Population, Reproductive and Sexual Health
Message From the Chair
Dear PFPRH colleagues,The past few years have been highly challenging
for those of us working in the PFPRH field. At times, virtually all the areas that make up our diverse Section have been under attack. The Global Gag Rule continues to frustrate our efforts to expand integrated international family planning/reproductive health (FP/RH) services. Safe abortion in the United States is increasingly restricted, and Roe v. Wade’s days may be numbered. Comprehensive sex education is increasingly attacked and replaced by abstinence-only approaches. In international settings, the widely known ABC approach to HIV prevention (A for abstinence, B for being faithful, C for condoms) is more and more limited to A and B. International organizations are discouraged from undertaking programs with commercial sex workers, programs that could prevent thousands of new HIV cases every year. “Language police” attempt to restrict use of progressive terms that form the basis of our work. The list goes on and on.
As a result of these trends, we too often find ourselves on the defensive, wondering what restrictions will come next and how they will affect us, rather than focusing our full energies on the vital and worthy goals of our work
. Instead of increasing access to quality FP/RH services, and promoting favorable policies that expand sexual and reproductive rights, sometimes it seems we are struggling just to stay afloat. Then again, as an unknown philosopher once said, a smooth sea never made a skillful mariner.
What do these worrisome trends have in common? Most reflect increasing government intrusion into private sexual and reproductive health issues, and restrictions rather than expansions of individual rights. But it seems to me that an even more worrisome answer is that they all demonstrate, to greater or lesser degrees, a trumping of ideology over science and evidence.
Further, the ideology often comes backed by misinformation—-what I call anti-evidence—-that allows ideological decisions to masquerade as evidence-based.
For example, rather than expand the ABC approach in international programs to ABC+, based on evidence showing that more than A, B, and C is needed to prevent HIV in all common circumstances, ideology forces programs to restrict activities to large A, medium B, and small C. In the worst cases, anti-evidence of dangers associated with condom use are used to scare people from using that method, and the program becomes A-B-no-C. Meanwhile, in the United States, recent evidence from the National Longitudinal Survey of Adolescent Health showed that 88 percent of students who took “virginity pledges” had sex before marriage, and their rates of sexually transmitted infections (STIs) were almost identical to non-pledgers. But this is not likely to diminish proponents’ eagerness to enforce abstinence-only approaches.
Some political leaders may disagree with our causes based on deeply held and reasoned beliefs, but far too many have allowed short-term political interests to prevail over evidence that clearly points in other directions. As a result, worthy approaches and proven best practices are restricted or ended, leading to increased numbers of unintended pregnancies, unsafe abortions, HIV/AIDS cases, and other adverse sexual/ reproductive health outcomes for individuals, families, and the global community.
Given these recent trends and events, it seems to me that the theme for this year’s APHA Annual Meeting—-Evidence-Based Policy and Practice
—-couldn’t occur at a better time. Over the course of history, science and evidence-based practices periodically undergo challenges, but their base of logic generally prevails in the end. The ability to test and replicate findings, the resulting breakthroughs leading to irrefutable gains, and the logic of sound evidence, all should eventually lead to favorable policy decisions and effective programs. I genuinely believe that people throughout this country—-red state or blue—-would support all our FP/RH positions if they had even a fraction of the evidence that we have through our work. In many ways, it is our inability to make supportive evidence more widely known that allows political leaders to be swayed by opposition voices.
Yet even in this environment, there are many things we can do
as PFPRH Section members to counter these trends:Go to APHA… and beyond.
First and foremost, please bring the best of your ideas and research to the APHA Annual Meeting this year. This is a golden opportunity to challenge opposing ideologies and start shifting policies and decisions back toward best practices known to improve health outcomes. It’s also a golden opportunity to challenge our own mindsets, broaden our minds, and present new ideas for programs and approaches to improve sexual and reproductive health. So let’s make it a great turnout in New Orleans, and help give the conference high visibility. I know that Young Mi Kim is well on the way to producing an outstanding program!Share your important findings beyond APHA
as well, through journal articles, presentations, interviews, letters to newspapers, etc. The wider our Section’s research is known, the harder it will be for anti-evidence to refute.Stay informed and become active. Read APHA newsletters and act on their alerts.
APHA advises periodically about specific PFPRH issues, but all APHA positions deserve our support. Many are related to FP/RH, and supporting them can strengthen APHA as a body, increasing its effectiveness when PFPRH issues arise.
Please see Lois Uttley’s report below on her experience as Section representative to the APHA Action Board
. She would love more Section members to become involved with policy and advocacy issues that will further our goals. Become active—-our opponents are, and so should we!Help build our Section leadership.
We will elect new leaders through web-based elections May 13-June 17. Please watch for an announcement from APHA telling you how to vote, and most important, please vote! We have a great slate of candidates. See the complete list of those running in the report of the Nominating Committee below as well as in the most recent edition of The Nation’s Health
Please also take advantage of the Annual Meeting each year to become more active in our Section yourself
. Join a Task Force as a way to stay informed and influence the APHA annual program and policies. Task force leaders always welcome new members at business meetings, usually held on Sunday at the beginning of the week of the conference. See the reports of Task Force Chairs 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.Let us know your ideas.
