Improving women’s access to reproductive health services | Associate Professor Angela Dawson

I was motivated to work in maternal reproductive health as a result of a personal experience I had when I was in my early twenties I was visiting a family in Rural Malawi and there was great sadness in the household because two of the five children have been stillborn. When I spoke to the mother she told me that she really didn’t want a large family and she was not much older than myself at that stage. When I realised that these deaths could have easily being prevented and that this women had little access to antenatel care or even family planning services, I was pretty much motivated to work in public health. The research I’ve been involved in has led to practical recommendations and policy options to better prepare local and international organisations to deliver sexual and reproductive health services in humanitarian crises and so these crises include things like wars, whether there are epidemics, natural disasters and also complex emergencies where there’s internal conflict and mass displacements of populations and famine or food shortages and also where there’s fragile failing health political and economic kind of systems. So at the Australian level I’ve been involved in impact evaluations of taxpayer funded projects and advise the Australian Government on investment in this area. Internationally these programs have lead to significant change. So for example there’s been 23 policy changes across a number of poor countries where sexual and reproductive health has been integrated into the disaster management and response policies of those countries along side water, sanitation and food. This is really important because what it’s done is prioritise sexual and reproductive health. The evaluations that I’ve been involved in have really contributed to train personnel in the space, so there’s been over four thousand national coordinators trained across the world to respond in crises settings. So in 2015 in Nepal for example these trained people delivered care and services to over 20,000 people across the country and this includes things like caring for pregnant women and their newborns, delivering contraception, preventing gender-based violence and assisting those who are affected by that, and also preventing HIV transmission. I think it’s really important to be strategic about this from the start and think about impact early on. This means that you need to work with a range of people to help create an environment for change. So for example the research needs to not only involve a team with academic researchers but health professionals, consumers, community people and decision-makers across a number of sectors and at a number of levels. So for example the work that we did in Sri Lanka that examined adolescent’s sexual reproductive health highlighted some real gaps in education and information needs of adolescents. So our team comprised of academics and health professionals working in the district as well as teachers, but we also had an advisory panel where we strategically invited key decision makers from the provincial and national education and health ministries so that meant that they were across the findings from the start and that they could advocate for change when they actually returned to to make decisions about policy. So we were fortunate to create a bit of a groundswell that resulted in the development of a quite unique module for training, bringing community midwives and teachers together in their pre-service training. This has lead the implementation of the first training module for community midwives and teachers in their pre-basic education and has resulted in a policy change which has brought the Health and Education Department closer in terms of training of teachers and primary healthcare workers.

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