Population, Reproductive and Sexual Health
Section Newsletter
Fall 2005

MESSAGE FROM THE CHAIR

Section Chair Tim Williams, John Snow Inc., 1616 N. Fort Myer Drive, 11th Floor, Arlington, VA 22209 Phone: (703) 528-7480 Fax: (703) 528-7480 E-mail: tim_williams@jsi.com

Dear PFPRH colleagues,

Today and in recent weeks, our thoughts are properly overwhelmed by the aftermath of Hurricane Katrina. The images of destruction from the storm itself shocked us as no storm in memory, and every day it becomes clearer that Katrina’s consequences will be with us all for months and years to come. To the individuals and families who lost loved ones, homes, businesses, and more — our hearts, prayers, and best wishes go out to you. This unique event robbed tens of thousands of people of their community —t hat sense of familiarity with known surroundings that makes us much of who we are. Things can never be quite the same. We can at least hope that all the private and (woefully belated) public relief and restoration efforts will give people new hope for new beginnings.

Clearly, we all want to help Katrina victims in a way that “matters.” Since there has been so much relief coverage lately, we are all well aware of worthy charities, and I applaud all who have contributed already. Nevertheless, past history shows that while American generosity for disaster relief is immense, and her response swift, her memory can be short. After initial good deeds, minds can quickly turn to other things. I don’t think the memory of Katrina will fade any time soon, but I do think it’s worth keeping up support and donations after others feel they’ve done their share. So here is a message from APHA that may help those of you still searching for a way to give. I hope it is still reasonably up to date and helpful:

In the immediate future, the best thing that people can do to help is to provide support to the agencies and organizations that are involved in the relief efforts, and the best (and quickest) way to make a contribution, is to send money to these organizations so that they can continue their work to aide the people who are affected by the hurricane. Information about the organizations is available on the APHA Web site at:
<http://www.apha.org/meetings/new_orleans_update.htm>.

It also occurs to me that Katrina may understandably turn people’s thoughts away from other forgotten poor and forgotten, smaller “disasters” and chronic conditions that are the focus of much of public health work, including that of our Section. The noble support flowing to Katrina victims and future disaster planning, while absolutely vital, may nevertheless gradually divert scarce charitable dollars from longer-term preventive public health programs. This is true of both private donations and government support for family planning/reproductive health (FP/RH) — and indeed all discretionary spending. Even this president, who has never seen a deficit he didn’t want to increase, has finally said that government spending will be cut, and I think we all know where the cuts won’t come from!

Such a possible turn of events would be highly ironic, as it was precisely the lack of investment in preventive infrastructure such as levee reinforcement, in the face of strong evidence of the benefits, which made the end-result of Katrina so much worse than it could have been. How sad if one of the legacies of Katrina is that the attempt to invest in one form of prevention (fortifying large numbers of cities against future natural and manmade disasters) occurs at the expense of less visible but highly successful programs such as FP/RH, that in very different ways provide crucial preventive health benefits to needy individuals, families, and communities. I believe we must make an especially strong case at this juncture to raise the importance of our work in the eyes of policy makers everywhere, and as always focus energies on continuous program improvement, so we can make stronger arguments for support based on solid evidence of success.

And speaking of evidence, APHA will indeed go on, and the theme this year is Evidence-Based Policy and Practice. As I said in my Message from the Chair last Spring, this topic couldn’t come at a better time. Political decisions related to FP/RH continue to be made on the basis of what I call “anti-evidence.” Ideology continues to trump science, just at a time when we need science and sound evidence to deal with ever more complex challenges in our FP/RH and other public health work. Such ideological decisions continue to chip away at women’s and couples’ access to quality RH services, leading to outcomes that, while mostly private and far less visible than catastrophes such as Katrina, are tragic nonetheless, and almost always preventable.

So please join me and hundreds of others in APHA this year. Now is our chance to present positive evidence of what it takes to design, test, implement, manage, evaluate, and scale up FP/RH programs, our achievements and lessons learned, successes and failures, and the messages we can bring to policy-makers to encourage sound, evidence-based decisions. Young Mi Kim has put together a terrific program, with sessions that appear packed with high quality and innovative presentations. As always, the main challenge is likely to be deciding what sessions to skip. Thank you, Young Mi!

Unfortunately, as you all know by now, New Orleans will not be able to host the conference, but APHA has been able to reschedule for Dec. 10-14 (the normal Saturday – Wednesday schedule). Three years ago Philadelphia proved to be a wonderful conference site, so although it will be cooler than New Orleans, it promises to be a highly rewarding and enjoyable event as always.

Let me close with a plea to all of you, especially to relatively new members, to become active in APHA advocacy and leadership. Our Section has the opportunity to influence APHA policy — and eventually broader national policies — by bringing our issues to APHA leaders. Please see the report by Lois Uttley, our Section’s representative to the Action Board, on FP/RH issues that she and the Board have been or are currently working on. Many thanks to Lois for her continued work and dedication on these issues!

Another way to become involved with policy and leadership issues is to join a Task Force in an area of interest to you. Most Task Forces will meet during the conference on Sunday, Dec. 11, but check the online program to find the time of the group or groups that most interest you. Task Force leaders love new faces and new ideas, and it’s a great way to learn more about APHA, specific technical areas, and to contribute new ideas to current leaders. See the Fask Force reports in this newsletter for more information. Task force chairs and other current officers are also listed on our Section Web site, <http://pfprh.org/>, which also has useful information on policies, fact sheets, standing committees, awards, etc.

Wishing you all a great fall, and see you soon in Philadelphia!