Please e-mail me <email@example.com
> or other Section leaders with any ideas you have for improved leadership and effectiveness. This can include anything from information requests, information you’d like to share with the Section, and ideas for improved Section visibility or action. There is a tremendous amount of expertise and energy in our Section membership and leaders. I am eager to explore ways to utilize it creatively for the benefit of improved FP/RH.Keep doing good work based on good evidence.
No matter the political climate, we must keep striving for good programs that advance FP/RH, meet people’s needs, and that reflect the best available evidence. We are energized by our own ideology as well, so as good social scientists, we must always listen to our own evidence and be willing to challenge our own ideas. This is how we have continually improved programs through the years, and will continue to do so in the years ahead, and how we will once again eventually shift to a more supportive PFPRH policy environment.
May we find calmer seas ahead someday, and become “skillful mariners” in the meantime! I look forward to seeing you in New Orleans!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: <firstname.lastname@example.org>
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Capitol Hill Rally
On Nov. 9, 2004, during APHA’s 132nd Annual Meeting & Exposition, hundreds of APHA members joined forces to walk Capitol Hill for public health, including a number from our Section. The solidarity and genuine interest expressed by hundreds of members during the rally to walk the Hill for public health was made evident by the fact that together APHA members visited more than 495 congressional offices.
Among those participating from our section were Section Chair Claire Brindis of California and Action Board representative Lois Uttley of New York. They and other Section members were able to express special concern to members of Congress about reproductive health issues, including the failure of the Food and Drug Administration to approve over-the-counter status for Plan B emergency contraception.
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Increasing APHA’s Advocacy Power on Reproductive Health Issues
How can APHA increase its advocacy power in Washington at such a critical time for public health, including reproductive health? The Association’s national Action Board explored this question during a two-day retreat held at APHA headquarters in Washington, D.C., in February 2005. I attended, representing the Population, Family Planning, and Reproductive Health Section.
APHA Executive Director Georges Benjamin, MD, MPH, addressed the Action Board, giving an inspiring talk about how he views APHA as a “sleeping giant”
when it comes to our collective potential to influence national public health policy. He urged the Action Board and APHA staff who were present to work together to make our organization’s voice more powerful in Washington. Key issues for APHA action this year include saving Medicaid
(which is an extremely important source of health insurance coverage for low-income women of reproductive health age) and addressing health disparities
Among the steps that I and other members of the Action Board will be taking to meet Dr. Benjamin’s challenge are these:
1. Reviewing the base of existing APHA policy to identify any gaps in policy or out-of-date policies that need to be updated.
Of special interest to our Section are three policy areas that have been identified in which new policies are being developed or need to be developed:
a. Comprehensive sexuality education in grades K-12.
A proposed policy has been drafted by the HIV/AIDS Section and is moving forward through the APHA policy review process. I contributed suggestions for improvement of the draft policy, acting on behalf of our Section.
b. Policy on mid-to-late-term abortion.
APHA staff have identified this as an area in which little or no policy exists and is asking for development of proposed policy. Anyone interested in working on this can contact me at email@example.com
c. Pharmacist refusals to dispense birth control or emergency contraception, based on religious or moral beliefs.
APHA staff have asked our Section to draft such policy so that the staff will have a clearer policy base from which to take action. I am gathering a working group to begin drafting a proposed policy and will welcome participation by interested Section members. Our goal will be to prepare what is known as a “late-breaker” resolution that could be submitted close to the time of the November APHA Annual Meeting and considered for adoption by the Governing Council during that meeting. Contact me at <firstname.lastname@example.org
> if you would like to work on this.
2. Identifying ways in which new and existing APHA policy can be implemented, both at the national and state level.
APHA has a strong and extensive base of existing policy, and new policies are adopted each year. If you are unfamiliar with our policies, visit the Legislative, Advocacy and Policy section of the APHA Web site at <www.apha.org
>. When issues arise in Congress, APHA staff consult the base of existing policy in determining what position to take. So, getting a policy adopted does matter, and has long-term potential to improve APHA’s ability to take action, even years after the policy is approved. APHA staff are very responsive to suggestions from members, especially those of us on the Action Board. So, if a reproductive health issue has arisen on the national level, and you believe existing APHA policy would allow us to take action, let the APHA staff or me know immediately.
3. Seeking advocacy action by APHA members to help staff in communicating public health concerns to Congress and federal officials.
The APHA advocacy staff is small and can only do so much. They need the help of our members in communicating with federal officials. You can help in the following ways:
a. Join the APHA’s Legislative Advocacy Network.
It’s easy to do. Just go to <www.apha.org/legislative/
> and click on “Join APHA’s Legislative Advocacy Network.” You will begin to receive e-mail alerts from APHA staff on current issues that need our advocacy attention. Please respond to these alerts as quickly and diligently as possible.
b. Keep informed about top health issues before Congress.
For example, you can find out about Medicaid and its importance for reproductive health by visiting APHA’s Medicaid Advocacy Center on the APHA Web site at <www.apha.org/legislative/legislative/medicaid
.htm>. The Medicaid Advocacy Center has a Medicaid Backgrounder for APHA members that includes specific discussion of reproductive health issues. I contributed this information on behalf of our Section.
c. Find out who your Congressional representatives are and contact them on key reproductive health issues.
APHA staff have repeatedly stressed how important it is for APHA members to develop working relationships with their own Congressional representatives. A visit to your Congressperson in his/her district office during Congressional recesses can be a great idea. Let your Congressional representative know you care about reproductive health issues and will be watching his or her votes. Offer to provide background or educational information for your representative on key issues.
d. Participate in APHA rallies and advocacy days in Washington.
