Sexual and reproductive health of women living with HIV in Egypt: Unmet needs and unfulfilled dreams

The gender profile of the HIV/AIDS epidemic has changed since it emerged 30 years ago when infections were concentrated in key populations of men such as injecting drug users and men who have sex with men. In 2012, women accounted for nearly 50 percent of the estimated 35.3 million people living with HIV/AIDS globally. In the Middle East and North Africa, 44 percent of infected adults are women. The past 30 years have also witnessed remarkable improvements in access to high-quality information and medical services, including services for prevention of mother-to-child transmission of the virus. With care and treatment for HIV/AIDS becoming more accessible, women living with HIV have become healthier, live longer, and make plans for a future that includes parenting. While many programs have focused on preventing mother-to-child transmission, the rights of women living with HIV to fulfill their sexual and reproductive health (SRH) needs have been greatly overlooked. This study explores the SRH needs of women living with HIV in Egypt and identifies the challenges they face in achieving their reproductive goals. The study aims to inform changes to policy and spur new programming that will lead to more comprehensive and compassionate care for women living with HIV

Understanding married women\u27s vulnerability to HIV infection in Egypt: An exploratory study

This study examines the behavioral, sociocultural, economic, programmatic, and legal factors that aggravate Egyptian women’s vulnerabilities to HIV/AIDS. The study concludes that in low-prevalence settings like Egypt, targeted interventions are the most strategic and cost-effective: for example, HIV awareness-raising with a special focus on the preventive role of consistent, correct condom use, and creating a cadre of peers that could provide psychosocial support and HIV counseling to migrant workers. Furthermore, premarital and antenatal care programs should include HIV awareness-raising and provider-initiated counseling and testing after screening of women to identify those at risk for HIV infection. Concurrently, efforts should be made to empower women (e.g., through microloans or vocational training) as well as addressing inequitable gender norms and revisiting legislation and policies that discriminate against women and exacerbate their vulnerability to HIV

Scaling up the provision of family planning messages in antenatal and postpartum services in Upper Egypt

An operations research study by the Population Council’s FRONTIERS program in 20 facilities in Upper Egypt showed that integration of birth spacing messages into antenatal and postpartum care was feasible, acceptable to women and their husbands, and was associated with increased postpartum contraception. This report describes the initial and scale-up phases, their outcomes, challenges, and recommendations for improvement. In addition to successfully scaling up the program, the main achievement was securing the support and investment of senior MoHP officials at the central level, as well as the support and commitment of managers and supervisors at governorate and district levels. The report recommends more assistance to help MoHP adopt and integrate healthy timing and spacing of pregnancy messages in different programs

Seminar on male involvement in reproductive health in Egypt: Summary of research findings and future directions

As more work in the area of male involvement in reproductive health (RH) is expected in Egypt, it is important that researchers and donor agencies become aware of existing studies, topics covered, and main research findings so duplication can be avoided. It is also important that policymakers and program managers learn about the results of existing studies so they can use those results in designing more effective policies to increase male involvement in Egypt. To address this need, the Population Council’s ANE OR/TA Project organized a seminar on “Disseminating Results of Research on Male Involvement in Reproductive Health in Egypt” held on May 4–5, 1998, in Alexandria. Participants included key researchers, program managers, policymakers, and donors. The two-day meeting included plenary sessions as well as discussion groups. The main themes were husband-wife communication and decision-making about FP/RH, perceptions of sexuality, involving men as partners in RH, RH needs of adolescents, and future directions in programs and research to increase male involvement in RH. This report is a summary of the presentations along with comments and suggestions that were made on each topic

Do public health services in Egypt help women exercise their reproductive rights?