NOMINATIONS COMMITTEE

Chair Tim Williams, John Snow Inc., 1616 N. Fort Myer Drive, 11th Floor, Arlington, VA 22209 Phone: (703) 528-7480 Fax: (703) 528-7480 E-mail: tim_williams@jsi.com

One nice feature of APHA each year is the chance to welcome a new group of Section leaders. Web-based elections for new officers were held in May, with multiple candidates for all positions. It is a great pleasure for me to announce the winners for the following positions:

Chair: Margaret E. Green, PhD, MA

Secretary: Lawrence B. Finer, PhD

Governing Council: Lindsay Stewart, MPH

Section Council: John Santelli, MD. MPH, and Hannah Searing, MHS, MA


I heartily welcome this new group of PFPRH Section leaders and look forward to working with you and current Section officers to help us advance our Section’s work. I also especially want to thank all those who ran but did not win — it was an exceptionally strong slate, and all the candidates were highly capable. Even if you did not win this time, please consider running again at some point in the future.

Thanks and congratulations to all!

MEMBERSHIP REPORT

Chair, Erica Fishman, Asthma Program Coordinator, Minnesota Department of Health, P.O. Box 9441, Minneapolis, MN 55440-9441 Phone: 612-676-5213 E-mail: erica.fishman@health.state.mn.us

Our membership has remained relatively stable at 2.8 percent of total APHA membership. Over the years we have kept a steady core of members, and each month we gain new members (but never more than 10). As of June 30, 2005, our Section has 740 individuals for whom this is their primary Section. Once again, this number is lower than last year.

Please tell your colleagues of all the great benefits of being a member of our Section, including an informative newsletter. For those people who attend the APHA Annual Meeting, our Section is an invaluable resource for information regarding population, family planning and reproductive health-related sessions. It also provides an opportunity to meet informally with people who do similar work domestically and internationally. For more information, please contact Erica Fishman at <Erica.fishman@health.state.mn.us>.

ACTION BOARD REPORT

Board Representative Lois Uttley, Education Fund of Family Planning Advocates of NYS, 17 Elk Street, Albany, NY 12207 Phone: (518) 436-8408 Fax: (518) 436-1048 E-mail: Lois@mergerwatch.org

APHA has been taking action on a number of issues of particular concern to our Section, including the following:

1) Protecting Medicaid, a significant source of reproductive health care coverage for low-income women. APHA Executive Director Georges Benjamin has made this a top priority for advocacy. APHA members are being urged to contact their members of Congress and set up meetings in the members' district offices during Congressional recesses. Visit APHA's Medicaid Advocacy Center for helpful background information, fact sheets and talking points: <http://www.apha.org/legislative/legislative/medicaid.htm>.

On August 25, APHA released a "white paper" identifying four priorities Congress should protect when considering changes to Medicaid. The full text of the white paper, authored by APHA Health Policy Analyst Courtney Perlino, is available on APHA's Web site, <http://www.apha.org/medicaidwhitepaper/medicaidwhitepaper_full.pdf >.

2) Addressing the problem of pharmacists refusing to dispense contraceptives, including emergency contraception. Members of our Section are working with APHA staff, pharmacists, and leadership of the Action Board to develop and submit a proposed "late-breaker" resolution on pharmacist refusals for consideration by the Governing Council at December's Annual Meeting. Our policy objective is to ensure that women are able to fill their contraceptive prescriptions at local pharmacies without interference or moralizing from objecting pharmacists.

The resolution, if adopted, would become the basis on which APHA staff, sections and affiliates could take action to support or oppose any proposed laws or regulations dealing with this issue. To learn more or become involved in this effort, contact our Section's representative to the Action Board, Lois Uttley, at <lois@mergerwatch.org>.

FROM THE HILL

 
Terri Bartlett, Vice President, Public Policy and Craig Lasher, Senior Policy Analyst, Population Action International, 1120 19th Street, NW, Suite 550, Washington, DC 20036 Phone: (202) 659-1833 E-mail: tlb@popact.org (Terri) and clasher@popact.org (Craig)

As Congress returns to Washington in the aftermath of Hurricane Katrina, it faces a dramatically changed fiscal and political environment with significant implications for the congressional work schedule. Together with looming Senate confirmation fights for now two Supreme Court vacancies, predictions are being made that Congress may be in session until Thanksgiving. A number of contentious international family planning and reproductive health (FP/RH) issues are yet to be resolved. But with Congress and the White House consumed with relief and recovery efforts for the Gulf Coast states, international family planning, along with virtually every other legislative and policy concern unrelated to the disaster, is not garnering —and will not garner — much attention or priority in the near term.

In comparison with other recent years, Congress had actually made considerable progress on must-pass appropriations bills, including House and Senate passage of their respective versions of the foreign operations bills, which include FP/RH funding and policy language, prior to its August recess.

Preliminary staff-level discussions have taken place already in preparation for convening the formal conference committee of Senators and Representatives, who will negotiate remaining controversies likely to include some of the FP/RH provisions. Completing negotiations on a final bill will be complicated not only by the Supreme Court confirmation hearings in the Senate, but also by process issues resulting from changes in Appropriations Subcommittee jurisdictions; these changes added responsibility for funding State Department operations to the foreign operations bill in the Senate. A series of “continuing resolutions” — stop-gap funding bills to keep the federal government running until appropriations bills are enacted after the start of the new fiscal year — are expected to be necessary before Congress can complete its work and adjourn.

In addition to the appropriations process, the other outstanding questions in Washington concern whether the decision of the Bush administration to expand the requirement that recipients of U.S. government HIV/AIDS assistance have an official organizational policy opposing prostitution and sex trafficking will survive a legal challenge by DKT International, and when the State Department will finally announce its inevitable decision to withhold the FY 2005 contribution to the United Nations Population Fund (UNFPA).

