NFOG activities in FIGO – good to know before the FIGO 2009 Congress

The FIGO 2009 Congress will take place in Cape Town in October. Africa is one of the areas where complications during pregnancy continue to be the leading cause of death and disability for women of reproductive age. During recent years, the Nordic Federation of Societies of Obstetricians and Gynecologists (NFOG) has increased support to programs conducted within the FIGO umbrella to reduce maternal and newborn mortality and morbidity. We would like to give updated information, and call the attention of NFOG members to FIGO and to its activities before the forthcoming world congress of obstetrics and gynecology in Cape Town. The International Federation of Obstetrics and Gynecology, FIGO, was founded in 1954 in Geneva, and currently the federation is composed of 113 member societies, five of them being the Nordic national societies of obstetrics and gynecology. During the past years, a number of members of the Nordic societies have served as officers in the FIGO Executive board or otherwise contributed to different FIGO activities. The executive board is composed of six officers and representatives of 24 member societies. In 1997–2000, professor Markku Seppälä from Finland served as the FIGO President, and currently, Elisabeth Person and Jerker Liljestrand, members of the Swedish Society of Obstetrics and Gynecology (SFOG) are members of the FIGO Executive board. Together with other Nordic colleagues active in FIGO, they have promoted our awareness of the needs and problems of women's health in a global perspective. FIGO has four main committees: Ethics, Gynecologic Oncology, Sexual and Reproductive Rights, and Safe Motherhood and Newborn Health (SMNH). The SMNH project aims to reduce unacceptably high rates of maternal mortality and morbidity, and to improve access to maternal and newborn care in developing countries. The NFOG member societies have participated most actively in the work of SMNH projects. Obstetric emergencies are threatening even in high-standard obstetric units, which is likely to increase the willingness of the Nordic colleagues to help health care personnel in countries where women are still in danger to die during labor and delivery due to lack of access to good quality health care. Two of the eight Millennium Development Goals set by the United Nations are within the mandate of FIGO: Goal 4 to reduce child mortality and Goal 5 to improve maternal health. To achieve these goals, FIGO called on its member societies to submit proposals to improve maternal health. Ten countries: Haiti, Kenya, Kosovo, Moldova, Nigeria, Pakistan, Peru, Uganda, Ukraine, and Uruguay were selected to receive grants over a four-year period to implement their projects. The project teams are led by a part-time project director often supported by a project co-director and researcher. However, with the work largely undertaken by full-time health practitioners, the country projects rely heavily on voluntary work. To establish collaboration between the societies in developed and low-income countries, FIGO started so-called twinning projects. The obstetrics and gynecology society and midwifery association of each project country has been affiliated to a society in a high-income country. A few projects began in 2006 whereas the majority, including also the Nigerian and Pakistani projects began in 2007 (1). The Danish Society of Obstetrics and Gynecology (DSOG) has been affiliated with the Nigerian society, and SFOG is collaborating with the Pakistani society. The programs have been customized according to individual country's needs, but they all aim to improve maternal and newborn health. The aim of the projects in Nigeria and Pakistan is improvement and provision of basic emergency obstetric care. The role of the twinning society is to support the local society, and to provide expert help in implementing the program planned by the local society and coordinated by the FIGO Project Coordinator based in London. The main economical burden is carried by FIGO and the local authorities. NFOG has supported the visits of the Swedish and Danish teams to Pakistan and Nigeria. The difficulties and progress of the Swedish twinning program have been recently reported in AOGS(2). In spite of difficulties like civil unrest, security problems, natural disasters, high staff turnover, and slow acceptance of the project in community, an increase in services was evident between the visits in March 2007 and in June 2008. The SMNH projects will be presented and discussed on Sunday, 4th October at the FIGO 2009 Congress. Attending the congress will give the twinning partners an opportunity to meet and make plans for further development of the projects. Therefore, NFOG supports both the Nigerian and Pakistani project directors, and the participation of two Pakistani and one Nigerian colleagues to attend the FIGO congress. The majority of maternal deaths during pregnancy, delivery or in the six weeks after delivery occur in sub-Saharan Africa or in southern Asia. Our colleagues in these areas are struggling hard to improve maternal and neonatal health. NFOG will continue to support the FIGO twinning projects, a form of support, which is widely accepted and supported by the members of NFOG, and well in accordance with NFOG bye-laws stating ‘work for the improvement of reproductive health all over the world’ as one of the aims of the federation.

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