Tag: women's health

Merck Foundation Wins Most Influential NGO of 2024 for Efforts Shaping Africa’s Future

Photo by Hush Naidoo on Unsplash

Merck Foundation, the philanthropic arm of Merck KGaA Germany has been awarded as the “NGO of the Year 2024”, the Most Influential NGO Shaping Africa’s Future and Leading Community Empowerment, by Avance Media, a leading rating and voting firm in Africa.

On receiving the accolade, Senator, Dr. Rasha Kelej, CEO of Merck Foundation and One of 100 Most Influential Africans for five consecutive years – from 2019 till 2023 expressed, “I am thrilled and proud to share that Merck Foundation has been voted as the “NGO OF THE YEAR 2024”, out of the list of 10 NGOs Leading Community Empowerment in Africa, shortlisted by Avance Media, big thanks for everyone who voted for us, we would not have been able to make it without your support and trust in Merck Foundation’s significant role in shaping the future of African communities.”

Winning the “NGO of the Year 2024 ” as per people’s votes acknowledged their collective efforts in shaping Africa’s future through key sectors such as health, education, and economic empowerment.

“This recognition inspires me and my team to continue our mission to transform the patient care landscape, drive cultural change, support girls’ education, empower women, and break the stigma around infertility in Africa and beyond. We are committed to contributing to improving lives of the people.” Dr. Rasha Kelej added.

Merck Foundation was initially announced as one of 10 Most Influential NGOs Shaping Africa’s Future, along with other leading NGOs working in Africa like Save the Children, Plan International, Doctors without Borders, Africa Women’s Development Fun, African Medical & Research Foundation, and others. Merck Foundation was then voted for as the NGO of the Year 2024, out of the 10 NGOs listed.

Since 2012, Merck Foundation, together with their Ambassadors, the First Ladies of Africa, and Partners like Ministries of Health, Gender, Education, and Communication, continues to transform patient care across Africa and bring cultural shift with regards to a wide range of social and health issues, including breaking the stigma around infertility, supporting girls’ education, ending child marriage and FGM, stopping gender-based violence, and raising awareness about diabetes and hypertension.

“I am happy to share that we have provided more than 2080 scholarships to young doctors from 52 countries, in 44 underserved medical specialties. Many of our Merck Foundation Alumni are becoming the first specialists in their countries. Together, we continue to make history,” Dr. Kelej added.

The scholarships of one year, two year and three year fellowship, diploma and master course have been provided in 44 underserved medical specialties like Oncology, Diabetes, Cardiology, Endocrinology, Respiratory, Acute Medicine, Sexual and Reproductive medicine, Embryology, Respiratory, Critical care, Psychiatry, General Surgery, Dermatology, Emergency and Resuscitation Medicine, Gastroenterology, Neuroimaging for Research, Pain Management, Neonatal Medicine, Clinical Microbiology & Infectious Diseases, Advanced Surgical Practice and more.

Through their “More Than a Mother” campaign which is a strong movement that aims to empower infertile and childless women through access to information, education and change of mindset, Merck Foundation has been building quality and equitable reproductive and fertility care capacity, breaking infertility stigma and raising awareness about Infertility Prevention and Male Infertility.

“I am happy that we are contributing to building and advancing fertility care capacity in Africa and improving better access to women’s health. I am very proud to share that we have provided till today more than 650 scholarships of Embryology, Fertility and Reproductive care to young doctors from 39 different countries. Moreover, we also support childless women by helping them start their own small businesses. It is all about giving every woman the respect and support she deserves to lead a fulfilling life, with or without a child”, Senator, Rasha Kelej explained.

Moreover, Merck Foundation strongly believe that Education is one of the most critical areas of women empowerment. Therefore, through their “Educating Linda”, Merck Foundation contributes to the future of young African girls who are brilliant but underprivileged, by providing more than 700 scholarships, to cover their school  fees till they graduate, and thousands of school items to schoolgirls in many African countries including Botswana, Burundi, Malawi, Ghana, The Gambia, Nigeria, Zambia, Zimbabwe, Ghana, Namibia, Democratic Republic of the Congo, Niger and more.

I am happy that we are contributing to building and advancing fertility care capacity in Africa and improving better access to women’s health

Dr. Rasha Kelej

Additionally, Merck Foundation has been raising awareness about many critical social issues including breaking infertility stigma, supporting girl education, women empowerment, ending FGM & child marriage, stopping GBV and important health issues like Diabetes & Hypertension prevention, early detection & Management; promoting healthy lifestyle; infertility awareness & management and more. Merck Foundation has introduced many unique and innovative ways like Songs, Animation Films, Children Storybooks, Health Media Trainings, “Our Africa” TV Program, Awards for Media, Filmmakers, Fashion Designers and Musicians and more.