These slides present results from a Population Council study conducted in Egypt aimed at identifying factors that prevent Egyptian couples from attainment of their reproductive goals using a rights-based, gender-sensitive analysis of family planning service demand and supply. The analysis focused on six aspects of clients’ rights: clinic/provider readiness, accessibility and affordability, privacy and confidentiality, choice and autonomy, informed decisionmaking, and the right to complain. The presentation concludes with recommendations for closing gaps that exist with regard to protection of clients’ rights to autonomy, choice, informed decisionmaking, privacy, and confidentiality

Important lessons on FGM/C abandonment from four research studies in Egypt

Female genital mutilation/cutting (FGM/C) continues to be a widespread practice in Egypt. According to the 2014 Egypt Demographic and Health Survey, the prevalence of FGM/C was 92 percent among ever-married women aged 15–49. However, Egypt continues to witness a drastic surge in the medicalization of FGM/C, with 74 percent of women aged 19 years and younger circumcised by medical practitioners, compared to 55 percent in 1995. This policy brief provides key results and recommendations of four studies conducted by the Population Council/ Egypt under the Evidence to End FGM/C project, in coordination with Egypt’s National Population Council. The four studies investigated the process through which families reach a decision on FGM/C; study the impact of FGM/C campaigns on the perspectives surrounding the practice; examine the characteristics of abandoners and challenges they face in maintaining their position; and understand the drivers of the medicalization of the practice. The ultimate goal of the studies, conducted between 2016 and 2019, is to assist the National Taskforce for Ending Female Genital Mutilation/Circumcision in developing evidence-based policies and programs to accelerate the abandonment of FGM/C

Critical analysis of interventions against FGC in Egypt

Community-based programs designed to discourage the practice of female genital cutting (FGC) in Egypt started as early as the 1920s, however, NGOs seldom document the implementation, strengths, and weaknesses of each approach; or difficulties faced in implementation or ways of overcoming those difficulties. The present meta-assessment was designed by the Population Council to address these issues. Recommendations proposed to increase the effectiveness of anti-FGC interventions in Egypt include: conducting formative research to assess the needs of individuals/communities; using more participatory learning techniques in awareness-raising seminars and training workshops; focusing messages not only on the health hazards of FGC, but also on the social, religious and legal aspects of the practice; and adding a component on communication methods to training programs for outreach workers and community advocates

Ending the medicalization of female genital mutilation/cutting in Egypt

This policy brief examines the extent of medicalization of female genital mutilation/cutting (FGM/C) in Egypt, the characteristics of girls who were cut by medical personnel, factors that may have contributed to increased medicalization, and potential interventions that could influence both physicians and the public to completely abandon the practice. The data show that younger cohorts of women, those from higher wealth quintiles, higher levels of education, and living in urban regions are more likely to have been cut by medical personnel. More importantly, the analysis shows that despite medicalization being more common among young women with the above-mentioned characteristics, it is in fact prevalent among all groups of young women and in all regions of Egypt. In order to end the practice of FGM/C, interventions must aim to stop physicians from performing FGM/C, while correspondingly aiming to decrease the demand of the public for FGM/C. Additionally, interventions must address underlying cultural and religious norms that perpetuate the practice of FGM/C. The brief includes specific recommendations to address these factors

Maternal and neonatal health services in Sudan: Results of a situation analysis

This project brief is based on the results of a situation analysis (SA) study that was done collaboratively by the Population Council and Sudan Ministry of Health (MOH) with funds from UNFPA, UNICEF, and Packard Foundation. The analysis showed an uneven distribution of reproductive health (RH) staff across Sudan, and nurses and nurse midwives are the key in RH services. There was also limited access to family planning services. Antenatal care was limited, and pregnant women in the study seldom received counseling on birth spacing or birth preparedness. Birth attendants also lacked adequate knowledge and skills. Emergency obstetric care was also lacking in many secondary and tertiary care facilities, which put women suffering from labor complications at greater risk. The situation analysis has pointed to a number of gaps in the availability and quality of maternal and neonatal health services, which contribute to the high levels of maternal and neonatal mortality in Sudan