Boston Evening Transcript, August 13, 1913

The School for Health Officers opened its doors on September 29, 1913, offering a one-year program concluding in award of a “Certificate of Public Health.” Potential applicants were expected to have “pursued satisfactory courses” in French and German, as well as physics, chemistry, and biology, with a medical degree strongly recommended. “Experience teaches that preferment for position and advancement to higher positions come more readily to those who have a medical degree,”

the whole text (455 kb, pdf)
remember: send a message to AH

Health in the Post-2015 Development Agenda

http://www.worldwewant2015.org/health
Welcome! This platform is an open and inclusive consultation space to discuss the role of health in the post 2015 development agenda. We hope that this consultation will draw  a representative cross section of views and start to build consensus in five key areas:  What are the lessons learnt from the health related MDGs?  What is the priority health agenda for the 15 years after 2015?  How does health fit in the post 2015 development agenda? What are the best indicators and targets for health?  And how can country ownership, commitment, capacity and accountability for the goals, targets and indicators be enhanced?

How to participate


Read and comment on background papers and meeting reports

Respond to the call for papers

Participate in online e-discussions

Join in via Twitter using #health2015

Key documents
Outline of proposed process for global thematic consultation on health. September 2012.
UN System Report: Realizing the Future We want for All. July 2012.
Health in the post-2015 UN development agenda: thematic think piece. UNAIDS, UNICEF, UNFPA, WHO. May 2012.



Forwarded by: Marge Berer
Editor, Reproductive Health Matters
E-mail: mberer@rhmjournal.org.uk
Web (RHM): www.rhmjournal.org.uk
Web (Elsevier): www.rhm-elsevier.com

religion and health

look for this site:
http://www.jstor.org/discover/10.2307/1449332?uid=3738320&uid=2&uid=4&sid=21100718975201
http://hpq.sagepub.com/content/7/4/365.short
http://heb.sagepub.com/content/25/6/700.short
http://www.tandfonline.com/doi/abs/10.1207/S15327965PLI1303_04
it is a part of ResearchGate discussion

Sexual Education in Denmark

DFPA launches 5th edition of successful CSE campaign in Danish schools

For the 5th year running the Danish Family Planning Association (DFPA) on Monday launches a national campaign on comprehensive sexuality education (CSE) in Danish primary schools, lower secondary schools and upper secondary schools.

Once again the campaign is reaching record numbers of participants – all in all a total of 186,252 pupils aged from 10 to 19 years are enrolled in the campaign named Uge Sex (Week Sex).

Week Sex targets pupils from 4th to 13th grade in Danish primary and secondary schools. Almost 40 percent of pupils in primary and lower secondary schools in Denmark participate in the campaign in week six from the 6th to the 10th of February.
The purpose of Week Sex is to give teachers the opportunity to access quality CSE materials, which ensure captivating and professional sexuality education. The DFPA produces new materials for both pupils and teachers every year.

This year the title of the campaign is ’Gender really matters’, focusing on the desire, opportunities and right to express your gender on your own terms – without being discriminated.

The Danish minister for Education and Children, Christine Antorini says:
- The DFPA manages the important task of bringing into focus subjects, that can be difficult to talk about and the association has just assisted us in making whole new materials for the teachers. It focuses on the right to be who you are and contributes to the opportunity to teach about sexuality in a very competent way.

When the DFPA launched Week Sex in 2008, 39,000 students were enrolled, and that number has grown steadily over the past five years. In 2005 the DFPA carried out a mapping of CSE in Danish schools, which showed that only 1 in 10 teachers were satisfied with the comprehensive sexuality education they were offering. It showed a lack of knowledge among teachers as well as lack of current CSE materials in the schools.

In 2012 the campaign has grown to consist of:

• 14 different materials targeting both pupils and teachers at different levels of education · A total of 620 pages of material was produced this year. · 
• The target groups are grade 4-6, 7-9, 10-13, different kinds of upper secondary schools (vocational schools, production schools, trade/economic schools, general upper secondary schools) and as well as schools for pupils with disabilities. 
• 3 different websites targeting different age groups. 
• 23 videos with pupils and famous people in Denmark + pupils and LGBT activists Uganda talking about gender issues.
• Events around the country – among these a pre-launch event Thursday at the Danish Parliament where 11 MPs were taught CSE with media present.

