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Wud U? Reviewing Barnardos’ App For Reducing The Risk of Sexual Exploitation

4 May, 14 | by shaworth

The Wud U? app was launched last month. The result of a joint project by Barnardos and Microsoft, it’s designed to be an educational tool for young people and professionals who work with them. It’s aimed at helping young people identify behaviours that may put them at risk of sexual exploitation.

Produced after extensive interviews with young people who had been victims of sexual exploitation, the app presents three scenarios, duplicating them from the point of view of male and female protagonists. You can read through the stories and make decisions for the characters, with feedback from the app as to whether these were sensible or not. If you decide to avoid a situation in which sexual exploitation takes place, the app has the character make the other choice, with the caveat that your decision would have been better in retrospect.

The decision to use the same story but reverse the sex of the protagonist is a nice touch, as the lack of standardisation of sexual education in the UK curriculum has lead to criticisms that it remains overly heteronormative, and attempts to be more inclusive have lead to voices of protests from the usual faith groups. By make the app more inclusive, it’s instantly more useful to more young people, which is great.

Visually, the app looks good, with high-quality illustrations in a modern, graphic-novel style; although this comes at a price: the app is 36MB, which is pretty hefty for what it provides, considering that the slick and addictive Candy Crush Saga comes in at 32MB. Although the app is free, it’s worth noting that using PAYG data prices from a main UK provider, the true cost of this app would be £18. Professionals requesting that young people download the app for teaching purpose should suggest that they do so via a WiFi connection.

Criticisms of the app have so far centred around the fact that some older teenagers may find the language of the app patronising. I’m in partial agreement with this; although I do think that simplifying the language keeps it accessible to those with literacy problems, but this comes at a price. I found one particular sentence, where the behaviour of those who exploit young people sexually is described as “clever” to be uncomfortable, as I think this is a word that has positive connotations. “Devious” would have been more appropriate, in my opinion, but this might have been rejected to keep the reading age on target.

Personally, I think there’s a different problem with Wud U? The app never clearly makes the point that the sexual exploitation of young people is wrong, and ultimately that the blame for the exploitation lies in the hands of those who are orchestrating the exploitation. Instead, by focusing entirely on the actions of the victims and extrapolating how their decisions have resulted in the situation in which sexual exploitation has taken place, it seems to place the responsibility of the exploitation on their shoulders. Whether this is intentional or not, and I doubt that an organisation like Barnardos sets out to victim-blame, I think a concession has to be made that sexual crimes don’t exist in a cultural and social vacuum. Last year, Robert Colover was suspended after commenting, during a trial that he was presiding over, that the thirteen year old victim was predatory , and criticisms of the handling of child sexual exploitation in Rochdale highlight that the young people involved were made to feel responsible for being victims of sex crime.

In an ideal world, an app like Wud U? would be no different to the signs in car parks suggesting that you hide your sat-nav to reduce the risk of a break in, but the fundamental difference between those two situations, is that if you report the theft of your sat-nav to the police, you can be sure that it will be taken seriously as theft, and that no one in court that by having a sat nav in the first place, you were in some way inviting the break in.

Wud U? makes little concession to this situation, and as such, I find that it falls short of what it could achieve. At the end of the stories, we never find out what happens to the perpetrators of the exploitation, only that the victims are being supported by Barnardos. By giving this repeated viewpoint that nothing will be done to prevent this happening again, and that the perpetrators will go unpunished, I’m left feeling that the situation is hopeless, which is opposite to the feeling of empowerment that the app is supposed to give me.

IPPF Says World Bank Failing To Commit To Reproductive Health Issues

19 Apr, 14 | by shaworth

A recent report by the International Planned Parenthood Federation (IPPF) criticises the World Bank for failing to increase its commitment to funding projects related to reproductive health. There are 222 million women whose needs for family planning remain unmet, and this figure is projected to increase to 900 million by 2015. The World Bank provides a major source of finance for health projects and services around the world, and so has an in important role to play in improving access to family planning services.

IPPF have produced a scorecare which will track the commitment and progress of the World Bank’s involvement in reproductive health issues. “The scorecard revisited: Monitoring and evaluating implementation of the World Bank’s Reproductive Health Action Plan 2010–2015” reveals that, since the introduction of the Reproductive Health Action Plan in 2010, the original ambitions have not been fully realized.