Since the last Section newsletter, a number of important legislative and policy developments — many related to those previewed above — have occurred in Washington. A detailed summary follows below.


FY 2006 APPROPRIATIONS BILL

The House debated and passed the foreign operations bill (H.R. 3057) on June 28, and Senate floor passage occurred on July 20. As usual, the draft Senate bill treats FP/RH programs more favorably by including a higher overall earmark for bilateral population funding ($450 million in the Senate bill versus $432 million in the House), modifying the Kemp-Kasten amendment to make it more difficult for the Bush administration to withhold a U.S. contribution to UNFPA, and calling for the repeal of the Mexico City-Global Gag Rule policy (http://www.globalgagrule.org).

Among other differences between the two bills: a Senate provision that exempts contraceptives and condoms from legislative and policy restrictions, such as the Mexico City-Global Gag Rule, that block access to U.S.-donated reproductive health supplies; House report language requesting an update on "informed consent problems" in Peru; and Senate bill and report language on child marriage and female genital mutilation (FGM), respectively.

The only FP/RH-related provision that was added by the Senate, other than the UNFPA amendment discussed below, is a floor amendment directing the Government Accountability Office to conduct an audit of the use of FY 2004 and 2005 funds within the Child Survival and Health Programs Fund, under with FP/RH programs are largely funded, and make "specific recommendations on improving the effectiveness of such funds."

For the full text of the House-approved bill, go to: <http://frwebgate.access.gpo.gov/cgi-bin/
getdoc.cgi?dbname=109_cong_bills&docid=f:h3057eh.txt.pdf>.

For the full text of the Senate-approved bill go to: <http://frwebgate.access.gpo.gov/cgi-bin/
getdoc.cgi?dbname=109_cong_bills&docid=f:h3057eas.txt.pdf>.

Despite the fact that the estimated cost of hurricane reconstruction is projected by many observers to eventually top $100 billion, these expenses are expected to be designated as “emergency” funds and will not require that corresponding cuts be made in the regular FY 2006 appropriations bills. However, there is rising concern about the potential effect of disaster relief on the economy and the budget deficit, which may lead to increasing congressional and public scrutiny of foreign assistance spending in light of domestic needs.

Given the controversies surrounding FP/RH issues — as well as numerous extraneous political, procedural, and schedule obstacles — advocates are doubtful that many positive FP/RH provisions will make their way into the final appropriations bill that will be approved by Congress and sent to the President for his signature.


ANTI-PROSTITUTION LOYALTY OATH

The Bush administration has recently expanded the requirement that recipients of U.S. government HIV/AIDS assistance have an official organizational policy opposing prostitution and sex trafficking in order to be eligible to receive funds. Based on a 2003 provision in the authorizing legislation creating the President's Emergency Plan for AIDS Relief (PEPFAR), the requirement for an official policy had previously been applied only to foreign NGOs. However, on June 9, a new policy directive was issued by USAID extending the requirement to domestic U.S. organizations.

A legislative fix seems improbable, but legal action appears promising. On August 11, DKT International, a USAID-funded contraceptive social marketing grantee recently denied funding for a condom distribution project in Vietnam after refusing to comply with this anti-prostitution loyalty oath, filed a lawsuit seeking an injunction blocking implementation of the new policy as an unconstitutional infringement on its right to free speech. A second legal challenge is also being contemplated by another organization, which is expected to file suit in New York shortly.

The loyalty oath has serious implications for the future of U.S. HIV/AIDS assistance and is just the latest in a series of directives from the Bush Administration that are increasingly threatening the independence and programmatic integrity of private U.S. organizations working overseas. Compelling organizations to have a policy condemning prostitution — or forcing speech on any topic — as a condition of receiving federal funds appears to many legal analysts to be unconstitutional.

Concern is sparked by how this requirement may undermine sound public health strategies for curbing the AIDS epidemic and for improving sexual and reproductive health around the world. This policy shift may also be a test case for those within the Bush Administration who might seek to expand the Mexico City Global Gag Rule policy to U.S. organizations with the goal of defunding many of USAID’s longstanding partner organizations and dismantling one of USAID's foreign aid success stories — the international family planning program.

The priority that social conservatives, both inside and outside government, attach to eradicating prostitution and sex trafficking is highlighted by House passage of an expansive amendment on the subject. The amendment, attached by Reps. Chris Smith and Steve King (R-Iowa) to the State Department authorization bill on July 20, requires the State Department to strictly enforce compliance with the expansion of the policy to U.S. NGOs and to collect, audit, and evaluate the organizational anti-prostitution policies of every PEPFAR grantee and subgrantee — foreign and domestic — and report to Congress within 90 days of enactment of the legislation. The amendment is unlikely to become law because the companion State bill is stalled in the Senate, in part due to the successful attachment of the Boxer amendment overturning the Mexico City Global Gag Rule policy.


UNFPA

Invoking the Kemp-Kasten restriction that prohibits funding to organizations that "support or participate in the management of a program of coercive abortion or involuntary sterilization," Secretary of State Rice is expected to withdraw the $34 million appropriated by Congress for FY 2005 before the end of the fiscal year on Sept. 30. For the fourth year in a row, this negative determination will be based on still unproven charges of UNFPA complicity in human rights abuses associated with the Chinese government's "one-child" policy.

While the Bush administration is widely expected to withhold the FY 2005 U.S. contribution to UNFPA, congressional supporters have worked to prevent a similar fate for the FY 2006 contribution.