2012 is the first year that the DFPA has included international angels to the campaign bringing in the voices of young girls and boys from Uganda on the same issues of gender that the Danish pupils were asked in the videos. Also, an article and two longer videos on LGBT rights and laws in Uganda/Africa/rest of the world are included in the CSE material.
2012 is also the second year that Sex og Politikk in Norway has adapted the campaign material to their own Week Sex campaign reaching a total of almost 37.000 pupils this year.
The Danish campaign also reaches Greenland and the Faroe Islands.

Next year, the campaign will also reach grade 2-3 and the following year grade 0-1.
For further information on Week Sex you are welcome to see further on www.ugesex.dk or to contact our project coordinator Pia Sandra Ernst Psa@sexogsamfund.dk or me.

Kind regards, BJARNE B. CHRISTENSEN Secretary General M +45 2729 0309 | D +45 3369 5609 | bbc@sexogsamfund.dk

Healthcare: Technology is a bigger cost driver than demography

by Julia Belluz on Friday, February 10, 2012 12:34pm (source) 

An aging population—or “gray tsunami”—is the shadow lurking in the background of health care, poised to drive up health-care spending and wipe out the system as we know it. Technology, on the other hand, is a means to improving efficiency in the system and reducing costs. Consider the early, sparkling promises of Obamacare south of the border or electronic health records in Canada. Policymakers trumpet this conventional wisdom—but it isn’t quite right.
As a recent report by the credit rating agency Standard & Poor’s argues, your grandmother’s visits to the doctor aren’t the key driver of health costs. Health technology, however—encompassing anything from drugs to diagnostic imaging—is becoming the great burden on the health systems of G20 countries.
Unlike the graying of the workforce, “These non-demographic factors carry lower long-term visibility on budgetary challenges for policymakers,” S&P notes, warning that if governments of developed economies don’t shift their focus from pension reform to figuring out how to constrain other causes of rising health-care costs, they’ll face “ballooning” debt levels and possible downgrades of their creditworthiness.
As novel and counter-intuitive as it may sound, S&P’s warning isn’t anything new, actually. Despite the popular rhetoric about the “gray tsunami” continually bandied about by politicians, there are some three decades of research showing that aging alone is a marginal and predictable driver of health-care cost increases, in the order of about 0.5 to one per cent per year. Most recently, a report by Canadian Institute for Health Information noted that population aging contributed an annual average growth of only 0.8 per cent.
Politicians, on the other hand, too often neglect to address the drain on public coffers from technology-related costs. According to the CIHI report, spending on prescription drugs grew at an annual average rate of 10.1 per cent between 1998 to 2007—a rise that was caused by both increased utilization and a change in the mix of drug types. Increasing diagnostic testing (lab and imaging) was another big driver. Plus, we’re all using the system more—not just older folks, noted Kimberlyn McGrail, assistant professor at the University of British Columbia. She has studied health care spending and found that “what is driving increasing health-care costs is greater intensity of service use. People of all ages are receiving more and sometimes more expensive services than used to be the case.”
So, we are gobbling up health care, and average health-care costs per head are going up, largely because of the way we use technology, noted McGrail. “There are new drugs and new conditions that they treat, there are new tests that can be done, and new recommendations for who should receive those tests and how often they should be getting them. There are new surgical procedures and better ways of doing older procedures that make surgery better and safer, but also means that a larger pool of people are considered ‘eligible’ to receive those interventions.”
This doesn’t have to be the case, though. Technology can and does save money in health care—when it’s used prudently. As UBC professor and veteran health researcher Morris Barer puts it, “technology in and of itself” is not the problem. “It’s that the uncritical application and use of new and more expensive technology—including drugs—can be a cost driver.”
Now, the big question we need to answer is how much of this increasing use of health care is actually improving our health and quality of life. For example, another area of swelling costs over the years has been physician services. Consider this report out of the Institute for Clinical Evaluative Sciences this week: Payment to Ontario physicians shot up to $8 billion in 2010, more than twice the $3.7 billion it stood at in 1997. (Doctor compensation now accounts for 20 per cent of total health care costs in the province, and Ontario is not alone; according to the CIHI report, physician spending across Canada was among the fastest-growing health categories in recent years, increasing at 6.8 per cent per year between 1998 to 2008.) But, ICES concludes, though we’ve continued to increase doctor pay, we haven’t determined whether this has led to improved patient outcomes or a better health system overall.
This all suggests we can take comfort in the fact that it’s not an unstoppable tsunami that’ll wipe us out. The problems we’re facing are amenable to sound policy responses. Instead of demographic determinism, “The real cost drivers are increased utilization, across all age groups, technology, and labour costs,” explains Canadian health-policy analyst, Marcus Hollander. “We have a policy and management challenge.”
That’s a nice thought, if only it were that simple. Politicking often gets in the way of lucid policy. A recent example was the Ontario Health Minister distancing herself from the suggestion that the province would no longer pay for elective cesarean sections—a reasonable move—after a public uproar. As André Picard, the Globe and Mail‘s health policy columnist, observed, “There was an outcry and the minister quickly backed down. So the province limits itself to delisting trivial things like vitamin D tests.” (All this unfolded on the eve of a report by economist Don Drummond, to be released next week, about how to eliminate the province’s public deficit. The “austerity czar” is expected to recommend drawing down C-sections as a cost-saving measure.)
So, for now, while policymakers promise “evidence-based decisions” to cut spending, they seem to be targeting only certain drivers of cost, possibly the ones they think voters will intuitively understand–like the aging population. “The gray tsunami is used as a distraction,” notes Barer, “and an excuse not to focus on the real sources of cost pressure.” Maybe the possibility of future credit downgrades and European-style austerity, as S&P foreshadows, will push Canadian policymakers in a truly evidence-based direction—and away from the tidal wave of easy rhetoric.
Julia Belluz, associate editor at The Medical Post, writes the Science-ish blog at Macleans.ca. Follow her on Twitter @juliaoftoronto

