44 20 7928 7099Email: figo@figo.org

The International Federation of Gynecology andObstetrics is a UK Registered Charity (No 1113263;Company No 5498067) registered in England andWales. The Registered Office is shown above.

President:Professor Sir Sabaratnam Arulkumaran(United Kingdom)

President-Elect:Professor Chittaranjan Narahari Purandare (India)

Past-President:Professor Gamal Serour (Egypt)

Vice President:Professor Ernesto Castelazo Morales (Mexico)

Honorary Secretary:Professor Gian Carlo Di Renzo (Italy)

Honorary Treasurer:Professor Wolfgang Holzgreve (Switzerland)

Chief Executive:Professor Hamid Rushwan (Sudan/UK) (Ex-offico)

Administrative Director:Bryan Thomas

Readers are invited to send all comments, articles andreports (by email to communications@figo.org or ondisk) to the FIGO Secretariat no later than 1 March2013 for the next issue.

The views expressed in articles in the FIGO Newsletterare those of the authors and do not necessarily reflectthe official viewpoint of FIGO.

Produced and edited by the FIGO Secretariat © FIGO2012.

International Federation of Gynecology and Obstetrics

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‘FIGO OBJECTIVES ON TRACK FOR 2015’

4 In ternat iona l Federat ion of Gynecology and Obstet r ics | December 2012

Colleagues, during thepast three years, I havehad the honour andpleasure to humblyserve as President ofFIGO. It has been anenriching andrewarding experiencefor me, and thank youfor your trust.

In my inaugural address in Cape Town, October2009, I said: ‘FIGO, building upon its pastachievements, is undertaking a change – achange that will make FIGO more visible andpalpable to obstetricians and gynecologistsaround the globe, particularly those in low-resource countries.’ I have worked tirelessly overthe past three years to fulfil my promises. Thecore of my change was education and training ofobstetricians and gynecologists, and capacitybuilding of member societies in developingcountries.

In Cape Town I proposed an 8-point *workplan toenable FIGO to play its role as a leading globalprofessional organisation in women’s health.Today I can confidently say that I am delighted tosee this ambitious workplan implemented, and ina sustainable way.

Professor Gamal Serour speaksat Rome 2012

members; Chairs and Members of FIGOCommittees and Working Groups; and mysecretarial staff, particularly Mr Bryan Thomasand Mrs Marie-Christine Szatybelko at FIGO HQ,and Mrs Azza El Tobgi and Mrs Gihan El Feki inthe Cairo office: you have all shown outstandingand exceptional commitment, enthusiasm,volunteerism and dedication which I greatlytreasure.

There is a huge unmet need of RSH informationand services for young people, particularlyadolescent girls. Dr Babatunde Osotimehin,UNFPA Executive Director, said: ‘Todaypregnancy and childbirth related complicationsare the major causes of death among girls 10–19years old in most developing countries.’

2010–2012 have been highly successful years forcampaigning and commitments for theimprovement of maternal and newborn health,with the launch of several initiatives including theGlobal Strategy for Women’s and Children’sHealth; the ‘Every Woman, Every Child’ Initiative;the Muskoka Initiative; and the ground-breakingLondon summit on Family Planning in July, callingfor unprecedented international politicalcommitment and resources to pledge US$4.6billion to provide an additional 120 million womenin the world’s poorest countries withcontraception by the year 2020.

Martin Luther King Jr said: ‘Of all the forms ofinequality, injustice in health care is the mostshocking and inhumane.’

Ban Ki-moon, UN Secretary-General, said: ‘Bygiving mothers to be the services they needbefore, during and after pregnancy and byproviding quality health care to all women, wecan save lives, prevent suffering and accelerateprogress towards all the MDGs.’

I say to mothers, sisters and daughters who haveneedlessly lost their lives and the many morewomen who have suffered injuries duringpregnancy and childbirth: please forgive us,because some of our societies failed to valueyour life. FIGO has joined forces to minimise thishappening again to current and futuregenerations, and to share in saving the lives of 16million women and children by 2015. Restassured that women will no longer be the silentvictims and unheard voices of substandardhealth care.