For example, the Senate-passed foreign operations bill rewrites the Kemp-Kasten language to prohibit funding only if an organization “directly supports” coercive practices and to stipulate that the restriction “shall not be construed to deny funding [to an organization] solely because the government of a country engages in coercive abortion or involuntary sterilization.” Since this provision is not included in the House bill and would significantly modify a longstanding prohibition, the Senate amendment is unlikely to become law. However, another pro-family planning provision, crucial in the event that the FY 2006 contribution is withheld, will be enacted since it is in both bills. It mandates that most of the FY 2006 funds appropriated for UNFPA will be transferred to USAID FP/RH activities should the contribution be blocked from going to UNFPA “because of the operation of any provision of law” (e.g. Kemp-Kasten).

In addition, Senators Hillary Clinton (D-N.Y.) and Lincoln Chafee (R-R.I.) successfully offered an amendment to the foreign ops bill during Senate floor debate limiting U.S. funding to specific areas of UNFPA's work such as safe delivery, contraceptive supplies, infrastructure, FGM, and obstetric fistula in countries other than China. UNFPA advocates had hoped to get the Senate on record on UNFPA for the first time since 1995 to strengthen the hand of Senate negotiators in pushing the Kemp-Kasten rewrite with the House. But the Clinton-Chafee amendment proved to be noncontroversial, and the language was approved by voice vote.


OTHER EMERGING ISSUES

Obstetric Fistula — During floor debate of the State Department authorization bill (H.R. 2601) on July 19, Rep. Chris Smith (R-N.J.) offered an amendment that modified a provision that Rep. Joe Crowley (D-N.Y.) had attached to the committee-reported bill by deleting specific reference to contraception in favor of a more general reference to family planning, making provision of family planning services optional, and adding promotion of abstinence and efforts to reduce child marriage to the list of permissible prevention activities to be offered in the obstetric fistula treatment and repair centers authorized in the underlying bill. The Smith amendment was adopted on a vote of 223 to 205.

The small, 18-vote margin of defeat is a tribute to the ability of our champions in the House — Reps. Crowley, Maloney, and Barbara Lee (D-Calif.) — and their credibility with their colleagues on these issues in being able to successfully define the pro-family planning position and family planning advocates’ quick mobilization in support. It may also indicate in part the high level of suspicion that is provoked whenever long-time program nemesis Chris Smith offers an amendment on international family planning.

WHAT YOU CAN DO

As a constituent, voter, and public health professional, your well-informed opinion on these vital programs has tremendous credibility and carries great weight with your Senators and Representative. Educate yourself and your friends, families, and colleagues on the positions of your members of Congress. Please let them know what you think.

We urge members of APHA to join the PAI action network to keep up with political developments in Washington. Go to <http://populationaction.org/action/getinvolved.htm> to sign up.

TASK FORCE REPORTS

Sexuality Task Force

Co-Chairs Jennifer Hirsch, Associate Professor, Dept. of Sociomedical Sciences, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032 Phone: (212) 305-1185 E-mail: jsh2124@columbia.edu and Leslie Kantor, Kantor Consulting, 600 Prospect Street, Maplewood, NJ 07040 Phone: (973) 763-3904 E-mail: LKantor@KantorConsulting.com and Dina J. Feivelson, 141 E. 33rd St., #9J, New York, NY 10016 Phone: (212) 532-4724 Fax: (212) 305-3702 E-mail: djf64@columbia.edu

The Sexuality Task Force business meeting is scheduled for Sunday, Dec. 11, from 2-3:30 p.m. At press time the location was not available, but this information will be included in the program. This year we are going to try something a little different for our Task Force meeting. At our meeting, we will be discussing two specific topics:

  • We are inviting all members of any Section or Task Force who are interested in sexuality to attend the meeting for general discussions of advocacy and science strategies to protect and promote sexual health. After making important contributions to the advocacy and scientific agenda of APHA in years past, of late the Sexuality Task Force has not been as effective as we would like. Part of this may be due to the fact that there is just a limit on how many Task Force meetings people can attend, and we see that many of the other Task Forces (Adolescent, Abortion, and APHA’s Action Board) are working on projects related to sexuality. So we are hoping that this will be an opportunity for us to join forces to put sexuality on the APHA agenda.


  • We will also be discussing ideas regarding our proposed Section name change, with the hopes of developing an idea for how to proceed Section-wide with conversations about this issue.


In addition, Lois Uttley, as the Section representative to the APHA Action Board, has called our attention to two more issues that might be of interest to sexuality-minded folks.

1) Promoting comprehensive sexuality education. There is a proposed policy that will likely be up for a vote before the Governing Council in the fall. This draft policy came out of the HIV/AIDS Section, and Lois helped comment on it on behalf of our Section, and later in the process as a member of the Joint Policy Committee. Assuming the authors make changes that were recommended by the JPC, the policy went forward from the JPC in July and will be sent to Sections for final comments. As a JPC member, Lois will be chairing the public hearing on this proposal at the Annual Meeting in December, and it would be great if Section members could come and comment on it. These meetings are open, so go and make your voice heard! Look in the program for more info regarding time and place.

2) Ensuring that women are able to obtain contraception and emergency contraception at pharmacies, even when one of the pharmacists objects to dispensing it for religious or moral reasons. Lois has been asked by APHA staff to develop what's called a "late-breaker resolution" on this topic for consideration by the Governing Council at the Annual Meeting. If you are interested in helping her think through how to make sure the prescription gets filled in a way that is seamless to the patient, while still allowing for pharmacist religious objections in certain circumstances (such as when a protocol is in place at a pharmacy to ensure that a non-objecting pharmacist will step in and serve the patient), contact her at <lois@mergerwatch.org>.