Source: Merck Foundation

Premenstrual Anxiety, Mood Swings Amount to a Public Health Issue

Photo by Sora Shimazaki on Pexels

With more than 64% of women suffering from premenstrual mood swings and anxiety, they represent a “key public health issue globally,” according to a new study in Archives of Women’s Mental Health.

The UVA Health study found that most women have premenstrual symptoms every menstrual cycle, with one of the most common symptoms, regardless of age, being mood swings or anxiety. At least 61% of women in all age groups surveyed reported mood-related symptoms every menstrual cycle, which the researchers say suggests “that premenstrual mood symptoms are a key public health issue globally.”

“Our study demonstrates that premenstrual mood symptoms are incredibly common worldwide,” said senior author Jennifer L Payne, MD. “More important, a majority of women reported that their premenstrual symptoms interfered with their everyday life at least some of the time.”

Better understanding premenstrual symptoms

To better understand the type of premenstrual symptoms women experience and how those symptoms affect their daily lives, the researchers analysed more than 238 000 survey responses from women ages 18–55 from 140 countries on the Flo app, which helps women track their menstrual cycle or track their mood or physical symptoms during and after pregnancy.

Food cravings topped the most common symptoms (85.28%), followed by mood swings or anxiety (64.18%) and fatigue (57.3%). Among the study respondents, 28.61% said their premenstrual symptoms interfered with their everyday life during every menstrual cycle, while an additional 34.84% said their premenstrual symptoms interfered with their everyday life sometimes.

“The incidence of reported premenstrual mood and anxiety symptoms varied significantly by country from a low of 35.1% in Congo to a high of 68.6% in Egypt,” Payne said. “Understanding whether differences in biology or culture underlie the country level rates will be an important future research direction.”

A group of symptoms — absentmindedness, low libido, sleep changes, gastrointestinal symptoms, weight gain, headaches, sweating or hot flashes, fatigue, hair changes, rashes and swelling — was significantly more frequent among older survey respondents, the researchers found. The increase in physical symptoms among older survey respondents “makes sense,” the researchers said, as many of these symptoms are associated with perimenopause, a transition period to menopause marked by irregular menstrual cycles.

Payne is hopeful that this survey data will help women get better care by making healthcare providers more aware of the frequency of these symptoms, especially anxiety and mood-related symptoms.

“There are a number of treatment strategies that are available to treat premenstrual symptoms that interfere with a woman’s every day functioning,” she said. “Increasing awareness of how common these symptoms are, and that if they impact functioning that there are treatments available, will help women improve their quality of life.”

Source: University of Virginia Health System

Abortion Behind Bars: Women in Prisons Have Extra Obstacles to Overcome

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Writing for GroundUp, Rebecca Gore lays out the challenges of access to abortion for women in South Africa’s prisons.

As the legal researcher to Justice Edwin Cameron, head of the Judicial Inspectorate for Correctional Services (JICS), I’ve visited several women’s prisons. A recent encounter with a nurse in a big overcrowded prison was a poignant reminder of the challenges women in prisons experience, especially when it comes to exercising their sexual and reproductive rights.

Cramped in her consulting rooms, the nurse shut the door to talk to me. Outside, weary inmates sighed and waited in line. We discussed how JICS might try to resolve various issues, from mental health to how regularly doctors visit.

On abortions, the nurse’s eyes sparked with alarm. She told me of a perplexing problem she is faced with when an inmate requests an abortion. Is it enough to notify the head of the prison (or area commissioner) – or must she seek their prior approval?

For her, the healthcare policy is unclear. With pressure from her superiors and rumours about another nurse being reprimanded for not obtaining prior approval, she opts for the more constrictive process.

When I raised the issue with the head of the prison, she pointed out a gap in the Correctional Services Act 111 of 1998.

As a result, the prison has developed its own policy. If the inmate is above 18 years

  • they put their request for an abortion in writing;
  • the nurse facilitates the arrangements; and
  • the head of the prison and area commissioner are merely informed (so that they are aware of the inmates’ movements).

The head of the prison assured me that the Department of Correctional Services does not intervene. She said it is important to ensure the woman is not a minor and to have the request in writing as it shields the department from potential litigation.

Distressed by this interaction, I had to dig deeper.

There are no easily accessible statistics on abortions in South African prisons. But we do know that women comprise less than 3% of the entire prison population. Lillian Artz and Britta Rotmann have found that women prisoners are “among the most socially and economically vulnerable members” of our society. Their imprisonment has “obvious deleterious effects on both children and the remaining family members charged with childcare responsibilities.”

The Choice on Termination of Pregnancy Act

The lodestar for all women seeking abortions in South Africa is the Choice on Termination of Pregnancy Act 92 of 1996. The Preamble recognises “the decision to have children is fundamental to a woman’s physical, psychological and social health” and that the state shoulders the duty to provide reproductive healthcare.