Gay marriage improves health

Legalising same-sex marriage may create a healthier environment for gay men, say US researchers.

The number of visits by gay men to health clinics dropped significantly after same-sex unions were allowed in the state Massachusetts.
This was regardless of whether the men were in a stable relationship, reported the American Journal of Public Health.
A UK HIV charity said there was a clear link between happiness and health.
Research has already suggested that gay men are more likely to suffer from depression and suicidal thoughts than heterosexual men, and that social exclusion may be partly responsible.
Same-sex marriages are legal in six US states, with Massachusetts the first to allow them in 2003.
Researchers from Columbia University Mailman School of Public Health surveyed the demand for medical and mental health care from 1,211 gay men registered with a particular health clinic in the 12 months prior to the change, and the 12 months afterwards.
They found a 13% drop in healthcare visits after the law was enacted.
There was a reduction in blood pressure problems, depression and "adjustment disorders", which the authors claimed could be the result of reduced stress.
Lesbian women were not included in the study as there were insufficient numbers to give a statistically meaningful result.
Dr Mark Hatzenbuehler, who led the study, said: "Our results suggest that removing these barriers improves the health of gay and bisexual men
"Marriage equality may produce broad public health benefits by reducing the occurrence of stress-related health conditions."
A spokesman for the Terrence Higgins Trust, a UK-based sexual health and HIV charity, said: "There is a known link between health and happiness.
"It's no surprise that people who are treated as second class citizens tend to have low self esteem, which in turn makes them more likely to take risks.
"Whether this is drugs, alcohol abuse, or unsafe sex, treating gay men unequally has lasting repercussions for their health."
Source: BBC News Online, 16 December 2011

HIV and RSHR

New Study Highlights Successful Health Interventions for Women Living with HIV
Existing Interventions Meet Sexual and Reproductive Health Needs
Washington, D.C. – What Works to Meet the Sexual and Reproductive Health Needs of Women Living with HIV, published in the latest issue of the Journal of the International AIDS Society,shows that much can be done now to operationalize evidence-based effective interventions to meet the sexual and reproductive health needs of women living with HIV.

The study draws on 35 evaluations of eight general interventions from 15 countries and multi-country reviews. While gaps in programming and research remain, the article shows that successful and promising interventions include:

• Providing contraceptives and family planning counseling as part of HIV services;
• Ensuring early postpartum visits providing family planning and HIV information and services;
• Providing youth-friendly services;
• Supporting information and skills building;
• Supporting disclosure;
• Providing cervical cancer screening;
• Promoting condom use for dual protection against pregnancy and HIV; and
• Providing anti-retrovirals, which can increase protective behaviors including condom use. 

It is also critical that both health providers and women receive the most up-to-date clinical information on the safety of family planning methods for HIV-positive women.  In January 2012, the World Health Organization will review the evidence to address the questions that have arisen over the years about the safety of hormonal contraceptives for women living with HIV.

As a sexually transmitted infection, HIV is inextricably linked with sexual and reproductive health. Women living with HIV, as well as HIV-negative women, benefit from interventions that give them control over their reproductive lives and reduce unintended pregnancy, HIV transmission and mortality and morbidity. Too often, discussions of sexual and reproductive health services for women living with HIV revolve around controlling fertility and ignore HIV-positive women’s needs for services that include attention to safe and healthy sexuality and a desire for children.