White Ribbon Alliance champion, Princess Sarah Zeid of Jordan said: “Women and men all over the world tell us that they desperately need ways to space the births of their children, to ensure not only the health and survival of mothers and newborns, but the prosperity of their families and communities. The international community recognizes the critical importance access to contraception plays in advancing equity and development around the world, and we applaud the on-going efforts of governments, organizations and civil society to ensure the rights of all women are realized.”

IPPF Director General, Tewodros Melesse speaking of the need to measure the World Bank’s efforts on reproductive health added: “We have a role to ensure that investment and programming are targeted efficiently and according to the different realities on the ground. Worryingly, our tracking shows that Bank’s new investments towards reproductive health for 2013, declined from 2012, both in absolute terms and as a percentage of the Bank’s total health budget. Reproductive health investments in 2013 made up 7% of the Bank’s total health budget, compared with 24% in 2012. If the Bank does not increase its new commitments to reproductive health in coming years, there is a risk of seeing a downward trend in the Bank’s future funding. This would be detrimental to a country’s ability to strengthen their health systems for people in poverty.”

“The Bank has a vital role to play in creating demand for essential reproductive health services for people. We remain optimistic that the Bank can turn around its performance by increasing the level of their investment in years to come and committing to a new reproductive health strategy from 2015”

Jackson Chekweko, Executive Director, Reproductive Health Uganda, IPPF Member Association said: “We need to see investment. This will ensure continued improvements in reproductive health outcomes on the ground for countries most in need of investment. It will help to accelerate progress on Millennium Development Goal 5, where least progress has thus far been made.”

 

UN Fails To Resolve Action On Ending Discrimation Based On Sexual And Gender Identity

18 Apr, 14 | by shaworth

The UN’s Commission On Population and Development  ended its 47th session in New York last week with the recommendation that the promotion of gender equality, reproductive health and rights are key priorities for sustainable development. The weeklong Commission was convened at the UN headquarters in New York to assess 20 years of progress since the ground-breaking agreements made at the International Conference on Population and Development (ICPD) in Cairo in 1994.

IPPF Director General Tewodros Melesse said “At this critical juncture in the post-2015 process, governments have renewed the commitments made in Cairo in 1994 and since. The right to control one’s fertility and sexuality is fundamental to social and sustainable development and governments have agreed it should be a core part of the next development agenda. Now we need strong leadership from governments to lead us into the next fifteen years.”. The Millennium Development Goals expire in 2015, and the Commission hopes that by integrating these key areas into development policy, that they will keep the human rights of women and girls at the top of the agenda.

Fifty-nine of the represented countries called for action to end discrimination and violence on the basis of sexual orientation and gender identity, and many expressed strong support for advancing sexual rights; however a small, yet vocal group of countries blocked language on sexual rights from the final agreement.

Governments will reconvene in September at the UN General Assembly to renew political support for the actions required to achieve the goals of the ICPD program of action.

 

FSRH launches new Quality Standard for Contraceptive Services.

11 Apr, 14 | by shellraine, e-Media Editor

The Faculty of Sexual and Reproductive Healthcare (FSRH) has published new guidance outlining the standards of contraceptive care that patients in the UK should expect to receive. A Quality Standard for Contraceptive Services, which was launched on Thursday 3rd April at the FRSH’s Annual Scientific Meeting in Belfast, sets out a range of key quality measures and required outcomes for new local authority and NHS commissioners to achieve.

For further information see the Press Release or the full document “A Quality Standard for Contraceptive Services”

 

 

Jaydess

6 Apr, 14 | by shaworth

Intrauterine systems delivering progesterone to the endometrium have been in use in the UK for some time. Most of us will be familiar with Mirena (Bayer), a system containing 52 mg levonorgestrel which can be used for five years. This month, a new intrauterine system was launched: Jaydess®, also produced by Bayer.

Jaydess® measures 28x30x1.55mm, and contains 13.5 mg of levonestrogel. Unlike its predecessor, it is licensed only for contraceptive use at the moment, and needs to be replaced after three years of use; however, it has a narrower insertion tube (3.80mm vs 4.75mm) and a slightly smaller frame, which may be of value in women with a stenosed cervix, or in nulliparous women. In comparison, a Pipelle is 3.1mm in outside diameter. In Bayer’s phase II, single blinded trials, slightly less cervical dilatation was needed for the Jaydess insertion and more women reported no pain on insertion in comparison with Mirena.