The Act provides that a woman can request an abortion during the first 12 weeks of the gestation period without any constraints. A medical practitioner must be consulted from 13 to 20 weeks to identify risks such as an ongoing pregnancy that may “significantly affect the social or economic circumstances of the woman”, and after 20 weeks, when life and injury-threatening risks are present. While a minor must be advised to consult with her loved ones, she cannot be denied an abortion if she chooses not to.

The policies pertaining to women in prisons are markedly different.

The Correctional Services Act is silent on abortions. But the Department’s Regulations (last amended in 2012) provide that the “National Commissioner may approve an abortion at state expense” – though only in particular circumstances. Strikingly, these do not include when a woman requests an abortion during the first 12 weeks. And they do not extend to women seeking abortions on purely socio-economic grounds.

Unsettling questions

Unsettling questions spring to mind: Why can women prisoners not request an abortion during the first 12 weeks? Why are socio-economic grounds for abortion neglected when socio-economic issues are generally more acute behind bars? Most pressing, how can the deeply personal choice of whether to have an abortion be at the discretion of the National Commissioner?

To complicate matters further, the latest B-Orders – detailed rules the department issues – do not mention abortions. Yet, the older set states under “Women’s reproductive health” that the services rendered include “termination of pregnancy”. No further details. However, the department’s “Health Care Policy and Procedures” provide for termination of pregnancy to be “performed at state costs for medical reasons only”. What about the other legitimate reasons that warrant abortions? This is rights-throttling.

To be clear: Women imprisoned in South Africa do not have the same standard of care when it comes to accessing abortions. They have extra obstacles to overcome. And without clearly outlined and implemented policies, there is room for misuse and, worse, abuse.

More concerns crop up: Does the “equivalence of care” principle not extend to the sexual and reproductive healthcare of women prisoners? Have female inmates been overlooked in the fight for reproductive justice?

Laws and reality

The right to a woman’s bodily autonomy is a burning issue across the world. The recent exposure of a draft majority opinion from the US Supreme Court revealed a sharp repudiation of the right to abortion.

Fortunately for us, in democratic South Africa, the right to abortion is not a lightning rod for the political elite.

The Bill of Rights gives everyone the right of access to healthcare services. Critically, this includes reproductive healthcare. And is further buttressed by the right to bodily and psychological integrity, which expressly includes the right to “make decisions concerning reproduction”.

South Africa has ratified international and regional treaties, including the Maputo Protocol, that explicitly entrench the right to abortion.

Yet, there is a disturbing disparity between laws and reality.

Despite these progressive laws, many women still struggle to access safe abortions at state expense. Instead, some find themselves obliged to turn to illegal, informal and often dangerous means. This has awful consequences, in a country with high levels of sexual and gender-based violence coupled with avoidable maternal deaths.

Hurdles to safe and legal abortions, such as lack of information, stigma, judgmental attitudes and mistreatment by healthcare workers, have been identified by Amnesty International.

These barriers lead to the proliferation of illegal and informal abortion providers and have a brutal and often life-imperilling impact on women from marginalised communities. For instance, a sex worker explained that she would opt for a “backdoor” provider. Why? Because for her, privacy has to trump safety. A recent article in GroundUp revealed how poor treatment and stigma have led to more (sometimes botched) illegal abortions among sex workers.

Equivalence of care

When it comes to prisons, we must remember that by and large prisons are designed with men in mind. It is for this reason that the United Nations Bangkok Rules acknowledges that women prisoners “are one of the vulnerable groups that have specific needs and requirements”, including female-centric healthcare needs. The Rules reaffirm the “equivalence of care” principle – those in prison have a right to the same standard of healthcare as the general public.

When it comes to women prisoners’ access to abortions, the reproductive justice framework is crucial. Researchers from the Black Women’s Health Imperative state that reproductive justice encompasses the “social, political and economic inequalities that affect a woman’s ability to access reproductive health care services”.

According to Rachel Roth, abortions are “deeply personal” and “shaped by the larger political, economic and social context of women’s lives.” In the carceral setting, “[e]very dimension of reproductive justice is negatively affected.” In addition, the Prison Policy Initiative observes that in the US context there are “insurmountable barriers” to accessing abortions behind bars and “people behind bars often have very few – if any – choices and autonomy when it comes to their reproductive health and decisions”.

Political will

With political will, prison policies can be changed so that the law extends abortion rights to these women and guards the exercise of these rights.

JICS is committed to working on this.

But, we need to go further.

We need to ensure that women behind bars know their rights through education and awareness campaigns – and that healthcare workers are well-trained and do not deter or stigmatise abortion seekers.

