Ian Askew, Director, Department of Sexual and Reproductive Health and Research including UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction

The Generation Equality Forum is over – but we know that work to build the evidence, advocate for change, and deliver on commitments made at the largest global feminist gathering in more than 25 years, continues.

At HRP, we are heartened by WHO’s commitments on ending gender-based violence; advancing sexual and reproductive health and rights; and supporting health workers as well as feminist movements and leadership. We are inspired by the thousands of activists working together to make the right to health and gender equality a reality for women and girls in all their diversity, during and beyond the pandemic.

I’m particularly pleased to draw your attention to The BMJ special series HRP produced with WHO and the United Nations University International Institute for Global Health (UNU-IIGH) on Women’s Health and Gender Inequalities. There are 13 articles, written by 40 authors working together across institutions from 15 countries, at different stages of their career. Three episodes of The BMJ Podcast are dedicated to the series, focusing on: advocacy, movements and civil society; research to advance women’s health; political drivers and government commitments. In each episode, intergenerational dialogues ground these issues in understanding of the past, present, and the brighter future we expect.

Knowledge exchange is critical for building the evidence base needed for change, and it was a pleasure to hear Muna Abdi, a Principal Investigator in Somalia, on TDR’s new podcast Global Health Matters. Muna talked about adapting and safely continuing research in the context of COVID-19, as part of a WHO and HRP implementation research study strengthening health workers’ communication to prevent FGM and care for survivors.

We saw another rich exchange last month, with these 15 winning implementation stories on how WHO global guidance for reproductive health can be successfully adapted to local need and context. Selected by the IBP Network, in collaboration with the Knowledge SUCCESS Project, these stories are told directly by the organizations leading change in their communities and offer many useful lessons to carry forward.

Data are key to accountability, and I want to draw your attention to two databases – one new, and one forthcoming – which can make a significant contribution to ongoing efforts on preventing and responding to violence against women. The interactive Global Database on Prevalence of Violence against Women presents the source data underpinning the recent violence against women prevalence estimates. It allows users to explore maps and create charts, deepening engagement and understanding of data from 159 countries on the prevalence of the two most common forms of violence against women globally.

The Violence Against Women Policy Database, which is due later this year, will examine governments’ commitments to the 2016 Global Plan of Action on Violence. Some excellent data visualizations of preliminary analysis were shared at the recent Seventy-Fourth WHO World Health Assembly.

At HRP we marked the recent Menstrual Hygiene Day with a number of events and support for a new definition of menstrual health, aligned to the WHO definition of health. WHO sees menstrual health as a public health issue, a human rights issue, and a gender equality issue that needs to be addressed in the context of a life course approach. Menstrual health is not only about hygiene during the monthly period. There are several dimensions – biological, social, and mental – and it’s crucial that menstrual health is on the global health agenda as a component of sexual and reproductive health and rights.

As we’ve said many times this year and will continue to repeat, pregnancy is not put on pause in a pandemic, and neither are every person’s fundamental human rights. It is very important for all who are pregnant or considering a pregnancy at this time to know what they should expect. We addressed pregnancy and COVID-19 in a recent episode of Science in 5, WHO’s video and audio series where experts explain the science related to COVID-19. The message from WHO is clear: safe and respectful pregnancy, childbirth and postnatal services are essential to maintain.

A critical new resource for this is the WHO Labour Care Guide, which supports health personnel to provide person-centred, safe and effective care during childbirth. The Labour Care Guide revises and replaces the traditional WHO partograph with updated, evidence-based reference ranges of labour progress. It creates a positive feedback and decision-making loop for skilled health personnel which includes each woman in decision-making about her own labour. The new online Labour Care Guide training course from The World Continuing Education Alliance, WHO, UNFPA and UNICEF can help health workers put these recommendations into practice – please do share widely.

The mindset of ‘let’s digitize!’ is more relevant than ever, particularly in the context of COVID-19. However digital health interventions are only effective if they include the whole spectrum of quality of care. Following the success of the antenatal care digital health intervention, we have just launched the next digital adaptation kit, an important element of WHO’s SMART Guideline approach to global normative recommendations in the digital age. The Digital Adaptation Kit for Family Planning keeps people – both health workers and service users – at the heart of the digital journey.

Another important launch this month was for the new WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention. There are shifts in WHO’s recommended approaches to cervical screening, including human papillomavirus (HPV) DNA based testing as the preferred method, rather than visual inspection with acetic acid (VIA) or cytology. There are also specific recommendations for women living with HIV, who are particularly vulnerable to cervical disease.

On 24 June WHO welcomed Self-Care Month, celebrating the power of individuals to manage their own health, in the context of a safe and supportive health system and wider enabling environment. Updated guidelines were launched, showing how health systems can promote self-care interventions and advance health and well-being for all, including for sexual and reproductive health and rights and the prevention and management of non-communicable diseases. I encourage you to follow along on social media, as WHO and HRP share daily #SelfCare tips to improve your health.

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