For those wishing further information, the product characteristics can be found at the MHRA  webpage.

 

European Society of Contraception Expert Group and Committee Vacancies

4 Apr, 14 | by shellraine, e-Media Editor

If you are interested in taking a more active part in the European Society of Contraception and Reproductive Health, then why not apply for one of these groups or committees?
http://www.escrh.eu/call_for_applications_committees_and_groups

Expert groups are groups of internationally recognized experts in different fields of contraception and reproductive health. Currently established groups:

  • Expert Group on Sexual and reproductive health and education
  • Expert Group on STI
  • Expert Group on Abortion
  • Expert Group on Hormonal contraception
  • Expert Group on Non-hormonal methods of contraception

NOTE:  you must have paid your 2014 subscription before you apply.
Closing date to apply:  1 May 2014

Jo’s Cervical Cancer Trust-new information, surveys and an online app

4 Apr, 14 | by shellraine, e-Media Editor

1.     Surveys: – Costs of cervical cancer and Sex & intimacy after cervical cancer treatment

In an effort to increase cervical screening uptake and reduce cervical cancer incidence Jo’s Cervical Cancer Trust is working to explore the impact that having cervical cancer can have on peoples’ income and wider financial situation, including additional spending, and producing information about sex and intimacy after treatment for cervical cancer.

They are looking for women who have been through a cervical cancer diagnosis to take part in 2 surveys; on the financial impact of cervical cancer; and about long term side effects related to sexuality and sexual function after treatment.

More information can be found on the website: http://www.jostrust.org.uk/support/research/cost-cervical-cancer-survey

2.    New online app created to raise awareness of cervical screening – Put Yourself In The Picture

Annually one in five UK women do not take up their cervical screening invitation and uptake is now on the decline. The Put Yourself In The Picture app aims to get people talking about cervical cancer and encourage women to pledge to attend a cervical screening which could save their life.

Find out more: http://www.jostrust.org.uk/selfie

3.    New information online and printed

 Four new miniature additions to information publications.

These mini fact sheets provide information on: human papillomavirus (HPV), cervical screening, abnormal cervical screening results, and being diagnosed with cervical cancer.

They complement the original mini on cervical cancer – the facts. They are credit card sized and ideal for women to pick up discretely to read when they’re ready.

New Guidance For Young People At Risk

3 Apr, 14 | by shaworth

A joint document designed to help healthcare professionals identify young children who may be at risk of sexual exploitation has been launched today. The project, Spotting The Signs, was funded by the Department of Health and produced by BASHH (the lead professional representative body for those managing STIs and HIV in the UK) and Brook (a charity which provides sexual health services for young people) . The document is a pro-forma, aimed at those working in sexual health services and is designed to be used within existing social and sexual health history frameworks, supporting professionals to engage young people in conversations about their risk of sexual exploitations.

Based on current research and evidence, the document assists professionals in indentifying circumstances and behaviours which be concerning, and reminds us about the dangers of assumptions based on the stereotypes we hold of certain social groups and cultures. The project was developed through consultations with young people.

The proforma was written by Dr Karen Rogstad of BASHH and Georgia Johnston of Brook. Dr Karen Rogstad is a  Consultant in HIV and Sexual Health at Sheffield Teaching Hospitals NHS Foundation Trust, and previously chair of the BASHH Adolescent Special Interest Group “This is the first national proforma to be developed which covers all sexual health providers working with young people, and that has been developed with young people’s input. It is particularly valuable because of the range of services that have evaluated it, including General Practice, and its endorsement by a wide range of organisations.  I hope it will help in identifying those young people who are being exploited as well as those who may be at risk in the future.”

Spotting the Signs is available to download from Brook and BASHH’s websites. It can be used alongside existing Brook guidance documents such as the traffic light toolkit which helps identify behaviours which may be cause for concern.

 


30 Mar, 14 | by shaworth

For those of you following the increasing restrictions on abortion providers and access to abortion in the US, the ongoing events in Texas will not come as much of a surprise. Abortion is a highly politicised issue in the United States, and perhaps nowhere more so than Texas, which has been the location of many abortion-related flashpoints in the last fifty years.