Today, more than ever before, we have thepolitical commitment, knowledge, knowhow,capacity and committed resources to make asignificant stride in saving the lives of women andnewborns.

To all those involved in the preparation of thisCongress: thank you for your unyielding efforts,dedication and determination to make it a realsuccess, and for your continuing efforts duringthe coming five days to make it one of the mostenjoyable and memorable Congresses in FIGO’shistory.

To my family, patients and Al Azhar University:thank you so much for your continuous supportand sacrifice, which has enabled me to fulfil myduties as FIGO President to the best of my abilityover the past three years.

The good news is that, at 1pm on Friday 12October, the baton will be picked up by ProfessorSir Sabaratnam Arulkumaran, the incoming FIGOPresident, and then I will have much more timefor you …hopefully!

My very best wishes to all.

Professor Gamal SerourFIGO Immediate Past PresidentThis is an edited version of the speech delivered byProfessor Gamal Serour at the Congress OpeningCeremony

*The 8-Point Plan1: Advocacy, partnerships, andcommitments

2: Continuing with ongoing projects3: Establishing a Committee for CapacityBuilding in Education and Training

4: Establishing a Committee forReproductive Medicine

5: Optimising utilisation of FIGOCommittees and Working Groups andtheir outcomes to increase theirvisibility

6: Ethics curriculum development inreproductive and sexual health forlow-resource countries

7: Improving the management,communication, and involvement ofmember societies and regionalfederations

8: Strengthening collaboration with UNorganisations, world federations,NGOs, FBOs and the private sector

[*Please also refer to Professor Serour’s Introduction inthe FIGO Three-Year Report 2009–2012, available onhttp://www.figo.org/publications]

Colleagues, I have been privileged to workalongside an excellent hardworking team towardsa common goal, directing individualaccomplishments towards organisationalobjectives. We had the necessary ‘fuel’ thatallowed common people to attain uncommonresults.

It is most appropriate for me to say now to allFIGO Past Presidents who inspired me; to myFellow FIGO Officers; the FIGO Chief ExecutiveProfessor Hamid Rushwan; Executive Board

I also say to various UN organisations, globalNGOs, sister professional organisations andmedical industries: you all, through your supportand our collaborative efforts, helped FIGO to playthe role it is supposed to fulfil to the best of itsability. Thank you so much for your support.

The number of women dying in pregnancy andchildbirth annually at long last declined in 2010 tothe figure of 287,000 maternal deaths, a globaldecline of 47 per cent since 1990. However, thisis not enough to achieve MDG 5a by 2015. Forevery woman who dies, around 20 more suffernear-miss and complications which jeopardisethe quality of their lives. Ninety-eight per cent ofall these deaths and morbidities occur indeveloping countries and are mostly preventable.Contraception alone can prevent 30 per cent ofmaternal deaths.

Today there are 222 million couples with unmetneed of modern contraceptives in the developingworld. Providing these unmet needs ofcontraceptives would prevent 21 millionunplanned births, 26 million abortions, 79,000maternal deaths, and 1.1 million infant deaths.Indeed, Margaret Chan, the Director-General ofthe World Health Organization, said: ‘Familyplanning deserves a much higher place in theinternational health agenda, especially incountries where fertility and unmet need arehigh.’

We should not forget that annually there are 340million new curable STIs, mostly in the 20–24 agegroup, resulting in 1.8 million AIDS-relateddeaths, and 275,000 cancer of the cervix relateddeaths. Three million girls and women aresubjected to Female Genital Mutilation (FGM) and50,000–100,000 develop obstetric fistulaannually.