A number of PRHFP Section members participated in the rally and advocacy day held in conjunction with last November’s Annual Meeting in Washington.PFPRH Section Gets Representation on Joint Policy Committee
APHA’s Joint Policy Committee is the entity that reviews proposed APHA policy statements and resolutions and works with authors of these statements to ensure that all policy and scientific/medical concerns are properly addressed. The JPC includes representatives from the APHA Action Board, Science Board, and Education Board. This year, Lois Uttley (the Section’s representative to the Action Board) was appointed to the JPC to represent the Action Board. She participated in the JPC’s annual spring policy review session at APHA headquarters in Washington April 19 and 20, 2005. She was further appointed by the JPC to chair one of the public hearings that will be held at this fall’s APHA meeting in New Orleans. She will preside over the public hearing on all proposed policy statements pertaining to “access to care” issues.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>
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Nominations Committee Report
It is almost time to vote for new leaders for our Section. We have an outstanding slate of candidates for Chair, Secretary, Governing Council, and Section Council to help us advance over the next few years. See the complete list of candidates below. Many thanks to all who agreed to run, and good luck to all! Web-based elections will be held May 13-June 17.
Please watch for an announcement from APHA telling you how to vote, and most important, please vote! http://www.apha.org/elections/Chair
(vote for 1):
Margaret E. Green, PhD, MA
Karen Hardee, PhD
Rebecka Lundgren, MPHSecretary
(vote for 1):
Yvette Cuca, MPH, MA
Lawrence B. Finer, PhD
Iris Meltzer, MPH. MAGoverning Council
(vote for 1):
Walter Klausmeier, BA
Lindsay Stewart, MPH
Lois Uttley, MPPSection Council
(vote for 2):
Henry Gabelnick, PhD
Melodie Holden, MPH. MS
Rebecca Warne Peters, MPH
John Santelli, MD. MPH
Hannah Searing, MHS, MAChair 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: <email@example.com>
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From the Hill
Predictions of dire consequences resulting from President Bush being re-elected and Republican control of both houses of Congress prior to the November 2004 election have not materialized—-so far.
As it did during the last four years, however, the Bush administration and its congressional allies are expected to continue their assaults—-legislative and administrative—-to undermine international family planning and reproductive health (FP/RH) programs. Among the trends likely to continue unabated:
- Comprehensive family planning and reproductive health strategies will be undermined, such as by promoting undefined “abstinence-until-marriage” activities in HIV/AIDS prevention efforts and by a generalized attack on risk reduction approaches to public health;
- Attacks on the landmark Programme of Action of the 1995 International Conference on Population and Development, other international agreements, and important international organizations like the UN Population Fund (UNFPA) and even UNICEF will be ramped up;
- More brazen initiatives such as expanding the Global Gag Rule (GGR) to U.S. non-governmental organizations (NGOs) may also be attempted (see <http://www.globalgagrule.org>) as foreshadowed by an impending extension of a requirement that organizations receiving U.S. HIV/AIDS assistance have an official policy opposing the legalization of prostitution and sex trafficking—l-ike the GGR, previously applied only to foreign NGOs—-to U.S. organizations;
- Efforts to divert blocked UNFPA funding to non-FP/RH related programs such as anti-trafficking will persist;
- Scientific data and peer-reviewed studies, available on government Web sites, will continue to be deleted or sanitized to appease narrow political interests; and
- Funding for global health conferences will be withdrawn because of questioning of U.S. policy, and government scientists restricted from attending international meetings with their peers.
Since the last Section newsletter, in addition to the election, a number of important legislative and policy developments have occurred in Washington—-most notably the belated approval of the fiscal year 2005 appropriations bill, the release of the President’s FY 2006 budget request, and skirmishes over the GGR on the Senate floor.
Currently, however, Washington policymakers remain preoccupied with finalizing a FY 2006 budget resolution and completing work on an $81 billion supplemental appropriations bill for the Iraq war and for tsunami relief, as well as intense Senate debate on the use of the filibuster for judicial nominations.Current Year Appropriations
On Dec. 8, 2004, President Bush signed into law a massive $388 billion omnibus appropriations package (H.R. 4818), which contained the foreign operations bill, including FP/RH funding and policy provisions, as well as eight other appropriations bills.
The $19.8 billion FY 2005 foreign operations bill largely maintains the status quo for U.S. international family planning/reproductive health (FP/RH) programs, in terms of both funding levels and policy restrictions. Here is a summary of some of the major FP/RH-related provisions:
- Funding: Total funding of $441 million for FP/RH has been earmarked for FY 2005, to be channeled through the U.S. Agency for International Development, including $375 million from USAID's Child Survival & Health Programs Fund. This funding level, slightly above the $432 million provided in FY 2004 and $16 million more than the President's request, will ultimately be reduced due to an across-the-board cut of 0.83 percent in all non-defense, non-homeland security spending. [After the cuts, total funding will equal $437.3 million, of which $371.9 million is from the CSH account.]