Abortion was legalised in the US in 1973, after the case of Roe vs Wade. Jane Roe was the pseudonym of Norma McCorvey, a Texas resident, who challenged the court for her legal right to terminate her pregnancy. The supreme court of the US voted that this was a private matter for the women seeking abortion, and as such was protected under the 14th amendment of the US constitution, which decrees the right to personal liberty.

After Roe vs Wade, individual states have brought in their own legislation to restrict access to abortion, in some ways reflecting the devolved differences in accessing abortion in the United Kingdom.

In Texas, abortion and politics related to abortion have flared up again recently, as the state government attempts to bring in laws that restrict the workings of clinicians and centres that provide abortions, despite opposition from ACOG and AMA. The restrictions include insistence that the physicians must have admitting privileges to a hospital, and restricts where medication for medical termination of pregnancy can be prescribed.

For pro-choice campaigners, these restrictions appear to be attempts to restrict and criminalise abortion through over-regulation. A third of centres providing termination of pregnancy services will close under the new laws, meaning that some Texas residents will need to travel hundreds of miles in order to procure an abortion.

Not all Texans are in favour of these measures and in June of last year, Senator Wendy Davis undertook an eleven hour filibuster to delay passage of the bill restricting access to abortion. Ultimately, this was unsuccessful; although it appears that Davis will now run for governor in the next election, and it’s likely that this will keep abortion related issues at the frontline of Texan, and American, politics for some time.

In the UK, we can think ourselves lucky that we live in a country with healthcare that’s free at point of access and comparatively liberal access to termination of pregnancy services; however, there is still huge disparity in access to termination of pregnancy in the UK, with abortion in Northern Ireland remaining highly restricted. We in mainland UK might consider our healthcare system to be superior to that of the US, but when we consider that a woman in Texas has more freedom to choose an abortion than her counterpart in Belfast, perhaps we are on very shaky ground indeed.

 

BPAS: Call for Mandatory Fortification of Flour

20 Mar, 14 | by shaworth

The British Pregnancy Advisory Service (BPAS) released a statement yesterday advising that flour in the UK should be fortified with folic acid as a public health measure to reduce the incidence of neural tube defects, such as spina bifida, in developing pregnancies.

 

The UK has one of the highest rates of spina bifida in the EU, and the rate has remained static for thirty years. The effects of the condition vary depending on the defect itself. If the neural tube fails to close, it can result in anencephaly, where the skull and brain do not form: a fatal condition. Other variations of the condition can result in lifelong disability.

 

That folate supplementation reduces the incidence of neural tube defects, but in order to be effective, folate supplementation must be initiated before a women realises that pregnancy has occurred, as the critical period for neural tube defects occurs in the first two weeks, before a missed period occurs. Seven years ago, the Scientific Advisory Committee for nutrition endorsed mandatory flour fortification with folic acid, and this was approved by the chief medical officers. Countries which have already introduced this measure, such as Canada, have already seen a fall in the incidence of neural tube defects.

 

BPAS is a charity that advocates reproductive choice, aiming to reduce the incidence of unwanted pregnancy with the use of contraception and offer the choice to end them with abortion. They treat more than 60,000 men and women each year. Ann Furedi, chief executive of the BPAS, said:

 

“Unplanned pregnancy‘s a fact of life and often a wonderful and welcome surprise, but it‘s unrealistic to expect women to be taking folic acid supplements on the basis that they might conceive. The fortification of flour with folic acid‘s a straightforward public health intervention which could spare hundreds of women every year from the painful decision to end a wanted pregnancy after a diagnosis of a neural tube defect.

 

“Many politicians problematize abortion but show little interest in addressing some of the issues which result in a woman needing to end a pregnancy. Whatever our differences on abortion, we should all be able to unite behind a simple measure with huge benefits. We call on the UK‘s health ministers to make the necessary changes to protect the health of pregnant women and their babies and we urge them to do this as a matter of urgency.”

 

In the meantime, healthcare professionals involved in the provision of family planning and sexual health should be aware of the recommendation for 400mcg of folic acid to be taken preconceptually in low risk women who wish to become pregnant, and that high risk women: women with diabetes, women with a neural tube defect themselves or with a previous affected pregnancy, women with coeliac disease, women with a BMI greater than 35 and women taking folate antagonist drugs such as sodium valproate, should taken 5mg of folic acid whilst attempting to conceive.

 

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