☰ Menu

Reproductive Health for All

A contribution from the

Geneva Foundation for Medical Education and Research

Eva Mathur, MA

2. Activities

2. Activities

2.1 Postgraduate course in reproductive medicine and reproductive biology

2.1.1 Postgraduate course 1992 - 2001

2.1.2 Postgraduate course material

See  Lecture plans, course files and reports

2.1.3 Course statistics

See Course statistics  1992-2001

2.2 Partnerships

Institutional partnerships have been formed with a number of centres in which a specific training or research activity has already taken place. Examples are centres in Albania and Romania. These partnerships ensure adequate feedback from trainees. In Romania, for instance, the trainees of the postgraduate course in 1995 are engaged as trainers in the national reproductive health programme. The partnerships also ensure continuous monitoring of scientific standards, effective utilisation of trained staff, good clinical practice and the workup of research proposals.

The postgraduate course in reproductive medicine and reproductive biology had at the end of 2001 received a total of 218 students. Many of the students belong to institutions with which the Centre has a formal collaboration and others are from institutions and countries where such partnerships have not yet been formed. However, as seen in the past, such initial training of individuals has led to larger scale collaboration and formal partnerships.

2.2.1 Romania

The project in Romania aimed at developing an authority of knowledge in reproductive health in Romanian university centres and providing support to improve training and research capabilities. Gynaecologists from eight university centres received advanced training in reproductive health; developed a reproductive health manual for use in the national reproductive health programme. Funding for this project was secured from the private sector and the United Nations Population Fund (UNFPA).

Further training programmes were developed with Romania. Indeed, a fairly substantial grant from the Swiss National Science Foundation materialised for postgraduate training in reproductive medicine and reproductive biology of yet two people; the exchange of staff; pre-graduate curriculum development in reproductive medicine; workshop in the establishment of a referral system of prenatal care, including the upgrading of skills in obstetric and gynaecologic ultrasonography; dissemination of information and to some extent the upgrading of equipment.
  • Project co-ordinator (Targu Mures, Romania): Dr Mihai Horga
  • Project co-ordinator ( Geneva): Dr Frank Lüdicke
  • Project manager (Geneva): Eva Mathur

2.2.2 Albania

The Swiss National Science Foundation provided funding to a project in Albania. The main components of this project were postgraduate training in reproductive medicine and reproductive biology for two people; a study tour (puericulture) to Geneva for two staff of the Ministry of Health, Tirana;  the training of some 30 midwives by Geneva staff in modern midwifery; a workshop in the establishment of a referral system of prenatal care, including the upgrading of skills in obstetric and gynaecologic ultrasonography; dissemination of information (Reproductive Health Profile - Albania) and to some extent the upgrading of equipment.

A larger scale partnership was established between the Centre and the Ministry of Health, Albania and the University of Tirana, in collaboration with WHO Collaborating Centre for Health Policies, Planning and Management, Department of Social Affairs, Canton of Ticino, Bellinzona. This project included postgraduate training in reproductive medicine and reproductive biology of four people, the technical support for the development and publishing of a reproductive health manual and practical training in communication skills in reproductive health. The project was approved by the United Nations Population Fund (UNFPA).

  • Project co-ordinators (Tirana): Dr Fjodor Kallajxhi, Dr Orion Gliozheni
  • Project co-ordinator (Bellinzona): Anna-Maria Fahrländer
  • Project co-ordinator (Geneva): Dr Frank Lüdicke
  • Project manager (Geneva): Eva Mathur

2.3 Regional activities

2.3.1 East Asian Region - menopause

A request to hold a consensus meeting on menopause in the East Asian region was expressed at the end of 1996. A meeting, co-sponsored by WHO, and to which some 20 experts from the region were invited, was held in Geneva in May 1997.

The main outcome of this meeting was:

The additional outcome of this meeting was that it served the purpose of a research needs assessment, as at the end of the meeting a number of research topics, which need to be addressed, were forwarded.

The funding for this project came from the private sector.
  • Project manager: Eva Mathur

2.4 The Cochrane Collaboration

The Cochrane Collaboration has developed in response to Dr Archie Cochrane's call in the 1970ies for systematic, up-to-date reviews of all relevant RCTs of health care. When 'The Cochrane Centre' was opened, in Oxford, in October 1992, those involved expressed the hope that there would be a collaborative international response to Cochrane's agenda. This idea was outlined at a meeting organised six months later by the New York Academy of Sciences. In October 1993 - at what was to become the first in a series of annual Cochrane Colloquia - 77 people from nine countries co-founded 'The Cochrane Collaboration'.

The Cochrane Collaboration has evolved rapidly since it was inaugurated at the 1st Colloquium, but its basic objectives and principles have remained the same as they were at its inception. It is an international organisation that aims to help people make well informed decisions about health care by preparing, maintaining and ensuring the accessibility of systematic reviews of the effects of health care interventions. The Collaboration is being built on eight values:
  • collaboration
  • building on the enthusiasm of individuals
  • avoiding duplication
  • minimising bias
  • keeping up to date
  • ensuring relevance
  • ensuring access
  • continually improving the quality of its work

Cochrane reviews (the principal output of the Collaboration) are published electronically in successive issues of The Cochrane Database of Systematic Reviews. Preparation and maintenance of Cochrane reviews is the responsibility of international collaborative review groups. At the beginning of 1997, the existing and planned review groups (over 40) cover most of the important areas of health care.

