The Guttmacher Institute and UNFPA estimate that ensuring access to modern contraception could prevent up to a third of maternal deaths.. Ensuring access to skilled care before, during and after pregnancy and childbirth, including emergency obstetric care, is another critically needed solution. Access to safe abortion, when and where legal, will also help to reduce maternal mortality; currently nearly 70,000 women die each year from unsafe abortion.
The contraceptive pill:
On May 9, 1960, the FDA in the United States approved a new technology that would revolutionize the lives of women and their partners: the birth control pill. "50 years after the pill - the revolution continues." The pill — together with other methods of contraception — is an important reproductive health technology that has had dramatic social, economic, and health benefits for women worldwide. Yet while 200 million women over the years have used the pill, over 215 million women are estimated to want, but not have, access to contraception.
According to Dr Amita Pandey, a young and dynamic gynaecologist of India, "A majority of Indian women do not have any right over their sexuality. In fact, a large number of women from all strata of the society, irrespective of their level of education and financial independence, have absolutely no say in their choice for sex, use of contraception or freedom to conceive. This results in a large number of unwanted pregnancies which finally end up in an unhappy motherhood or an MTP endangering the life of the women. Use of any contraceptive is pathetically low in India- variably reported to be around 40%, leaving behind a large hiatus of unmet need for contraception. The pill is freely available but is barely used by 15-20% women using contraception and the major reason behind this poor use is illiteracy, lack of information, as well as the difficulty to remember to take the pills daily. Amongst the other contraceptive choices available, DMPA & IUCD are popularly accepted by women probably because they require a onetime motivation and administration leading to a better compliance."
Cutting edge technology of mobile phones:
Leapfrogging landlines, mobile phone use in many developing countries of Africa, and also in India, have risen exponentially in recent years. Who could have thought till a few years ago, that this ubiquitous technology would bring new breakthroughs in health care information and access for women worldwide. Mobile phones are now being used by health providers at all levels to record health statistics, call for information or transport in case of emergencies, and provide ongoing advice to patients long-distance. They also provide opportunities for individuals to stay connected to help lines, district hospitals, and their providers - a critical ability in cases of obstetric emergencies and especially for women living in low-resource and remote places.
High-tech, low-resource cervical cancer screening and prevention tools:
There are more than 250,000 deaths from cervical cancer worldwide annually, the vast majority of which occur in the developing world. If detected early, cervical cancer is almost always curable. New efforts are making vaccines for Human Papillomavirus (HPV), the virus associated with cervical cancer, accessible in the developing world. In addition, a new DNA test has been developed which can identify HPV earlier and more accurately in women, before signs or symptoms are present. Plans are also underway for a high-tech HPV DNA test for low-resources settings, which can be administered effectively and easily without the use of running water or electricity, and which would dramatically reduce the burden of cervical cancer on women in the developing world.
Vaginal Rings: a novel tool for HIV prevention
Every day more than 3,000 women worldwide become infected with HIV. And HIV/AIDS is the leading cause of death for women of reproductive age worldwide. In Sub-Saharan Africa, women account for nearly two-thirds of estimated HIV infections; women and girls are disproportionately vulnerable to HIV/AIDS for a number of reasons, both cultural and biological.
Despite this challenge, women do not have the tools they need to protect themselves from infection. Current prevention options may be impractical for women who lack the power to ensure that their male partners use condoms or remain faithful, and for those who are married, want to have children or are at risk of violence.
New antiretroviral-based microbicides hold the promise of long-lasting and discreet HIV prevention for women that would not require the consent of a partner or husband. Trials of microbicides in various forms are currently underway.
On the second day of the ‘Women Deliver’ –the largest conference focused on maternal health in more than a decade-- in Washington DC, the International Partnership for Microbicides (IPM) announced the launch of a clinical trial, in Southern and East Africa, of a new vaginal ring containing an anti retroviral drug. The clinical trial, known as IPM 015, tests the safety and acceptability of an innovative approach that adapts a successful technology from the reproductive health field to give women around the world a tool to protect themselves from HIV infection. “Women and girls must be given the tools to protect themselves from HIV infection,” said Jill Sheffield, President of Women Deliver. “The contraceptive ring has been a formidable tool for women seeking more control over their reproductive health, and it is wonderful to see HIV researchers adapt this technology to tackle the single biggest killer of young women.
The vaginal ring used in IPM 015 is made of flexible silicone, is durable and would be easy to distribute — making it well suited for use in developing countries. Each ring slowly releases 25 mg of the ARV drug dapivirine over the course of 28 days, potentially providing sustained protection against HIV. The ring is manufactured by IPM, which has a royalty-free license for dapivirine from Tibotec Therapeutics, a division of Johnson & Johnson.
This tool is an innovative approach to HIV prevention that adapts a proven technology from the reproductive health field to the front lines of the fight against HIV/AIDS., and could one day empower women by providing long-lasting, discreet protection from HIV infection during sex.
“Biology and gender inequality continue to place women at greater risk of disease and death, particularly in developing countries,” said Elizabeth Mataka, the UN Secretary-General’s Special Envoy for AIDS in Africa. “All too often, women are not in a position to control their sexual health or protect themselves from HIV infection. By empowering women with new tools to protect their health, this ring technology could bring hope where there was none before.”
Innovative technologies can shape the lives of women, especially in the developing world. New innovations and technologies will have to be harnessed in creative and groundbreaking ways to address persistent reproductive and maternal health issues for women and girls worldwide, and dramatically alter the health and futures of women.
Shobha Shukla
(The author is the CNS Editor, has worked earlier with State Planning Institute, UP, and teaches Physics at India's prestigious Loreto Convent. Email: shobha@citizen-news.org, website: www.citizen-news.org)
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Banderas News, Mexico
Bihar and Jharkhand News Service (BJNS)
Thai-Indian News, Bangkok, Thailand
Modern Ghana News, Accra, Ghana
The Colombo Times, Sri Lanka