Finally, sexuality is a hot topic at the upcoming meeting. A quick review of the online program shows 125 sessions under the keyword “sexuality,” including poster sessions, papers and sessions on sexuality-related topics in the areas of health policies, HIV prevention, gender inequality, health services research, methodological issues, transgendered populations, and much more. While some of these sessions are sponsored by our Section, others are sponsored by HIV, Maternal and Child Health, Health Education, and a variety of other groups with APHA. We love the searchability of the APHA Web site, but because there are so many sexuality-related sessions and because we know how easy it is to get parochial and only attend PFPRH-sponsored events, this year we will be bringing back the famous pink sheet! For those of you who are too young to remember the pink sheets, the Sexuality Task Force used to produce a listing of all sexuality-related APHA events and distribute the pink sheet from our Section booth in the exhibit hall. Look for it again this year – and grab an extra one to share with a friend!

For more information about the Sexuality Task Force, contact Task Force co-chairs Jennifer Hirsch at <jsh2124@columbia.edu> or Leslie Kantor at <lesliekantor@comcast.net>.

Abortion

Chair Laureen Tews, Medical Abortion Initiative Director, National Abortion Federation, 1755 Massachusetts Avenue, NW, Suite 600, Washington, DC 20036 Phone: (202) 667-5881 E-mail: ltews@prochoice.org jhealy@ipas.org

As of early September, Laureen Tews has relocated from Washington, D.C., and is no longer with the National Abortion Federation (NAF). So we are searching for a volunteer(s) to chair the Abortion Task Force.

We generated some interesting ideas during our meeting at last year's APHA Annual Meeting and are looking forward to our meeting in Philadelphia. The Task Force will meet on Sunday, Dec. 11 from 4 until 5:30 p.m. All PFPRH-sponsored business meetings were scheduled to be in the Convention Center, so look for room information in your final program.

The Abortion Task Force maintains a listserv hosted by NAF. To be added to the discussion list, please e-mail <mallee@prochoice.org>. If you're interested in serving as a chair of the Task Force, please contact PFPRH section Chair Tim Williams at <tim_williams@jsi.com>.

Adolescent Reproductive Health

Co-Chairs John Santelli, Professor of Clinical Pediatrics and Clinical Population & Family Health, Heilbrunn Department of Population & Family Health, Mailman School of Public Health, Columbia University, 60 Haven Avenue, B-2, New York, New York 10032 (212) 304-5634 Fax: (212) 305-7024 E-mail: js2637@columbia.edu and Susan Newcomer DBSB/CPR/NICHD, 6100 Executive Boulevard, Building 61E, Room 8B13, Bethesda, MD 20892-7510 Phone: (301) 496-1174 E-mail: newcomes@mail.nih.gov and Iris Meltzer, Children’s Hospital Medical Center of Akron, One Perkins Square, Akron, OH 44308 Phone: (330) 543-8914 E-mail: imeltzer@chmca.org

Adolescents in the United States and in many other countries around the globe face considerable risk from sexually transmitted infections (STIs), including HIV/AIDS and unintended pregnancy. The Adolescent Task Force is interested in promoting the sexual and reproductive health of adolescents. The Task Force provides a forum for discussion of critical issues in the reproductive health for teenagers including:

  • Access to reproductive health services and sexuality education,

  • Confidentiality of care,

  • Sexual behaviors,

  • Prevention of STIs and unintended pregnancy, and

  • Government policies and local programs.


Past discussions have considered program design, the role of evaluation research in program implementation, whether there is an “acceptable age” for the initiation of sexual behaviors in adolescence, and the importance of understanding the role of young marriage around the world. Recent discussions at the Annual Meeting have focused on U.S federal policies designed to promote abstinence until marriage and enforcement of statutory rape reporting laws. The Task Force is currently working with the Society for Adolesent Medicine to develop a position statement on Abstinence-Only Educational (AOE) Programs and Policies. This position statement should be released this fall.

At the 2005 meeting in Philadelphia we plan to provide an update on policy developments in abstinence-only education. This update will include recent evaluation results of AOE programs, the impact of AOE on domestic and international programs, and human rights issues raised by these policies and programs.

Management/Sustainability Task Force

Co-Chairs Erica Fishman, Asthma Program Coordinator, Minnesota Department of Health, P.O. Box 9441, Minneapolis, MN 55440-9441 Phone: 612-676-5213 E-mail: erica.fishman@health.state.mn.us and Lisa A. Hare, Senior Policy Advisor, DELIVER - JSI, 1616 North Fort Myer Dr., 11th Floor, Arlington, VA 22209 Phone: (703) 528-7474 E-mail: lhare@jsi.com

The Task Force serves as a means to increase communication on management and sustainability issues, with a particular focus on sharing experiences between those members working internationally and those working domestically. This year we are pleased to be sponsoring several panels that focus on scaling up of reproductive health services, improving and sustaining reproductive health services for youth, and tools and approaches for financial and programmatic sustainability.

The Task Force meeting will be held on Tuesday, Dec. 13, from 6:00-7:30 p.m. At the meeting, you will have the opportunity to share experiences and ideas in a small informal setting. We will also review activities from the past year, discuss activities for the coming year and discuss possible sessions for the 2006 conference. The Task Force welcomes new and current members to join us. Please feel free to submit suggestions at anytime to the co-chairs.

OTHER COMMITTEE AND TASK FORCE INFORMATION

RESOLUTIONS COMMITTEE

Co-Chairs S. Marie Harvey, Associate Professor of Public Health & Director of the Research Program on Women’s Health, Center for the Study of Women in Society, University of Oregon, Eugene, OR 97403 Phone: (541) 346-4120, Fax: (541) 346-5096 E-mail: mharvey@oregon.uoregon.edu and Paula Tavrow, Deputy Research Director, Quality Assurance Project, University Research Company, LCC, 7200 Wisconsin Avenue, Suite 600, Bethesda, MD 20814, Phone: (626) 796-1890, Fax: (301) 941-8427 E-mail ptavrow@urc-chs.com.


