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Geneva, Switzerland, World Health Organization [WHO], 2018. 458 p.Girls and women who have been subjected to female genital mutilation (FGM) need high quality, empathetic and appropriate health care to meet their specific needs. This handbook is for health care providers involved in the care of girls and women who have been subjected to any form of FGM. This includes obstetricians and gynaecologists, surgeons, general medical practitioners, midwives, nurses and other country-specific health professionals. Health-care professionals providing mental health care, and educational and psychosocial support – such as psychiatrists, psychologists, social workers and health educators – will also find this handbook helpful. It includes advice on how to: 1) communicate effectively and sensitively with girls and women who have developed health complications due to FGM; 2) communicate effectively and sensitively with the husbands or partners and family members of those affected; 3) provide quality health care to girls and women who have health problems due to FGM, including immediate and short-term urogynaecological or obstetric complications; 4) provide support to women who have mental health and sexual health complications caused by FGM; 5) make informed decisions on how and when to perform deinfibulation; 6) identify when and where to refer patients who need additional support and care; and 7) work with patients and families to prevent the practice of FGM.
BMC Pregnancy and Childbirth. 2017 Jun 19; 17(1):194.BACKGROUND: WHO proposed the WHO Maternal Near Miss (MNM) tool, classifying women according to several (potentially) life-threatening conditions, to monitor and improve quality of obstetric care. The objective of this study is to analyse merged data of one high- and two low-resource settings where this tool was applied and test whether the tool may be suitable for comparing severe maternal outcome (SMO) between these settings. METHODS: Using three cohort studies that included SMO cases, during two-year time frames in the Netherlands, Tanzania and Malawi we reassessed all SMO cases (as defined by the original studies) with the WHO MNM tool (five disease-, four intervention- and seven organ dysfunction-based criteria). Main outcome measures were prevalence of MNM criteria and case fatality rates (CFR). RESULTS: A total of 3172 women were studied; 2538 (80.0%) from the Netherlands, 248 (7.8%) from Tanzania and 386 (12.2%) from Malawi. Total SMO detection was 2767 (87.2%) for disease-based criteria, 2504 (78.9%) for intervention-based criteria and 1211 (38.2%) for organ dysfunction-based criteria. Including every woman who received >/=1 unit of blood in low-resource settings as life-threatening, as defined by organ dysfunction criteria, led to more equally distributed populations. In one third of all Dutch and Malawian maternal death cases, organ dysfunction criteria could not be identified from medical records. CONCLUSIONS: Applying solely organ dysfunction-based criteria may lead to underreporting of SMO. Therefore, a tool based on defining MNM only upon establishing organ failure is of limited use for comparing settings with varying resources. In low-resource settings, lowering the threshold of transfused units of blood leads to a higher detection rate of MNM. We recommend refined disease-based criteria, accompanied by a limited set of intervention- and organ dysfunction-based criteria to set a measure of severity.
The role of FIGO in women's health and reducing reproductive morbidity and mortality. Special communication.
International Journal of Gynecology and Obstetrics. 2012; 119 Suppl:S3-S5.This special communication discusses the vision, values and mission of FIGO, the role of FIGO in women's health, and FIGO's channels for improving women's health.
[Maternal care in developing countries: recommendations of FIGO] Cuidados maternos nos paises em desenvolvimento --recomendacao da FIGO.
PLANEAMENTO FAMILIAR. 1992 Jul-Sep; (57):6.At the 13th General Assembly of the International Federation of Gynecology and Obstetrics (FIGO), which took place in September 1991, recommendations were formulated concerning the responsibility for maternal care in developing countries. The general recommendations included: to increase the access of women to maternal care by decentralization, and, in order to maximize the use of human resources, to ensure that the staff have the required minimum specialized training with continuous supervision for safe and effective delivery of service. Specific recommendations suggested that, when there is a lack of medical specialists, it is possible to train groups of medical personnel to carry out various functions, including emergency surgical procedures. These functions have to be clearly defined and competencies have to be maintained along with new competencies. FIGO must fund workshops on special techniques for midwives, general practitioners, technicians, and other health workers at the primary and secondary intervention levels. Taking into account the 5 major causes of maternal death, some fundamental practices could prevent and treat these women at the primary health care level: 1) for prolonged labor, its earliest possible diagnosis, its management, and practical guidance; 2) for postpartum hemorrhage, uterine massage, oxytocin, and manual removal of the retained placenta; for puerperal infection, early detection and practical utilization of antibiotics using a list of dosages; 3) for hypertensive cases during pregnancy, early identification and appropriate treatment; 4) for the prevention and management of complications of abortion, making available and acceptable contraceptives in order to prevent undesired pregnancies. The success of these measures depends on the support and participation of the community. Health workers must collect data for the evaluation of maternal care. The implementation of these recommendations requires the cooperation of national societies of gynecologists/obstetricians and associations of midwives and schools of nursing.
SAFE MOTHERHOOD. 1996; (20):10.During a 1994 workshop sponsored by the World Health Organization and the International Federation of Gynaecology and Obstetrics (FIGO), participants discussed 1) women's right to family planning information, education, and services; 2) women's right to a choice of options and to voluntary decisions concerning their health; and 3) the link between women's rights and women's health. Participants noted that obstetricians and gynecologists must expand their role to become women's advocates and must insure that women's rights to informed choice and informed consent are protected. Women should participate as equals in the planning, implementation, and evaluation of policies which affect them so that they can make fully informed decisions. The workshop produced the following recommendations: 1) FIGO should discourage practices that abuse women's rights to information and education on the procedures and treatments they face; 2) adolescents should receive reproductive health information, counseling, and services; 3) obstetricians and gynecologists should be trained in communication and counseling skills; and 4) national societies of obstetricians and gynecologists should encourage the provision of comprehensive reproductive health services, discourage female genital mutilation, and encourage provision of counseling for female victims of violence.