We must establish independent healthcare in prisons, a point recently raised by Justice Cameron. Without independent healthcare, women prisoners’ access to abortions will be limited by the closed-off and security-focused nature of our prisons. My encounter with the nurse would not have been as frank and candid if a correctional official had been present.

South Africa has a long way to go to guarantee all women and girls access to safe, free and legal abortions with respect for their dignity, privacy, health and bodily integrity. In this fierce battle for reproductive justice, we must break the silence and not perpetuate the invisibility of women and girls behind bars.

Republished from GroundUp under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Gore is legal researcher at the Judicial Inspectorate for Correctional Services.

Views expressed are not necessarily those of GroundUp.

Source: GroundUp

Women are Less Likely to Undergo Critical Heart Surgery

A scientific presentation at the 57th Annual Meeting of The Society of Thoracic Surgeons revealed that women are less likely to have a coronary artery bypass grafting (CABG) using guideline-recommended approaches, possibly resulting in worse post-surgery outcomes.

CABG is a major surgical operation involves bypassing atheromatous blockages in a patient’s coronary arteries with venous or arterial conduits harvested from elsewhere in the patient’s body.

Dr Oliver Jawitz and colleagues from Duke and The Johns Hopkins University School of Medicine used the STS Adult Cardiac Surgery Database (containing records of nearly all CABG procedures done in the US), and identified adult patients from 2011 to 2019 who underwent first-time isolated CABG, along with detailed demographic, clinical and procedural data.

The association between female sex and three different CABG surgical techniques from US and European guidelines was investigated. Grafting of the left internal mammary artery to the left anterior descending artery, complete revascularisation, and multiarterial grafting have been linked to better short and/or long-term outcomes. Despite this, the results indicated that women were 14%-22% less likely than men to undergo CABG procedures with these revascularisation strategies.

“With these findings, we did in fact see less aggressive treatment strategies with women,” said Dr Jawitz. “It is clear that sex disparities exist in all aspects of care for patients with coronary artery disease (CAD), including diagnosis, referral for treatment, and now, in surgical approaches to CABG. We must ensure that female patients undergoing CABG are receiving evidence-based, guideline-concordant techniques.”

The results are in accordance with an overall neglect of heart disease treatment in women. Women are much more likely than men to have non-typical symptoms of heart disease which are also subtler, such as abdominal pain and fatigue, as well as having their own particular set of risk of factors. This is compounded by women being underrepresented in cardiac disease study cohorts.

Women’s health historically focused on mother and child, and breast cancer. As such, the period from symptom onset to diagnosis and treatment is longer, allowing the disease to progress and worsen outcomes. This is also reflected by fewer women being referred for beneficial treatments such as CABG. 


“Delayed diagnosis of CAD in women leads to late initiation of key behavioral and pharmacologic interventions for minimizing heart disease risk, as well as delayed referral for invasive diagnostic and therapeutic procedures, including surgical revascularisation with CABG,” said Dr Jawitz. “This often means that by the time female patients undergo these procedures, they have more severe disease than males, as well as a greater number of comorbidities, which leads to worse outcomes.

“Now that we have identified specific differences in surgical approaches to CABG between females and males, we must further elucidate how these differences result in disparate outcomes such as increased mortality, readmissions, and complications,” he concluded. “These findings will help inform the development of sex-specific guidelines for the diagnosis and management of cardiovascular disease.”

Source: News-Medical.Net

Discovery of New Genetic Targets for Endometriosis Treatment

Endometriosis can be a debilitatingly painful disease which can lead to infertility, and has few treatment options for more severe forms – but new treatment options are unfolding as genetic targets for drugs are discovered.

Jake Reske, a graduate student in the MSU Genetics and Genome Sciences Program, explains: “There haven’t been many successful nonhormonal therapies for this form of endometriosis that have made it to the bedside yet.”

Some severe forms of endometriosis involve a gene called ARID1A. A mutation in this gene triggers “super-enhancer” DNA which in turn allows cells to run rampant and set up outside the uterus, causing great pelvic pain.

The researchers aim to implement a novel treatment, “epigenetic therapy”, to prevent the cells from running rampant. 

“It can seriously impact women’s quality of life and their ability to have a family and work,” said study supervisor Ronald Chandler, an assistant professor of obstetrics, gynaecology and reproductive biology. “It’s not easy to treat, and it can become resistant to hormone therapy. The most clinically impactful thing we found is that targeting super-enhancers might be a new treatment for this deeply invasive form of the disease.”

The compound they used targeted protein called P300, which suppressed the super-enhancers and relieving the effects of the  ARID1A mutation. This could also possibly be applied to other forms of endometriosis. The researchers plan to look for more compounds that can also target the P300 protein.  

Source: News-Medical.Net