Men and Reproductive Health

Héctor Sánchez-Flores, Center for Reproductive Health Research and Policy, University of California, San Francisco, Box 0936, San Francisco CA 941143-0936 Phone: (415) 476- 3375 Fax: (415) 476-0705 E-mail: hectors@itsa.ucsf.edu

ANNUAL MEETING PROGRAM PLANS

Chair-Elect Young-Mi Kim, Center for Communication Programs, 111, Market Place, Suite 310, Baltimore, MD 21202 Phone: (410) 659-6258 E-mail: ykim@jhuccp.org

First, I want to thank everyone who submitted an abstract. The quality of the abstracts was very high, which made the selection process enjoyable but difficult. I also want to extend my special thanks to those who reviewed the abstracts. You provided valuable insight and guidance.

We received about 350 abstracts dealing with very core issues in the area of population, family planning and reproductive issues. This reflects a lot of enthusiasm from the professionals in the field. As a result, we will have a rich program of diverse topics and new emerging themes, consisting of 28 oral presentation sessions, 10 poster sessions and four roundtables. Furthermore, many APHA Sections and Caucuses are co-sponsoring our sessions this year. There are also many sessions that I would encourage you to attend in other Sections, such as HIV/AIDS and MCH. A full list of co-sponsorships can be found on the APHA meeting Web site, <www.apha.org/meetings>.

Many of our sessions are focused on serving youths, contraceptive methods, safe abortion, emergency contraceptives, and HIV/AIDS. Other important topics covered are male involvement, gender issues, program sustainability, scaling-up, innovative interventions, maternal/perinatal health, sexuality, improving quality, integration of family planning and HIV/AIDS services, STDs, optimal birth spacing, maternal/child health, and policy issues.

Some program highlights are:

  • Scaling-up of reproductive health programs (3128.0; Mon 10:30 a.m. – 12:00 p.m.);

  • Integration of FP & HIV/AIDS services (3305. 0; Mon 2:30 – 4:00 p.m.);

  • Tools and approaches to financial sustainability for RH programs (3306.0; Mon 2:30 – 4:00 p.m.);

  • Drug store Dilemma: Can pharmacists refuse to dispense birth control? (4052.0; Tue 8:30 to 10:00 a.m.);

  • Why/why not abstinence programs? (4154.0; Tue 12:30 to 2:00 p.m.);

  • Scaling-up & policy implications (4156.0; Tue 12:30 – 2:00 p.m.);

  • Implementing Best Practices Initiatives (4249.0; Tue 2:30-4:00 p.m.);

  • Community change models: preventing adolescent pregnancies, STDs, HIV/AIDS (4250.0; Tue 12:30 – 2:00 p.m.);

  • Tools and strategies for performance improvement and quality (4332.0; Tue 4:30 – 6 p.m.);

  • Innovative methodologies to conduct behavioral surveillance of STD risk behaviors (Wed 8:30 – 10 a.m.);

  • Sex in the cities: sexual relationships, communication and decision making among African Americans and Puerto Rican Young Adults (Wed 12:30 - 2:00 p.m.).



For a detailed list of our Section’s sessions, please go to:

<http://pfprh.org/>.

NEW RESOURCES

The Population Council is pleased to announce that a new Policy Research Division Working Paper has been posted online. "Trends in the timing of first marriage among men and women in the developing world," by Barbara S. Mensch, Susheela Singh, and John B. Casterline, examines recent trends in the timing of first marriage or union for men and women in the developing world. With the exception of South America for both sexes and South and Southeast Asia for men, substantial declines have occurred in the proportion of young men and women who are married. The paper assesses whether the decline in the proportion of young people who are married is related to increases in schooling and urbanization. Policy Research Division Working Paper no. 202. New York: Population Council. Download the full working paper in PDF format at <http://www.popcouncil.org/pdfs/wp/202.pdf>.

A new report from the Population Reference Bureau, "China Confronts HIV/AIDS," describes the nature of the epidemic and details efforts by the Chinese government and the international community to contain the spread of HIV. It also examines the implications of the epidemic's current trends on future Chinese policy. To view or download the report, go to <www.prb.org> or <www.prb.org/pdf05/ChinaConfrontsHIVAIDS.pdf> (963 KB). Copies of the full-color report are available free of charge to those working in developing countries. If you would like to request copies, please contact PRB at prborders@prb.org>.

Also available from PRB is a new data sheet that catalogs the status of women in 168 countries. The data in the "Women of Our World 2005" wall chart show that women have seen gains in health, education, and rights over the last decade, but that progress has been uneven. Women in the poorest countries continue to be held back by gender inequality that limits their schooling, hinders their ability to plan their pregnancies, and affords them fewer economic and leadership opportunities than men. The data sheet, released this spring in advance of the 10-year review of the Fourth World Conference on Women, contains indicators on reproductive health, including maternal mortality, fertility rates, and HIV/AIDS, as well as education, work, and political leadership. An accompanying policy brief, "Taking Stock of Women's Progress," provides highlights of women's gains in these areas, as well as remaining challenges. The data sheet and brief are available online at PRB's Web site at <www.prb.org>. To view or download the materials, click on the attached links: "Women of Our World 2005" <www.prb.org/2005women>; "Taking Stock of Women's Progress" <www.prb.org/pdf05/TakingStockWomens.pdf)>. If you would like to request print copies, please contact PRB at <prborders@prb.org>. For more information, contact Lori Ashford (202) 939-5402 or >lashford@prb.org>.