- UNFPA: The legislation provides $34 million for UNFPA, subject to Kemp-Kasten restrictions (which prohibit funding to organizations that are judged to "support or participate in the management of a program of coercive abortion or involuntary sterilization" and that President Bush has used to withhold UNFPA funding for the past three years.) UNFPA is unlikely to receive any of this U.S. contribution in 2005 due to the rejection of a provision added to the Senate bill by Senator Patrick Leahy (D-Vt.) that would have modified the Kemp-Kasten amendment. However, the legislation does include language stipulating that any FY 2005 monies withheld from UNFPA under Kemp-Kasten must be reprogrammed to USAID for FP/RH programs, a significant development because of ongoing attempts by the Bush administration to divert UNFPA contributions to non-FP/RH programs.
- Reprogramming of Blocked FY 2004 UNFPA Contribution: The legislation specifies that only half of the $25 million that has been withheld from UNFPA in FY 2004 will be provided to USAID for FP/RH programs in Congo, Ethiopia, Georgia, Haiti, Kazakhstan, Kenya, Nigeria, Romania, Russia, Rwanda, Tanzania, Uganda, and Ukraine. The other $12.5 million will be diverted to the administration's anti-sex trafficking programs.
- Global Gag Rule: Regrettably, provisions included in the original Senate version of the foreign operations bill that would have overturned the GGR and/or exempted condoms and contraceptives from the GGR were not included in the final agreement.
For the full text of the bill, go to: <http://frwebgate.access.gpo.gov/cgi
-bin/getdoc.cgi?dbname=108_cong_bills& docid=f:h4818enr.txt.pdf>FY 2006 Budget Bilateral Assistance
Under the President’s FY 2006 budget request released in early February, family planning and reproductive health are slated to receive $425 million from all funding sources--the identical request levels recommended by the President last year and for the preceding three years—-of which $346 million is from the Child Survival and Health Programs Fund. The $425 million requested for FP/RH is a part of the $1.251 billion included in the CSH fund to address "critical health and family planning needs worldwide," according to State Department budget documents.
Of the two numbers, the amount from the CSH is the more significant to watch because the USAID Office of Population and Reproductive Health exerts greater control over how the funds are spent. [The difference between the CSH number and the total request from all funding sources is made up by additional funds programmed for FP/RH activities from other accounts such as the Economic Support Fund and assistance provided to Eastern Europe and the former Soviet republics.]
Please click on link below to view table of relevant figures in recent years, for purpose of comparison:
.doc> U.S. Contribution to UNFPA
The major change in the FY 2006 budget request from previous years is the manner in which the UNFPA contribution is handled. This year, the budget request proposes that "up to" $25 million be made available to UNFPA from the CSH fund "if not otherwise prohibited" (e.g. if the Kemp-Kasten prohibition is invoked), rather than funded out of the International Organizations and Programs (IO&P) account, along with all of the voluntary contributions for other UN agencies. In the budget requests for FY 2003, 2004, and 2005, there was no line-item budget allocated specifically for a UNFPA contribution.
By moving the UNFPA contribution to the CSH Fund, USAID will be required to reserve $25 million worth of CSH funds and will not be able to program those funds for other bilateral health activities—most likely those designated for FP/RH—until later in the year when Congress is expected ignore the President's proposal regarding UNFPA and earmark a contribution from the IO&P account. In the meantime, the programmatic difficulties will be compounded by budgetary shortfalls resulting from the significant reduction in the overall request for the CSH fund.Senate Repudiates the Global Gag Rule
On April 5, the Senate adopted a bipartisan Boxer-Snowe amendment repealing the Global Gag Rule during consideration of a combined State Department/foreign assistance authorization bill (S. 600) on a vote of 52 to 46.
Sponsored by Senators Barbara Boxer, (D-Calif.), and Olympia Snowe, (R-Maine), the vote on the amendment was an important reaffirmation of the Senate's opposition to this destructive policy and particularly encouraging given the more conservative makeup of the chamber in the wake of the November 2004 election. Eight Republican Senators voted in favor of the Boxer-Snowe amendment—-Senators Chafee (R-R.I.), Collins (R-Maine), Murkowski (R-Alaska), Smith (R-Ore.), Snowe (R-Maine), Specter (R-Pa.), Stevens (R-Alaska), and Warner (R-Va.)—-and not a single Democrat voted against the amendment. Senators Allard (R-Colo.) and Kennedy (D-Mass.) were absent.
The amendment ensures that U.S. foreign policy is consistent with American values, including medical ethics and practice, as well as free speech. It prevents the imposition of requirements that would be unconstitutional or untenable as a matter of policy here in the United States from being exported as a matter of U.S. foreign policy.
In 2003, the Senate adopted an identical Boxer amendment overturning the GGR. Like the current situation, the amendment was attached to the foreign aid authorization bill. Unfortunately, due to difficulties of getting an authorization through both the House and Senate, the last time such a bill was signed into law was 1985. As in past years, it is unlikely that the foreign aid authorization bill will make it to the President’s desk this year. Consequently, the GGR will likely remain in effect for the remainder of the Bush Administration.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 their Representative and Senators. Please let them know what you think.
Members of APHA are urged 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.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: <firstname.lastname@example.org> (Terri) and <email@example.com> (Craig)Related Files:Bilateral_Assistance_Chart.doc
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TASK FORCE REPORTS
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The APHA Abortion Task Force met during November’s Annual Meeting, with the election results weighing heavily on our minds. Needless to say, at the start of the meeting our mood was grim. And yet the 13 of us in attendance had an energizing, strategy-focused discussion. We started with an overview of the public policy and legislative landscape at the federal, state and international levels. One encouraging note that emerged from the discussion was the report that there are some positive developments in terms of the acceptability of and support for post-abortion care in the Bush administration and at USAID. There was an extensive post-abortion care meeting at APHA earlier in the day.
