Every individual has the right to decide freely and responsibly – without discrimination, coercion, and violence – the number, spacing, and timing of their children, and to have the information and means to do so, and the right to attain the highest standard of sexual and reproductive health (ICPD 1994). It is impossible to protect and fulfill the very reproductive health and right definition of ICPD 1994 without clinical expertise that provides the highest standard of sexual and reproductive health care and without reproductive health researchers that advocate evidence based reproductive rights. As an institution caring for the ICPD mission, Saint Paul’s Hospital Millennium Medical College department of Obstetrics and Gynecology trained three reproductive health fellows at the highest level. The training is the first of its kind in the region and the graduates will deliver advanced clinical service, training, and lead implementation and policy researches that will impact reproductive health at a national & global level.
The department of Obstetrics and Gynecology, SPHMMC, as mandated by the Academic commission of the college started a Reproductive health fellowship program in 2017 GC. The program goal is to produce physicians who are competent clinicians, trainers, researchers, advocates and leaders in issues related to family planning, comprehensive abortion care and broader reproductive health.
It is a minimum of two years program at the end of which candidates become subspecialists in reproductive health primarily family planning and comprehensive abortion care. The training involves clinical attachments, deductive trainings (seminars and tutorials), attachments abroad, including a one year clerkship at WHO, Geneva (on a competitive basis), attending various local and international relevant conferences, and taking a supervisory role in training of residents, undergraduate medical students and related in-service trainings.
The clinical year training is supervised by experienced professors and sub-specialist from USA medical schools like the University of Michigan and the University of Washington. The first year was clinical training to provide advanced reproductive health care to boost clinical skill, to provide advanced person-centered reproductive care. The Second year is a medical officer rotation at the WHO, Sexual and reproductive health and research department.
Ethiopia has made significant progress over the past decade in sexual and reproductive health. However, there are still many challenges ahead of us. Women still have a high unmet need for RH services. I find the impact of socioeconomic status on access to care very concerning. The current political, social, and economic challenges in different parts of the country are more likely to affect women and children as they are the vulnerable group. The fellowship gave me a unique opportunity to understand we need to have a holistic approach to address the current problems. It is a high time we shift our focus to the quality of care. I feel there are several areas for improvement. These include the policy, the health system we have in place for the implementation of the policy, and the service delivery. Since I didn’t have much experience in working in a non-clinical environment, the experience at WHO was a bit challenging especially at the beginning. Through time I was able to navigate my way in the working environment. The team was also very supportive. In addition, my hands-on experience from the global south was an input. I was able to work on the global aspect of reproductive health. It is evident for me now how countries have similarities but are also different in terms of their health challenges. I was able to see how evidence informs policy and programmatic decisions in different countries and participated in the global guideline development process.
Dr. Ferid Abbas
Ethiopia has made a remarkable improvement in sexual and reproductive health. The change in the legislation which was driven by high abortion related maternal mortality has helped women to have access to safe abortion care. Over the decades, the contraceptive prevalence rate has increased remarkably. Despite so many astonishing achievements, we are still lagging behind in meeting both the national and global goals set by WHO. There are multiple layers of sexual and reproductive health challenges that should be approached systematically. It is my utmost hope and ambition that we will be part of the solution at both policy and implementation level. Our expertise should bring a better day to Ethiopian women to enjoy their reproductive health and rights to the maximum. I got first-hand experience on the global perspective of reproductive health, become part of experts involved in decision making at a global level, and see how decisions are made to help countries ameliorate the health of their society. I’ve also learned the technical aspects of guideline development which is used as global guidance. I also got unique opportunities on global stages to present research findings as well as disseminate WHO guidelines.
Dr. Tesfaye Hurisa
In most developing countries reproductive health services are meant to save a life than providing person centered and right based service. This occurs mostly because of lack of awareness, social and cultural beliefs, restrictive laws, and poor availability of services among others. I am very happy to be among the first cohort of reproductive health subspecialists in Africa with my colleagues, Dr. Ferid and Dr. Tesfaye. It is exciting to be fully on board to provide the highest standard of reproductive health care and advocate reproductive rights. No words can completely capture the joyous feelings in my heart when I think of the WHO experience. It is all about augmenting the ability to balance and coordinate numerous priorities and well-developing problem-solving skills, thinking strategically and flexibly, and the ability to meet deadlines and multi-task in a fast-paced environment and adaptability to changing business needs. Besides, it is enhancing team management skills and the ability to establish and maintain a good working relationship. I lead surveys on research prioritization, conducted systematic reviews, and contributed to evidence synthesis and the WHO guideline developments. I also prepared webinars for WHO guideline dissemination and published various studies in peer-reviewed international journals.
Dr. Lemi Belay
This program was conceived and strongly supported by Prof. Senait Fisseha who is senior advisor to the DG, WHO and international programs director at STBF. We are very grateful to her contribution and continued support. Drs. Jason Bell and Sarah Prager were very instrumental in shaping the program and mentoring the fellows. We are also thankful to Dr. Feiruz Surur, the then department chair, Dr. Abdulfetah Abdulkadir – fellowship director – and the current department chair, Dr. Tadesse Urgie, for their key administrative guidance and leadership of the program. We would also like to acknowledge the other department members and center of excellence for RH (now SPIRHR – St. Paul Institute for Reproductive Health and Rights) team for their contribution to the success of the program.