Some FIGO representatives with Congress staff

President’s Session press conference: L–R: ProfessorSerour; Dr Paul De Lay (UNAIDS); Dr Flavia Bustreo (WHO);Dr Babatunde Osotimehin (UNFPA)

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CONGRESS NEWS

In ternat iona l Federat ion of Gynecology and Obstet r ics | December 2012 5

UNFPA Chief opens FIGO Congress,highlighting challenge of MDGsAn extract from UNFPA Executive Director Dr Babatunde Osotimehin’s speechWe are inaugurating this XX FIGO Congress ofGynecology and Obstetrics two and a halfyears before the world will hit the deadlineagreed by world leaders to reach theMillennium Development Goals. Although greatprogress has been achieved in several of thegoals, the one that concerns obstetricians andgynecologists the most, Goal 5 on improvingmaternal health, is lagging behind in manycountries of the developing world. Women,especially poor women, still die while pregnantor in childbirth, often of preventable causes.

One woman dies everytwo minutes givingbirth or in pregnancy.These are preventabledeaths. Let us behonest: these arewomen that could havebeen saved if one of uscould have assistedthem in their pregnancyand delivery, or could

have provided them with contraceptives, orattended to complications arising from pregnancyor childbirth.

Much more work needs to be done to meet theMDG targets. Gynecologists, obstetricians andmidwives are the most natural professionalpartners, together with governments, multilateralorganisations, civil society and womenthemselves, to push hard on actions towardsachieving the health-related MDGs, particularlyMDG5.

We must work together to meet this achievablegoal. But in order to do so, we should ensurethat women and adolescent girls have access tosexual and reproductive health services in anintegrated way, that they receive these services– voluntary high-quality family planning, maternal

health, especially access to emergency obstetriccare and skilled birth attendants, and STIprevention, including prevention of HIV – in thesame place, at the same time, by the sameprovider. By doing this, we will supportstrengthening health systems at all levels, butespecially at the grass-roots level, close to wherewomen live. It is there we have our major gap inhuman resources for health. There are notenough providers in places near to andimmediately accessible to women.

To realise the MDGs, governments need to takeresponsibility for the public health needs of theircitizens, for maternal health, family planning,sexual health, in the only equitable mannerthat works – by providing publicly funded,well-resourced services and by adding healthworkers in those places that lack them. Weshould make sure that we give a definite solutionto the most challenging gap of a functioninghealth system, that is, its workforce shortage,quality and equitable distribution. We all knowthat a health system that can prevent maternaldeath is a functioning system.

Addressing the human resources for the healthshortage gap will require innovative ideas,comprehensive solutions. It is not enough to trainmore health workers if policies do not addressthis issue in a comprehensive way, if the numberof health workers that drop out of the systemonce they are trained is around 50 percent as isthe case in some countries in Africa; the reasonis because there are not enough work incentivesfor them to remain employed. UNFPA looksforward to working closely with professionalassociations like FIGO and the InternationalConfederation of Midwives, along with other UNagencies like UNICEF, WHO, UNAIDS, UNWomen and the World Bank to address theseissues together.(printed with kind permission from UNFPA)

Dr Babatunde Osotimehin

Women obstetrician/gynecologistsrecognised at FIGOGeneral AssemblyIn 1997, for the first time, FIGO presented anumber of Awards in Recognition of WomenObstetricians/Gynecologists to doctors,nominated by their peers, who had made aspecial contribution internationally ornationally to promote the development ofscience and scientific research in the fields ofgynecology and obstetrics; and who,throughout their career, had promoted betterhealthcare for women, mothers and theirchildren.

The awards wereofficially presentedas an inclusive partof the Rome 2012General Assembly,to highlight theirimportance.

The recipientswere described byProfessor GamalSerour during theawards ceremonyas ‘primerepresentatives offemale practitionersin their homenations’.