We then moved on to a discussion of strategies for addressing the challenges ahead
and the role that APHA and APHA members can best play. Given the limited presence of APHA staff and leaders in the public discourse around abortion, we focused on how to leverage our public health and abortion expertise most effectively.
Position statements: 1) We should all remember that APHA has many very strong policy statements on abortion
, and we should use them and refer to them in our own work; 2) Since APHA recently archived some “out-of-date” statements, including abortion related statements, we agreed that reviewing the existing statements to assess if there are any gaps is worthwhile.
Messaging (public health, morality): 1) Given the “morality” theme that emerged from the election exit polls and APHA’s expertise in public health, we should work to develop a few strong talking points on public health and morality as they relate to safe, legal abortion.
The two areas where we focused were a) the disproportionate impact of illegal abortion on various communities, and b) the mortality rates of safe abortion vs. unsafe abortion. 2) Review Bush’s speeches and pull out language that the president uses that is consistent with our positions
and use this for messaging. For instance: We agree with President Bush that health care decisions should be between a patient and their doctor; We agree with President Bush that women should have access to post-abortion care. We don’t agree that women should be exposed to unsafe abortion before they can access that care. 3) We could work to get research into the public discourse re: the impact of coercion (i.e. “informed consent” laws that are actually biased counseling) and an adversarial environment on women. Perhaps frame this as “abortion stigma syndrome” when the public discourse is focused on post-abortion stress syndrome; and b) outcomes for women who were denied abortion and for their children.
We finished with a discussion of the need to look for uncommon coalitions and partnership opportunities, for instance, with organizations that work on foster care and child abuse issues.
At the end of the meeting, we had a list of items that we wanted to work on, including:
- Set up a listserv for the Abortion Task Force.
- Develop the list of abortion-related issues for which we can provide experts and e-mail that list to the Task Force and the Population, Family Planning and Reproductive Health Section listserv so we can fill in the experts.
- Research Bush’s speeches for areas where we agree.
- Review existing APHA policy statements to see if there are gaps and if amendments or additional policy statements are needed.
- Develop a few talking points on abortion related to public health and morality.
- Locate “10 Commonly Asked Questions” document for review.
- Locate research that has been done re: 1) women who were denied abortion and their children, and 2) impact of coercion and adversarial environments on people’s mental health (to draw parallels with the climate around abortion and “informed consent”/biased counseling).
We have set up an Abortion Task Force listserv, but unfortunately we haven’t made much progress moving forward on the other action items we generated at our meeting. If any of them spark your interest, please let us know. And if you’d like to join the listserv, e-mail Laureen Tews, the Abortion Task Force chair, at <firstname.lastname@example.org
>.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: <email@example.com> <firstname.lastname@example.org>
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Adolescent Reproductive Health
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.
The Task Force sponsors or co-sponsors invited scientific sessions on topics of interest to members. Recent discussions at the Annual Meeting have focused on U.S. federal policies which are designed to promote abstinence until marriage and enforcement of statutory rape reporting laws. The Task Force is currently working with the Society for Adolescent Medicine to develop a position statement on abstinence-only programs and policies.
At the 2005 meeting in New Orleans, we plan to provide an update on policy developments in abstinence education and reporting of statutory rape.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: <email@example.com> and
Susan Newcomer DBSB/CPR/NICHD, 6100 Executive Boulevard, Building 61E, Room 8B13, Bethesda, MD 20892-7510 Phone: (301) 496-1174 E-mal: firstname.lastname@example.org
and Iris Meltzer, Children’s Hospital Medical Center of Akron, One Perkins Square, Akron, OH 44308 Phone: (330) 543-8914 E-mail: <email@example.com>
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Management/Sustainability Task Force
The Management and Sustainability Task Force sponsored an exciting panel session at the 2004 Annual Meeting in D.C., “Managing and Sustaining Family Planning and Reproductive Health Programs in the Face of Change: Funding Shifts, Health Reform and Political Swings.” Panelists presented papers on planning for contraceptive security in Latin America and the Caribbean as USAID phases out its contraceptive support, strengthening family planning in a newly decentralized health sector in the Philippines, creative approaches to funding family planning services in Massachusetts in the face of declining state and federal funding, and a review of Mexico's family planning program several years after donor support was withdrawn.
Erica Fishman, a co-chair of the Management and Sustainability Task Force, concluded the panel by presenting the common elements among the presentations that cut across the countries and domestic U.S. and international family planning programs. Similarities included using data to inform key financial and management decisions, understanding client needs and providing programs that respond to them, responding to government funding restrictions, using innovative approaches to continue services as donor or government funding declined, and the need to build collaborations. Many of these themes were echoed by audience members during the question and answer period, with a lively discussion of how best to target donated or subsidized products to lower income groups. Directly following the panel, the Management and Sustainability Task Force held its annual meeting to discuss the upcoming year and potential topics for the next Annual Meeting.
The co-chairs reviewed all the abstracts submitted under management and sustainability for this year’s Annual Meeting in New Orleans. We are excited about the number and quality of abstracts received, and look forward to some informative panel presentations.