This article is drawn from What Works for Women & Girls: Evidence for HIV/AIDS Interventions (www.whatworksforwomen.org), a ground-breaking, comprehensive website documenting the evidence for effective HIV interventions for women and girls. 

Medvedev signed a new law on Health Care

arrived from Secretariat@epfweb.org

Last week, on 22 November, the President of the Russian Federation, Dmitriy Medvedev, signed a draft law that will have a series of implications on Russian women’s access to SRHR, both positive and negative. "Basics of the protection of the health of the citizens of Russian Federation," as the law is entitled, went through three readings in the State Duma (lower house of Parliament) and was the subject of wide debate in Russian society with interventions from the Orthodox Church, civil society and academia, and was heavily criticized by the Head of the National Medical Chamber of the Russian Federation, Mr. Leonid Roshal. For its final reading, more than 300 amendments were presented, 109 of which were adopted.

The new law will affect Russian women’s sexual and reproductive health and rights in three ways:

1. Access to abortion:

First, as regards access to abortion, Article 56 § 3 of the new law introduces a new "silence period", ie. a mandatory waiting period before performing an abortion. According to the article 55 § 3, abortions conducted on a woman's request within first 12 weeks of pregnancy will require a waiting period of 48 hours in the case of pregnancy in the 4th-7th week or 11^th-12^th weeks, but not later than end of 12th week of pregnancy and with waiting period of 7 days in the case of the pregnancy of 8-9th weeks. The law also sets the provision for obtaining an abortion in Art 56 § 4 that reads: "Abortion is conducted on social grounds until 22 weeks of pregnancy and in case of medical need, irrespective of the duration of pregnancy” (social grounds are set by the Government of the Russian Federation).

2. Conscientious Objection of abortion providers

Additionally the law introduced the possibility of conscientious objection in the article 70 § 3 that states "the treating doctor in agreement with the relevant official (head) of the medical organisation (division of medical organisation) may refuse to follow the patient or his treatment and also inform in written form about this refusal to conduct an abortion if this refusal does not directly threaten the life of patient and the health of those around him. In the case of refusal of the treating doctor to follow and treat the patient and in the case of notice in written form about the refusal to conduct an abortion, the official (head) of the medical organisation (division of medical organisation) must organise a replacement of the treating doctor.”

3. Family Planning services

Regarding family planning, the law guarantees free family planning consultations (Art 51 § 1); free medical assistance during pregnancy, during delivery and post-pregnancy (Art 52 § 2); provision of nutrition for pregnant women and breastfeeding mothers as well as children under 3 years old including through special nutrition delivery "points" (art 52 § 3), sets rules for assisted reproduction (Art 55). The law overall guarantees free medical assistance, allows the patient to choose the doctor and medical institution (once a year) as well as sets out unified standards of delivering medical assistance on the entire territory of the Russian Federation.

According to unofficial sources, only Members of the Unified Russia (ruling party) voted for the law (306 in favour, 123 against) in the State Duma. We are trying to clarify this with the Duma officials. 

Many thanks to the colleagues at Russian Association on Population and Development and Centre for Reproductive Rights for providing necessary information.

For those interested, more information is available in the links provided below and in the document attached:

• Federal Council Website: Law was adopted by the Federal Council on the 9th November
  http://asozd2.duma.gov.ru/main.nsf/%28Spravka%29?OpenAgent&RN=534829-5&02
• Federal Council Statement - decides to approve the law, the law is enacted as of 9 Nov :
  http://asozd2.duma.gov.ru/work/dz.nsf/ByID/9DBE72E110F249CAC3257943004EB952/$File/54043708-54046798.doc?OpenElement
• Duma website: http://www.duma.gov.ru/news/273/107861/
• Minutes of the Duma sitting:
  http://asozd2.duma.gov.ru/work/id.nsf/SGDProt/E947819B3C0EDBEEC325793B002E48FA/$File/Sovet309%D1%88.doc?OpenElement 
  (informs about the decision to forward the law to the Federal Council, lists who was present at the Duma meeting, but does not provide voting results)
• Kremlin: President Medvedev signs the law
  http://kremlin.ru/news/13612

Russian Church participation in health care

case of hospital # 71 in Moscow

no other participation detected

Why it is so popular?

1/4 births in Britain today is now carried out by caesarean, a major operation which costs the NHS thousands of pounds a time.

The rate has more than doubled since 1980, and some research suggests their growing popularity has been driven partly by more affluent mothers demanding them - those who critics say are "too posh to push".

Many obstetricians consider the rate to be too high.