FIGO’s congratulations extend to: ProfessorKohinoor Begum (Bangladesh); Dr SylviaAyeley Deganus (Ghana); Professor KristinaGemzell Danielsson (Sweden); Dr Vesna IKesic (Serbia, Montenegro and Republic ofSrpska); Dr Lucy Lopez Reyes (Peru); DraBlanca Rosa Manzano Ovies (Cuba); DraTécia Maria de Oliveira Maranhão (Brazil); DrKamini Rao (India); Dr Duria AbdellewahabMohammed Rayis (Sudan); and Dr SudhaSharma (Nepal).

Professor Gamal Serour presenting the award to DrKamini Rao (India), a former Chair of the FIGOCommittee for Women’s Sexual and ReproductiveRights

Some of the award recipients

A recipient

FIGO honours figureheads in globalmaternal and newborn healthThe FIGO Congress Opening Ceremony is traditionally the occasion onwhich to feature the series of awards traditionally made to obstetrician/gynecologists who have excelled in their service to FIGO or to women’shealth. Awards are also given to highly distinguished people outside thisprofession who have performed a service to women’s health.

In Rome, Professor Hamid Rushwan presented FIGO Distinguished MeritAwards to Dr Ralph Hale, former Executive Vice-President of theAmerican College of Obstetricians and Gynecologists (ACOG) and amember of the FIGO Executive Board for many years; Dr Sergio Pecorelli,former Chair of FIGO’s Committee on Gynecologic Oncology, and formerEditor of the highly influential FIGO Annual Report on the Results of Treatment in GynecologicCancer; and Dr Duru Shah, who represents FOGSI at FIGO and is also a member of FIGO’s EthicsCommittee.

FIGO’s second awards category, the FIGO Recognition Awards, honoured Michelle Bachelet,former President of Chile, and the first Under-Secretary-General and Executive Director of UNWomen; Sarah Brown, CEO of the Office of Gordon and Sarah Brown, and Global Patron of theWhite Ribbon Alliance for Safe Motherhood; and Jill Sheffield, founder and president of WomenDeliver, and former president of Family Care International.

Professor Chiara Benedetto(EBCOG President), Masterof Ceremonies

L–R: Professor Gamal Serour, Dr Duru Shah, Dr SergioPecorelli, Dr Ralph Hale and Sarah Brown Professor Serour with Jill Sheffield

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In ternat iona l Federat ion of Gynecology and Obstet r ics | December 20126

New African Federation of Obstetrics andGynaecology (AFOG) launched at Congress

CONGRESS NEWS

A new African Federation of Obstetrics andGynaecology (AFOG) was launched at ahistoric meeting during the Rome Congress on8 October 2012. Over 20 national societies anda host of interested observers attended themeeting, which was chaired by Chief ExecutiveProfessor Hamid Rushwan.Remarks were given by Professor JosephKaranja, ECSAOGS President; Professor EusèbeAlihonou, SAGO’s First and Past-President;Professor E Maaouni, Maghreb FederationPresident; and Professor Bomi Ogedengbe, WestAfrican College of Surgeons President. Theyoutlined the work of their organisations and theirready support for the establishment of an AfricanRegional Federation.Special inaugural addresses were given by DrLuis Sambo, Regional Director, WHO AFRO andProfessor Gamal Serour, FIGO Past-President.The Constitution of the new Federation wasendorsed, and elections took place to select theFederation’s Officers and decide on the locationof its Secretariat.

Elected Officers:• President: Dr YirguGebrehiwot, (Ethiopia)

• Vice President: ProfessorEusèbe Alihonou (Benin)

• President Elect: ProfessorOladapo Ladipo (Nigeria)

• Honorary Secretary: DrAmir Elnahas (Sudan) TheSecretariat will be housedby the Obstetrical &Gynaecological Societyof the Sudan

• Honorary Treasurer: Professor Bhaskar Goolab(South Africa)

Professor Hamid Rushwan commented: ‘This isan enormous achievement for all of theobstetricians and gynecologists in Africa, whohave been working hard towards theestablishment of a pan-African body to bringthem together and target the improvement ofwomen’s health in the region, and the scienceand practice of obstetrics and gynecology.