For further information, please contact Lisa A. Hare (contact information below).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: <firstname.lastname@example.org>
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: email@example.com
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Sexuality Task Force
The last straw…: Sexuality Task Force Report
Are we just feeling our age, or is it actually becoming unbearable to wake up and read the newspaper every day? Over the past several years, we have started to feel that in addition to Operation Iraqi Freedom and the War on Terror, there is another war – perhaps a bit more metaphorically, but no less a war for that – being waged right here on American soil, right under our very noses, and we would call it… The War on Sex.
Of late, we have seen key skirmishes in this endless war around federal funding for abstinence-only education, wardrobe malfunctions, access to emergency contraception, and minors’ rights to travel across state lines for pregnancy terminations. In some creepy way, even the Terry Schiavo case seems part of the same nefarious project; the underlying object of these thrusts and parries is to deprive us even of the right to say when we are alive or not. Depending on the moment, the forces of evil are flexible in their sometimes simultaneous deployment of discourses in which government must be kept out of people’s intimate lives while at the same time imposing rigid federal guidelines on what can happen in the classroom – or even the bedroom.
We are not given to conspiracy theories (well, maybe just a little), but we have to admit that the last straw came for us when for two years running the Sexuality Task Force was scheduled to meet at 6 a.m. during the APHA Annual Meeting. We had been chugging along nicely up to then, having successfully written a policy proposal on comprehensive sexuality education that was endorsed by APHA’s Governing Council, sponsored a number of well-attended sessions, and gathered at least a dozen people at our annual Task Force meetings at APHA. Now we realize that this was not a decision made by any of our dear friends in the Section leadership, and so we can only conclude that somehow the forces of evil have realized that those who participate in the PFPRH section’s Task Forces are in some ways the Maginot line, the last stand between here and some Handmaiden’s Tale-like future, and so they are trying to keep us from gathering our energies effectively and planning an effective collective response.
We will not, however, be vanquished. All of us who work on all the Task Forces are in our various ways committed to the same underlying project – the rights to reproductive health, to pleasure, to self-determination, to gender equity and, more broadly, to a just and sustainable future, and now more than ever it is critical that we join forces and consider what we can do as a Section, as Task Forces, and as individual public health advocates to keep our agenda moving.
We are looking forward to meeting with renewed vigor this coming November in New Orleans, and hope to have more than a quorum as we pause to consider what is to be done in the days, months, and years ahead. At our Task Force meeting we will be sharing the results from our pilot survey from last year’s Annual Meeting about the Section name, and discussing what those findings suggest about whether and how we should move ahead with the name-change issue. New Orleans, as the center of Sin in the heart of the red south, is a perfect place to sit, sip a hurricane, and ponder our nation’s ambivalence about sexuality. We hope it also the perfect place to begin to craft a Section-wide agenda in response.
See you in The Big Easy!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: <firstname.lastname@example.org>
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: <email@example.com>
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Other Committee and Task Force Information
MEMBERSHIP COMMITTEE Chair, Erica Fishman, Asthma Program Coordinator, Minnesota Department of Health, P.O. Box 9441, Minneapolis, MN 55440-9441 Phone: (612) 676-5213 E-mail: <firstname.lastname@example.org> RESOLUTIONS COMMITTEECo-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: <email@example.com>
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 <firstname.lastname@example.org> Men and Reproductive Health Task ForceHéctor 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: <email@example.com>
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Annual Meeting Program Plans
New Orleans, Louisiana November 5-9, 2005
Preliminary session titles for the scientific sessions to be held at the 2005 Annual Meeting in New Orleans are as follows:Oral Presentations
Abstinence Programs: Policies and Empirical Research Evidence
Access to Safe Abortion Services in the United States
Addressing Safe Abortion
Communication Campaigns and Social Marketing in Reproductive Health
Community Change Models: Preventing Adolescent Pregnancies, STDs, HIV/AIDS
Expanding Contraceptive Choice through Integration and Scaling-up of Newer Family Planning Methods
Funding Family Planning and Reproductive Health Services
Gender-Based Violence: Context, Consequences, and Program Responses
HIV/AIDS Issues in High Prevalence Countries
HIV/AIDS Risk for Married Women
HIV/AIDS: Preventive Interventions to Treatments
IUD: Recent Evidence and Country Efforts to Revitalize the Method
Implementing Best Practices Initiative: A Global Collaboration
Improving and Monitoring Reproductive Health Commodity Security
Improving and Sustaining Reproductive Health Programs for Youth in Developing Countries
Innovative Methodologies to Conduct Behavioral Surveillance of STD Risk Behaviors
Integration of Family Planning & HIV/AIDS Services
Men and Reproductive Health: U.S. and International Experiences and Lessons
Monitoring and Evaluation: Implementing and Evaluating Reproductive Health Programs
Optimal Birth Spacing: Evidence-based Practices
Pharmacy Refusal – Limited Access to Contraceptives in the U.S
Pharmacy Refusals to Dispense Emergency Contraceptives
Post-Abortion Care: Programming for Success
Research and Practices in Maternal and Child Health
Scaling-up of Reproductive Health Programs: Lessons Learned around the World
Sex in the Cities: Sexual Relationships, Communication and Decision Making among African American and Puerto Rican Young Adults
Sexuality and Gender Relations in Cultural Diversity
Tools and Approaches to Financial Sustainability for Reproductive Health Programs
Tools and Strategies for Performance Improvement and QualityPoster Sessions
Abortion: U.S. and International Perspectives
Best Practices and Knowledge Management: Tools, Interventions and Outcomes
Contraceptives: Introducing New Methods and Reinforcing Existing Methods
Emergency Contraceptives: Challenges and Lessons
Factors That Affect the Sexual and Reproductive Health of Young People
HIV/AIDS/STI: Prevention to Care
Issues in Maternal and Perinatal Health
Monitoring and Evaluation: Improving Family Planning and Reproductive Health Services
Reproductive Health for Young People: U.S. and International Viewpoints
Cost-effective Reproductive Health Programs: Challenges and Lessons
Gender, Violence, Male Involvement
Youth, Abortion, Emergency ContraceptionChair-Elect Young-Mi Kim, Center for Communication Programs, 111, Market Place, Suite 310, Baltimore, MD 21202 Phone: (410) 659-6258 E-mail: <firstname.lastname@example.org >
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A remembrance by Dick Grossman:
Many of you knew Penny Satterthwaite, who was a member of our Section. She lived from Feb. 6, 1917, until Feb. 15, 2005 -- 88 years. During that time she did pioneering work on clinical trials of oral contraceptives in Puerto Rico. Later she worked with the Population Council, the Ford Foundation, and UNFPA in several countries.