A collaborative review group's plan of work must be based on agreements reached at one or more exploratory meetings of those interested in becoming involved in the group. The plan defines the scope of the group and the specific topics falling within the scope. It describes who will have responsibility for planning, co-ordinating and monitoring the group's work (a co-ordinating editor, supported by an editorial team). It describes how the group will identify and assemble in a specialised register as high a proportion as possible of all the studies relevant to its declared scope; and who, drawing on the studies in the register, will take responsibility for preparing and maintaining which reviews. Every group appoints an individual to organise and manage the day-to-day activities of the group, who is based at the same place as the co-ordinating editor.

2.4.1 Reviews

The following reviews, conducted at the Centre, are published or in press for the Cochrane Library:

  • Comparison of laparoscopy and minilaparotomy to perform tubal sterilisation
  • Medical versus surgical methods for first trimester abortion
  • Betamimetics for fetal distress
  • Vitamin A supplementation to reduce maternal morbidity
  • Medical methods for first trimester abortions
  • Surgical methods for first trimester abortions
  • Second versus third generation oral contraceptives
  • Tubal occlusion methods for female sterilisation
  • Cervical ripening methods for first trimester abortion

 2.5 Dissemination of information

2.5.1 www.gfmer.ch

The worldwide electronic networking via Internet offers an innovative and unique approach to interactive communication, retrieval of information and education. The Centre's electronic bookshelves have been reorganised and transferred to www.gfmer.ch with the primary goal  to provide health professionals with an up-to-date, precisely conceived information network specifically catering to the needs of the medical community, as follows:

  • Compilation of medical links, which are identified and categorised in a logical manner enabling the user to have ease in finding the desired information. The information server has linkages to a large number of information sources.
  • Selected publications, produced by staff of the Centre can be accessed.
  • Availability of updated medical guidelines and protocols
  • As an additional communication feature, gynaecologists will be encouraged to share their views and opinions on subjects that concern their medical activities.

2.5.2 Reproductive Health Profiles from Eastern Europe

2.5.2.1 Albania

See Reproductive Health in Albania

2.5.2.2 Armenia

See Reproductive Health Profile - Armenia

2.5.2.3 Georgia

See Reproductive Health in Georgia

2.5.2.4 Hungary

See Reproductive Health in Hungary

2.5.2.5 Lithuania

See Reproductive Health Profile in Lithuania

2.5.2.6 Russia

See Reproductive Health Profile in Russia

2.5.3 Reproductive Health Profiles/Information from various geographical regions

2.5.3.1 Brazil

See Maternidade Escola Assis Chateaubriand, Universidade Federal do Ceara: Manual for training of Traditional Birth Attendants (TBAs) and Community Health Workers in Reproductive Health.

2.5.3.2 Cameroon

See Reproductive Health Profile - Cameroon

2.5.3.3 Indonesia

See Reproductive Health in Indonesia

2.5.3.4 Egypt

See Reproductive Health Profile in Egypt

2.6 Research projects

2.6.1 "The prevalence of sexually transmitted diseases in the region of Bafang, Cameroon"

In collaboration with l'Hôpital Ad Lucem, Bafang, Cameroon.

2.6.2 "Assessment of morbidity in induced abortion on request in Armenia and Romania"

In collaboration with the University of Targu Mures, Romania.

2.6.3 "Infertility in Eastern Europe: A survey in nine Eastern European Countries"

In collaboration with Szeged University, Hungary  -  Infertility in Eastern Europe, a survey of the current status in 9 countries.

2.7 Links with Non-Governmental Organisations (NGO)

2.7.1 IAMANEH

The Centre encourages collaboration with NGOs active in maternal and child health.

Over the last few years, a strong collaboration has developed between the Centre and the International Association for Maternal and Neonatal Health ( IAMANEH). This NGO, was founded in 1977 and is a non-governmental, non-profit organisation dedicated to fulfilling the goals of the Safe Motherhood Initiative (SMI) initiated in Nairobi, Kenya in 1988, focuses its activities on the improvement of maternal and neonatal health, in particular in the less developed nations, where 99 and 98 percent of respectively maternal and neonatal deaths take place.

IAMANEH, as a health-related NGO, is always working within the context of the National Health Policy of the countries where it is active and has through its national sections often been able to react expeditiously to calls for support. It applies innovative approaches and its initiatives have demonstrated to reach lower levels of maternal and neonatal mortality and morbidity, particularly in those areas, where its national sections are active.  IAMANEH's governing body is the General Assembly of all its members and is held every three years on the occasion of IAMANEH's triennial International Congress on Maternal and Neonatal Health organised by one of the National Sections. The year 2000 conference was held in South Africa.

The Centre provides postgraduate training and practical training to selected staff of IAMANEH’s national sections. Some 50 gynaecologists/obstetricians have been trained to date and many of them are now following further specialisation and involved in project activities to benefit mothers and infants.