‘I encourage all societies in the African region togive AFOG full support and to work hard towardsbuilding a strong regional body that will helppromote the importance of women’s health inAfrica.’

Babatunde Osotimehin (Executive Director,UNFPA); Dr Luis Sambo (Regional Director forAfrica, WHO); Professor Gamal Serour (PastPresident, FIGO); Professor Jill Sheffield(President, Women Deliver); and Dr Paul De Lay(Deputy Executive Director, Programme,UNAIDS).

Questions posed – moderated by Dr JoannaCain – covered the role and importance ofprofessional organisations in achieving thehealth-related Millennium Development Goals,the challenges faced, and how professionalorganisations can be promoted in this respect.

The Leadership in Obstetrics & Gynaecology for Impact and Change(LOGIC) Initiative in Maternal and Newborn Health (MNH) is supportingeight FIGO Member Associations in their endeavours to improve MNHpolicy/clinical practice and their organisational capacities.

FIGO LOGIC organised two successful sessions at the XX FIGO WorldCongress: one session on the implementation of facility-based MaternalDeath Reviews (MDRs) and Near Miss Reviews (NMRs)1 in low-resourcecountries, and one session on organisational capacity strengthening ofprofessional associations in obstetrics and gynecology.

MDRs/NMRs• ESOG (Ethiopia) shared their analysis of MDR/NMR data from ninepublic hospitals and reported on improved maternal health services,including improved availability of health workers, blood and ambulances.

• SOGON (Nigeria) is working with Government authorities and otherpartners to agree on the way forward for implementing MDRs in Nigeria,including guidelines, protocols and tools.

• SOGOC (Cameroon) has provided MDRtraining and set up Committees in fivehospitals as well as developed guidelines andsummary tools.

• SOGOB (Burkina Faso) is working with theMinistry of Health (MoH) and other partners toroll-out MDRs nationally in Burkina Faso.

Organisational capacitystrengthening• FOGSI (India) has developed into a successfulprofessional association over the last 60years. It is represented on numerousGovernment of India bodies, and has 216member societies and 27,000 members.

• AMOG (Mozambique) has gone through an extensive strategic planningprocess, which has enabled the association to engage constructivelywith partners. Achievements include the provision of technical expertise

to the MoH, including on MDRs, emergency obstetric care, and long-lasting contraceptives.

• NESOG (Nepal) has successfully improved communication with itsmembers, including via their website, text messages, Facebook anddistribution of a newsletter and an academic journal.

• AOGU (Uganda) has used Maternal and Perinatal Death Review data toadvocate for increased resources for MNH and improvements inservices. For example, in collaboration with partners, AOGU helpedinfluence the Ugandan government to increase funding for reproductivehealth by 30 per cent.

Launch of FIGO LOGIC ToolkitFIGO LOGIC has developed, in collaboration with the Society ofObstetricians and Gynaecologists of Canada (SOGC), an electronic Toolkitwith organisational capacity strengthening resources and tools for healthprofessional associations.

The Toolkit brings together a collection of information,resources and tools for anyone interested in fosteringorganisational change within a health professional association,either through the conduct of occasional activities or byinitiating a more thorough capacity building process.

Using the Toolkit will lead to better understanding of whatmakes an organisation strong; what the different elements oforganisational capacity building are; how a change processcan be initiated; and how practical activities can beconducted to support such change processes.

The Toolkit is available in English, French and Spanish atwww.figo-toolkit.org

1 A facility-based MDR is a “qualitative, in-depth investigation of thecauses of and circumstances surrounding maternal deaths” in healthfacilities, while a NMR is the “identification and assessment of cases inwhich pregnant women survive obstetric complications” (Lewis,Gwyneth, 2003. ”Beyond the Numbers: reviewing maternal deaths andcomplications to make pregnancy safer”, British Medical Bulletin 2003;67: 27–37, The British Council, 2003.)