I first met Penny at APHA meetings, then visited with her in Pennsylvania. She was always warm and friendly, with a wonderful memory for people and events, but very modest about her role in the important work she did. I will miss her.
Penny graduated Magna Cum Laude from Pomona College in 1937, and from the University of California School of Medicine in San Francisco in 1942. She worked in Puerto Rico after finishing her internship, where she met and married William Satterthwaite. The young couple, along with their son David, traveled to rural China in 1947. Here Penny was involved in a UNICEF program to train "barefoot doctors" -- villagers who gave basic medical care to people in their communities. Tragically, William died in 1949; Penny and David returned to the United States in 1951.
Penny and David settled again in Puerto Rico in 1952, where Penny was moved by the poverty and suffering she saw around her -- particularly the plight of women who had more children than they could care for. She became involved in running the first clinical trials on oral contraceptives.
After 15 years in Puerto Rico, Penny lived and worked in other countries (including Thailand, Pakistan, Bangladesh, Mexico and Venezuela) contributing to international family planning programs. Later she worked as a short-term consultant in several other countries.
After retiring from her primary profession as a public health physician, Penny moved to Langhorne, Pennsylvania, where she had a very active life as a volunteer. She served on the boards of several nonprofit organizations, plus acted as a translator for indigent Spanish-speaking patients. Penny received many awards, including the NCIH (now Global Health) International Health Award, and the Women's Health Award of the American Medical Women's Association.
She is survived by her son, David Satterthwaite.
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Join the Section Listserv!
The Population, Family Planning, and Reproductive Health Section has a listserv for its Section members. Join the listserv – and use it! Let other Section members know about:
- the latest developments in our field,
- job postings,
- grants that are available,
- action alerts,
- new projects,
- upcoming conferences,
- releases of new publications,
and any other information you think might be of interest to the Section memberhship.
Here's how to subscribe:
* In the "To" line of the e-mail, type: email@example.com. Note: use lower-case letter "L" and not the number one.
* In the "Subject" line of the e-mail, type . Note: use lower-case letter "L" and not the number one.
* Leave the body of the message blank and send.
Please note that if you signed up for the listserv before it was established at APHA about two years ago, you need to sign up again. If you haven't received any notices from the listserv in recent months, please sign up again. Note that one does not need to be a PFPRH Section member to receive the listserv; it is open to everyone.
To post a message to the listserv, send an e-mail addressed to <firstname.lastname@example.org>.
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From theWorld Health Organization's Department of Reproductive Health and Research
comes the latest edition of WHO's important publication, Medical Eligibility Criteria for Contraceptive Use.
It can be downloaded from: <http://www.who.int/reproductive
-health/publications/RHR_00_2_medical_eligibility_criteria_3rd/index.htm>. This document aims to improve access to quality care in family planning by providing recommendations on medical eligibility criteria for selection and use of contraceptive methods. The document is intended to be used by policy-makers, programme managers, and the scientific community, and aims to assist the preparation of guidelines for service delivery of contraceptives. The document contains guidance on 22 different family planning methods.The Program for Appropriate Technology in Health
announces a new toolkit entitled Resources for Emergency Contraceptive Pill Programming
. This toolkit is intended to help program managers, policy-makers, and donors make emergency contraceptive pills widely available to women in developing countries through reproductive health programs. In most countries of the world, women do not know about ECPs or have easy access to them. The toolkit provides guidance, technical information, and sample materials developed by PATH and other organizations. The toolkit contains ten modules, and can be found on the emergency contraception resources page at <http://www.path.org/resources/ec_resecpprog
-tookit.htm> and can be accessed by clicking on <http://www.path.org/files/RH_ec_toolkit
.pdf>. It is also available on CD-ROM in both English and Spanish. To order a copy of the CD-ROM, please send a message to <email@example.com
The Population Council
announces several new publications on Early Marriage.