The Synergy HIV/AIDS Online Resource Center contains 3,845 searchable online documents relevant to HIV/AIDS project management,research, and reproductive health issues. For questions or inquiries, please e-mail: <SynergyInfo@s-3.com>.

YouthNet announces a new publication series – YouthNet Briefs: Summaries of Research Findings, Country Projects, and Technical Leadership. The first nine briefs are now available at <http://www.fhi.org/en/Youth/YouthNet/Publications/YNbriefs.htm>. They include such topics as Use of Maternal and Child Health Services by Adolescents, HIV Counseling Services (Tanzania), Using Radio to Keep Young People in School (Zambia), and Youth-Centered Participatory Learning and Action. To request a printed copy or to subscribe to our mailing list for other announcements and information from YouthNet, please send requests to <youthnetpubs@fhi.org>.

Two new PSI working papers examine secondary abstinence and sexual behavior in youth from Cameroon, Madagascar and Tanzania. One paper uses data from the 2003 Cameroon and 2002 Madagascar Adolescent Reproductive Health Surveys to identify the impact of individual-level and community-level factors that contributed to secondary abstinence. Another new PSI Working Paper uses data from the 2003 Tanzania Trust Survey to determine the extent to which trust in one's partner can explain a lack of protective sexual behavior. For more information on PSI research or to request a copy of Working Papers 63 or 64, visit <www.psi.org/research/>.

The Association of Reproductive Health Professionals (ARHP) announces the publication of the Directory Of International Reproductive Health Opportunities For Medical Students, 3rd Edition. The Directory includes: a listing of more than 50 overseas opportunities for medical and nursing students; a checklist for preparing for an overseas experience; guidelines for international volunteers; a comprehensive listing of funding resources; region-specific resources such as language courses; and maps and site-related graphics. This publication is available online at
<http://www.arhp.org/files/InternationalDirectory.pdf>. For print copies of this and other ARHP publications, visit <www.arhp.org/store> or contact Rachel Fey at <RFey@arhp.org> or (202) 466-3825.

The National Abortion Federation (NAF) is pleased to announce the availability of Bridging the Gap Between Abortion Training and Abortion Provision: Recommendations from a National Symposium. This report presents the key findings and recommendations of a symposium held in October 2000 to discuss best practices in abortion training and to consider strategies to ensure that the resources invested in abortion training result in actual increases in the number of qualified abortion providers. The participants were the National Abortion Federation, Planned Parenthood of New York City, the Consortium of Planned Parenthood Abortion Providers, and The Access Project. The report can be accessed at <http://www.prochoice.org/pubs_research/publications/downloads/professional_education/Bridging_the_Gap_Training_Symp.pdf>. Also new from the NAF is Clinical Training Curriculum in Abortion Practice, 2nd Edition. The current volume updates content from the original to reflect new data, current practices, and terminology and additionally includes techniques of manual vacuum aspiration and medical abortion. The curriculum, available on CD-ROM, includes 10 modules related to various aspects of abortion service delivery including counseling and informed consent, estimating gestational age, medical screening, procedure selection and techniques, pain management, management of complications, and follow-up. Each module includes detailed, referenced notes, learning objectives, essential points, and suggested experience for the trainee, and a corresponding PowerPoint slideset. One module is dedicated to evaluation of the trainee and the training program. Supplementary modules (included): The Abortion Option: A Values Clarification: Guide for Health Care Professionals and NAF’s Clinical Policy Guidelines 2005. For more information and to order your copy, visit the NAF Web site at <http://www.prochoice.org/education/resources/naf_curriculum.html>. The curriculum is also available for download on the NAF Web site.

The FRONTIERS Project has several new Operations Research Summaries available. Senegal: Community Education Program Increases Dialogue on FGC, 2005 discusses how FRONTIERS, working with Tostan (a nongovernmental organization based in Senegal), evaluated the effects of a community-based education program on awareness, attitudes, and behavior regarding reproductive health and female genital cutting (FGC). Results show that women who participated in the education program have higher levels of knowledge and improved attitudes concerning human rights, gender-based violence, FGC, and reproductive health. OR Summary (2 pp) <http://www.popcouncil.org/frontiers/orsummaries/ors54.html>
Full report: "The Tostan program: Evaluation of a community-based education program in Senegal"
<http://www.popcouncil.org/pdfs/frontiers/FR_FinalReports/Senegal_Tostan%20FGC.pdf>.
Burkina Faso: Community Education Program Scaled-Up in Burkina Faso, 2005 describes how the project tested the replication of Tostan's community-based education program in two provinces of Burkina Faso. The intervention was successfully adapted and replicated, and increased awareness of human rights and women's health, and reduced support for female genital cutting (FGC). OR Summary (2 pp.) <http://www.popcouncil.org/frontiers/orsummaries/ors55.html>
Full report: "Experience from a community-based education program in Burkina Faso: The Tostan program" <http://www.popcouncil.org/pdfs/frontiers/FR_FinalReports/BurkinaFaso_FGC.pdf>
Other publications on research on FGC are available on the Web site at <http://www.popcouncil.org/frontiers/projects_pubs/topics/fgc/fgc_afRI.html> including:
Kenya: Female genital cutting among the Somali of Kenya and management of its complications, 2005; Kenya: Medicalization of female genital cutting among the AbaGusii in Nyanza Province, Kenya, 2004; and Ethiopia and Kenya: Testing the effectiveness of integrating community-based approaches for encouraging abandonment of female genital cutting into CARE's reproductive health programs in Ethiopia and Kenya, 2004.