LOGIC at the Congress

Dr Yirgu Gebrehiwot,new AFOG President

International Federationof Gynecology and ObstetricsElectronic toolkit onStrengthening OrganisationalCapacity of HealthProfessional Associations

Fédération internationalede gynécologie et d’obstétriqueTrousse d’outils électroniquesur le renforcement descapacités organisationnellesdes associations deprofessionnels de la santé

Federación Internacionalde Ginecología y ObstetriciaSerie de Herramientas sobreel Fortalecimiento de laCapacidad Organizacionalde las Asociaciones deProfesionales de la Salud

Dr Segun Adeoye, LOGICProject Manager with theSociety of Gynaecology andObstetrics of Nigeria(SOGON), carries the FIGOLOGIC banner

Toolkit bookmark

FIGO adopts newGeneral AssemblyResolution at Rome2012During Rome 2012, a Resolution on‘Unmet Need for Voluntary Contraception’was approved, which can be accessed athttp://www.figo.org/projects/general,along with previous Resolutions.

‘Professional associationsmust play major part intackling MDGs’, concludesPresident’s Session 2012A traditional Congress highlight, the ‘President’sSession’ – which this year focused on ‘The Roleof Professional Organisations in AcceleratingProgress on Health-Related MillenniumDevelopment Goals’ – took place in front of apacked audience on the first day of theCongress.

The panel – introduced by Sarah Brown, CEO ofthe Office of Gordon and Sarah Brown, andGlobal Patron of the White Ribbon Alliance forSafe Motherhood – was comprised of majorfigures in global maternal and newborn health: DrFlavia Bustreo (Assistant Director General, Familyand Community Health, WHO); Professor SergioAugusto Cabral (President, IPA); Frances Day-Stirk (President, ICM); Professor Paul Howell(President, Obstetric Anaesthetists Associationand Chair of Obstetric Committee, WFSA); Dr

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7In ternat iona l Federat ion of Gynecology and Obstet r ics | December 2012

CONGRESS NEWS‘Why did Mrs X Die, Retold’– remake of WHO filmpremiered at Rome 2012‘Why Did Mrs X Die, Retold’ – a short animatedfilm telling the story of one unfortunate woman’sjourney through pregnancy and childbirth – waslaunched at the FIGO World Congress in Romeon 7 October 2012.

It is a remake of the World Health Organizationseminal 1980’s film ‘Why Did Mrs Die?’, which isbased on a lecture by a pioneer in the SafeMotherhood Movement, Professor MahmoudFathalla (a former FIGO President). The film paintsan accurate picture of the dangers women arefacing across the world, and the need to helpthem.

The remakewas overseen byDr Gwyneth Lewisand Ms AmyGadney of HandsOn for Mothersand Babies,an organisationmaking educational

tools for women in poor areas of the world:www.handsonformothersandbabies.orgThe film can be viewed at the following link:http://www.handsonformothersandbabies.org/ or access it via the FIGOwebsite: http://www.figo.org/news/why-did-mrs-x-die-retold-launched-figo-world-congress-2012-0010519

Professor Hamid Rushwan,FIGO Chief Executive,commented: ‘FIGO wasindeed privileged to begiven this remarkable film tolaunch at the Congress. Wewish to extend our sincerethanks to Dr GwynethLewis, Amy Gadney andEmily Goldner for theirunstinting dedication andprofessionalism. Above all,we thank Professor

Mahmoud Fathalla, without whom this excellentproject could not have been achieved. The film isas moving and relevant today as it was 30 yearsago – it continues to be a necessary call to armsfor the global health community.’

You can also read: ‘On Safe Motherhood At 25Years… Looking Back, Moving Forward’, byProfessor Mahmoud Fathalla, at the above FIGOlink.

Unveiling ‘The FIGOFertility Tool Box™’:Facilitating theachievement of universalaccess to reproductivehealthThe FIGO Fertility Tool Box™, consisting of sixcomponents dealing with overcoming personaland societal barriers to infertility care, prevention,diagnosis, treatment, referral and resolution, plusthe FIGO Fertility Daisy™, which deals with whyone should care about infertility, was launched inRome by Professor David Adamson, Chair of theFIGO Committee for Reproductive Medicine.