Early marriage is a neglected human rights abuse that affects millions of girls worldwide. The Population Council has developed two-page country-specific briefing sheets to inform and draw greater attention to this issue. Briefing sheets are currently available for Ethiopia: <http://www.popcouncil.org/pdfs/briefingsheets/ETHIOPIA
.pdf>, Mali: <http://www.popcouncil.org/pdfs/briefingsheets/MALI
.pdf>, Mozambique: <http://www.popcouncil.org/pdfs/briefingsheets/MOZAMBIQUE
.pdf>, Nigeria: <http://www.popcouncil.org/pdfs/briefingsheets/NIGERIA
.pdf>, and Zambia: <http://www.popcouncil.org/pdfs/briefingsheets/ZAMBIA
.pdf>. There is also a new brief on The Implications of Early Marriage for HIV/AIDS Policy
, based on research by Judith Bruce. Over the next decade in developing countries, more than 100 million girls under the age of 18, "children" as defined by the Convention on the Rights of the Child, will be married. In countries with HIV epidemics, these girls, most of whom live in Africa and Asia, are at substantial risk for HIV/AIDS infection. This brief is based on a background paper prepared for the WHO/UNFPA/Population Council Technical Consultation on Married Adolescents, which brought together experts from the United Nations, donors, and nongovernmental agencies to consider the evidence regarding married adolescent girls' reproductive health, vulnerability to HIV infection, social and economic disadvantage, and rights. This brief is online at <http://www.popcouncil.org/pdfs/CM
.pdf>. The French-language version is now available at <https://www.popcouncil.org/pdfs/EMBFR
is pleased to announce a new resource: Youth-Friendly Services: An Annotated Web-Based Guide to Available Resources.
This guide describes the 14 major existing global resources for building stronger youth-friendly services, with URL links to the available documents. The resources are grouped into advocacy/planning, assessment/implementation, provider training curricula, job aids, and evaluation. The guide is presented in two forms: as a quick, Web-based reference tool and also as a short publication that can be downloaded and used in planning meetings. EngenderHealth, YouthNet/Family Health International, PATH, and the World Health Organization developed this resource.
The Interagency Gender Working Group
announces the Implementation Guide on Reaching Men to Improve Reproductive and Sexual Health for All
. The Implementation Guide captures the programmatic issues discussed at the Reaching Men to Improve Reproductive Health for All international conference held in Dulles, Va., Sept. 15-18, 2003. It provides examples of how to develop, implement, and evaluate reproductive health programs that involve men in ways that promote gender equity and improve health outcomes for men and women. The primary audience for this guide is in-country reproductive health program managers and technical staff of implementing agencies, government, and non-governmental organizations. View (and download) the Web-based version at <http://www.jhuccp.org/igwg/
> or order the CD-ROM at <http://www.hcpartnership.org/Publications/
> (listed at the bottom of the page). The guide was produced for the Interagency Gender Working Group (IGWG) by the Health Communication Partnership (HCP) based at the Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs.
The Alan Guttmacher Institute
has recently released several publications related to Adolescent Sexual and Reproductive Health (including HIV) in Sub-Saharan Africa
. These new publications cover Malawi, Nigeria, Burkina Faso, Uganda and Ghana. In addition, there is also a policy analysis of the role of reproductive health providers in preventing HIV and the costs and benefits of sexual and reproductive health interventions. Please go to <www.guttmacher.org
> to download the publications or order hard copies. These include: Short Summaries:
In Their Own Words: Adolescents’ Views on Sexual and Reproductive Health in Sub-Saharan Africa; Reducing Unintended Pregnancy and Unsafe Abortion in Uganda: Early Childbearing in Nigeria: A Continuing Challenge; Adolescents in Burkina Faso: Sexual and Reproductive Health; Adolescents in Ghana: Sexual and Reproductive Health; Adolescents in Malawi: Sexual and Reproductive Health; Adolescents in Uganda: Sexual and Reproductive Health; Role of Reproductive Health Providers in Preventing HIV; The Benefits of Investing in Sexual and Reproductive Health. Full Reports:
Qualitative Evidence on Adolescent’s Views of Sexual and Reproductive Health in Sub-Saharan Africa; Adolescent Sexual and Reproductive Health in Malawi: A Synthesis of Research Evidence; Adolescent Sexual and Reproductive Health in Uganda: A Synthesis of Research Evidence; Assessing Costs and Benefits of Sexual and Reproductive Health Interventions.Journeyworks Publishing
announces the publication of nine new sexual health pamphlets, available in both English and Spanish, including: How to Say No to Unwanted Sexual Attention; Teaching Your Teen About Sexual Responsibility; 6 Great Things About Abstinence; Birth Control: Share These Questions with Your Partner;
and HIV and STDs: Share These Questions With Your Partner.
Free review copies are available to health professionals and educators by calling (800) 775-1998, sending a fax to (800) 775-5853, visiting the web site at <www.journeyworks.com
>, or writing to Journeyworks Publishing, P.O. Box 8466, Santa Cruz, CA 95061-8466. For information on bulk pricing, call (800) 775-1998; prices start at $16 for 50 pamphlets and $1.95 per poster.
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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 listserve; 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 website, please contact Cynthia Green at <firstname.lastname@example.org
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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 Monday, August 29, 2005
Division of Reproductive Health, MS K-35
Centers for Disease Control and Prevention
4770 Buford Highway, NE
Atlanta, GA 30341
Phone: (860) 232-3262
Fax: (860) 232-6648
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Population, Reproductive and Sexual Health Newsletter Archives