CARE is very pleased to share the first two working papers in a series of publications the Sexual and Reproductive Health Team will be issuing. They are: Learning by Inquiry: Sexual & Reproductive Health Field Experiences from CARE in Asia (working paper # 1, case studies from three countries examining CARE’s interesting and innovative work, and a brief analysis of some shared themes arising from the work examined) and The IDEAS Model for Demonstration and Replication: An Experience from CARE India (working paper # 2, CARE India's approach to scaling up successful pilot programs, called “Demonstration and Replication,” and describing the five key elements to their approach). The working papers can be downloaded from CARE’s Web site at <http://www.careusa.org/careswork/whatwedo/health/hpub.asp>.

MEASURE DHS (Demographic and Health Surveys) announces several new publications. The Madagascar 2003-2004 Nutrition Chartbook is a compilation of nutrition-related data on children and women based on the DHS survey conducted there. The survey founds that almost half of the children in Madagascar are considered stunted, and that a child’s nutritional status was found to be strongly related to his or her mother’s level of education. Anemia occurrence is extremely high in Madagascar as seven in 10 children age 6-59 months and half the women age 15-49 suffer from some form of anemia. For the entire chartbook, go to: <http://www.measuredhs.com/pubs/pdftoc.cfm?ID=545>. A Focus on Gender: Collected Papers on Gender Using DHS Data presents a collection of six working papers on the dynamics of gender in developing countries. Five of the working papers in this volume focus on the gender questions in the core DHS questionnaire, particularly the questions on household decisionmaking and women’s autonomy and empowerment, and their relationship to different population, health, and nutrition (PHN) outcomes of interest. The last paper examines whether PHN outcomes vary by women’s experience of domestic violence. For the entire report, go to <http://www.measuredhs.com/pubs/pdftoc.cfm?ID=547>. Trends in Demographic, Family Planning, and Health Indicators in Ghana highlights trends in population, family planning, and maternal and child health in Ghana based on DHS surveys conducted between 1988 and 2003. Women now wait longer to have their first birth and the proportion of young women age 15-19 that have had a child or are pregnant with their first child has declined. Current use of any modern contraceptive method has steadily increased for women age 15 to 49, along with their desire to stop childbearing. For the entire report, go to <http://www.measuredhs.com/pubs/details.cfm?ID=544>. Ghana Trend Analysis for Family Planning Services is a new analysis of trends for selected family planning services ndicators in Ghana that shows that, between 1993 and 2002, infrastructure and service availability have improved–almost all facilities now offer family planning services five or more days a week. Sexually transmitted infection service availability at family planning facilities has also increased substantially. However, availability of equipment and materials for client examinations has not changed and less than half of the facilities are fully equipped for family planning examinations. For the entire report, go to: <http://www.measuredhs.com/pubs/details.cfm?ID=479>. Jayapura City Young Adult Reproductive Health Survey reports the results of a survey carried out in Jayapura City, the capital of Papua, Indonesia, where one in four people is between the ages of 15 and 24. The survey was aimed at providing baseline data on issues related to knowledge, attitudes, and behaviors of young unmarried women and men regarding sexual activity, reproductive health, family planning, and HIV/AIDS prevention. Ninety-five percent of the women surveyed and 88% of the men knew about modern contraceptive methods. Nine in 10 respondents said that they would prefer using a modern contraceptive method, preferably supplied by public health sources. However, unmarried people are not eligible to receive contraceptive methods from public health sources, even though 8 percent of women and 23 percent of men openly admit having had sexual intercourse before marriage. For the entire report, go to: <http://www.measuredhs.com/pubs/details.cfm?ID=532>.

The latest issue of Population Briefs, the Population Council's research newsletter, is now available on the Population Council Web site. It includes stories on recently completed studies in Pakistan and Nepal of attitudes and behaviors surrounding violence against women during pregnancy. These investigations were some of the first of their kind in South Asia and suggest a high level of physical abuse during pregnancy. A biomedical story reports that exposure to low levels of phthalates can alter levels of testosterone (the male sex hormone), increase the proliferation of cells in the testes, and significantly accelerate the onset of male puberty in rats. (Phthalates are chemicals used to make plastics-such as those used in food packaging and infant toys-more flexible.) A story from Ghana reports on a new program improvement approach that takes mechanisms that work for individual behavior change and adapts them to bring about policy and program change within institutions. A program providing reproductive health education and livelihoods skills training to adolescent girls in the slums of Allahabad, India, has shown that such interventions are acceptable to parents, feasible to implement, and exert some positive influence on the circumstances of girls. However, investigators found that narrowly focused, short-duration programs may fail to make a broad impact on girls' lives. To access this issue and read any of these stories, please click on the following link:
<http://www.popcouncil.org/publications/popbriefs/pb11(3).html>

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Section Web Site

The Population, Family Planning, and Reproductive Health Section Web site can be accessed at <www.pfprh.org> or at <www.apha.org/sections/sectwww.htm>. Thanks go to Section Council member Larry Finer, who developed the site.

You can find general information about the Section and its leadership; information on our standing committees, Task Forces, Section awards, and listserv; current and past newsletters; links to other sites of interest; Section contact information; and more.

If you have suggestions for further improvements or can help to maintain the Web site, please contact Cynthia Green at <cgreen@cedpa.org>.

Submissions to the Newsletter

Share your news! Let us know about books or papers you have recently published, upcoming conferences you are involved in, or policy or program news that might be of interest to fellow Section members. Perhaps we can abstract an article or include a description of an innovative program. Please send all submissions by Friday, April 21, 2006 to:

Susanna Binzen
Division of Reproductive Health, MS K-35
Centers for Disease Control and Prevention
4770 Buford Highway, NE
Atlanta, GA 30341
Phone: (770) 488-6273
E-mail: SBinzen@cdc.gov