He said: ‘The Tool Box is simple, usable, andevidence-linked; a very flexible tool for adaptationin different environments and countries. It ishoped that it will be used by many providers ofwomen’s healthcare to increase access to quality,cost-effective infertility prevention andmanagement. We have taken into account theinternational sensitivities with respect to culture,religion, politics and economics.’

He added: ‘Infertility, specifically in low-resourcesettings, is important and its management isjustified by the positive impact on quality of life,burden of disease, political commitments, non-discrimination, family planning, prevention ofsexually-transmitted infections, affordability andprotection of resources – each item symbolisedby a petal of the daisy.

‘Though the tool is intended primarily forwomen’s healthcare providers, we hope it willalso be used by policy makers.’

The FIGO Fertility Tool Box™ can be accessed athttp://www.figo.org/news/resources/FIGO_Fertility_Tool_Box

Professor MahmoudFathalla, former FIGOPresident

Rebranded FIGO CancerReport 2012 availableThe former ‘Annual Report on the results oftreatment in Gynecologic Cancer’ has beenretitled the ‘FIGO Cancer Report’ and thelatest edition was launched to tie in with theFIGO Congress.

It brings together updates on the staging andmanagement guidelines on each site-specificgynecological cancer, and GestationalTrophoblastic Disease; and separatechapters from a developed and developingworld perspective on pathology,chemotherapy and radiation.

The system that has been used for collectinginternational data on gynecologicalmalignancies is being reconstructed andmodernised and will be available at the nextWorld Congress in 2015.

The Report is available from the FIGOSecretariat at €30 (email figo@figo.org).

Global attention for2012 World Report onWomen’s Health

‘Although Millennium Development Goal(MDG) 5 encompasses the reduction ofmaternal mortality and the improvement ofsexual and reproductive health, every MDGhas an impact on women’s health as theyaffect women most: eradication of poverty,gender equality, education, reduction of childmortality, HIV/AIDS, tuberculosis, andmalaria,’ commented Professor SirSabaratnam Arulkumaran, presenting theWorld Report on Women’s Health at theCongress on 8 October.

The Report – published by FIGO every threeyears to coincide with the Congress – is anoverview of the major areas within women’sglobal maternal and reproductive health. Thegoal of the 2012 Report – the theme ofwhich is ‘Improving Women’s Health’ – is tofocus on these wider issues, expanding thefocus for professionals beyond the traditionalbasic obstetric functions.

‘The medical activities that need to beimplemented to prevent maternal mortalityand morbidity are known, but global progresscannot be achieved unless effective policiesare introduced by governments that enablewomen to access such care,’ ProfessorArulkumaran explained.

He added: ‘The FIGO 2012 World Reporton the topic of improving women's healthprovides ample information to alloweveryone to take action at an individual,institutional, and professional level. It is acall for action based on evidence. Itaddresses how we can act, in addition towhat has happened or what is currentlygoing on. One single organisation orgovernment cannot achieve these tasks.In addition to the global cooperation ofpartner organisations, every one of ushas to take some responsibility toimprove women’s health.’

The 2012 Report is published as aSupplement (Volume 119, Supplement 1)to the International Journal ofGynecology & Obstetrics (IJGO), and isavailable at http://www.ijgo.org/issues?issue_key=S0020-7292(12)X0011-0

L–R: Professor Sir Sabaratnam Arulkumaran (FIGO),Report Editor, with contributors Dr Mike Mbizvo(WHO), Dr Wolfgang Holzgreve (FIGO) and Dr AndréLalonde (FIGO) at the press launch

World Report contributorFrances Day-Stirk (ICM)

An online snapshot

Professor Adamson (right, alongside former FIGO HonorarySecretary Professor Ian Fraser) at the ReproductiveMedicine press conference

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