A reproductive health project in Latin America recently received a much-needed boost from the Bill & Melinda Gates Foundation that pledged $5 million to expand family planning and reproductive health services to women, men and adolescents in Brazil, Bolivia and possibly several other countries.
The project, whose principal investigator is Ruth Simmons, professor of public health, aims to improve reproductive health services by training and improving communication among health care workers.
In this part of the world, both women and men have tremendous difficulty in getting access to good contraceptive services and other services related to reproductive health issues, such as menopause, cervical cancer and breast cancer screening, Simmons says. We will be training and networking with other health care professionals and their staffs to make these services available in regions where they previously were weak or non-existent.
The School of Public Health project is a collaboration with the Population Council of Brazil and Reprolatina, a private, non-profit reproductive health organization in southern Brazil.
Simmons and her colleagues, Margarita Diaz of Reprolatina and Juan Diaz of Population Council of Brazil, have introduced and improved reproductive health services in four Brazilian municipalities. Their goal is to expand their work throughout Brazil and other Latin American countries.
The Foundation grant will help fund an interactive Web site to encourage regular communication between health care providers in the participating countries. The Web site will be expanded to all Latin American countries by the fourth year of the five-year project.
The project is based on a model developed by the World Health Organization.
Simmons, a political scientist who specializes in family planning issues in Third World countries, has conducted research in this area for many years. She began her work in India in 1967.
There, Simmons notes, I saw a wide gap between how services were described by policy makers and what actually happens in the villages. I witnessed the difficulties faced by the public sector in organizing services of acceptable quality. I have since had the opportunity to work in other countries and have seen some successes in Bangladesh, Ghana and China, she adds.
Because health care resources are limited in these countries, many caregivers have no other choice but to focus their resources on meeting immediate medical needs, such as prenatal care. Simmons and her colleagues expect the project will have a major impact on the reproductive health status of the poor by:
High levels of unwanted pregnancy, abortion and mortality in Latin America in large measure result from lack of access to good contraceptive services, the project managers wrote in their grant application. Services for adolescents and men typically are not available. Obtaining a family planning appointment even for married women is often so difficult that some women equate it to winning the lottery. Managers and providers in the public sector do not know how to mobilize existing resources to bring about change because they are not in regular contact with each other to learn about strategies that have succeeded elsewhere.