Ibis Organizational Report, 2002-2005

Ibis Reproductive Health

Organization Report 2002–2005

Mission Ibis Reproductive Health aims to. improve women’s reproductive autonomy, choices, and health worldwide.

Abortion Contraception HIV/STI Prevention

Dear Friends: It is with great pleasure that we share with you Ibis Reproductive Health’s first Organization Report, which provides a brief summary of our work from inception through 2005. Charlotte Ellertson, a visionary in our field, started Ibis in 2002. Her death from breast cancer two years later has had a profound impact on all of us, both personally and professionally. The past 18 months have been filled with sadness, but also with a renewed commitment to Charlotte’s vision of a world where women have the information, resources, services, and freedom to make choices about their reproductive lives.

We have recently completed a thorough review of our work to date, identifying priority goals for the next five years in three key program areas: abortion, contraception, and HIV/sexually transmitted infection (STI) prevention. Our work is designed to be centrally relevant to critical reproductive issues of today and the future. We are optimistic about new approaches for preventing HIV and STI; results from the Methods for Improving Reproductive Health in Africa diaphragm trial and ongoing microbicide effectiveness trials could yield tools to dramatically change the course of the HIV epidemic. We have seen a surge of new contraceptive methods on the US market such as the patch, vaginal ring, and levonorgestrelreleasing IUD, and we aim to free these and other methods from unnecessary clinical restrictions. In today’s political climate, we are also proud to include improving access to safe and legal abortion as a major goal.

From the President Kelly Blanchard holds a Master of Science in Population and.

International Health and a Bachelor of Arts degree in social studies. from Harvard University. Prior to joining Ibis Reproductive Health, she was a Fulbright Scholar in Ghana and worked as a Program.

Associate at the Population Council in New York and South Africa, where she managed a growing regional program on reproductive health.

Kelly joined Ibis in 2003 as an Associate and opened our Johannesburg. office. Her most recent research has focused on emergency contraception, medication and surgical abortion, microbicides, and barrier methods. for HIV prevention; she has authored or co-authored over 20 articles. on reproductive health issues in developing countries. Our Board of.

Directors appointed Kelly President of Ibis in November 2004.

We are excited about Ibis’ future. We are a vibrant organization, and it is a pleasure to work with such an excellent and committed group. We are also grateful for the wonderful collaborators and colleagues, researchers and advocates, without whom the work described here would not have been possible. We look forward to continuing to work with you and to developing new and exciting future collaborations. I hope you will enjoy reading about our projects. Please contact us if you would like more information or have comments or questions.

Kelly Blanchard President, Ibis Reproductive Health December 2005

1

Research Area | Abortion Safe, legal abortion is a critical component of women’s reproductive autonomy, and one that is increasingly under attack in the United States and elsewhere. The restrictive political climate reinforces our commitment to this issue. Our work to improve women’s access to safe abortion methods worldwide includes:

Social Science Postdoctoral Fellowship in Abortion and Reproductive Health The Ibis Fellowship supports four fellows to conduct multi-disciplinary social science research on abortion and other reproductive health topics, and to develop as leaders in their fields. The program fosters fellows’ collaborations with advocates and service providers, and fellows provide technical and research assistance to advocacy organizations. Two fellows are based at Ibis in Cambridge and two at the University of California at San Francisco.

Investigating barriers to abortion services in the US, including the willingness of hospital nurses to staff abortion procedures and the impact of restrictive policies on disadvantaged women, particularly Medicaid recipients and incarcerated women.

■

Evaluating the introduction of medication abortion services in the public health sector in South Africa.

■

Jillian Henderson, PhD, MPH focuses on the organization and delivery of women’s health care, particularly access to reproductive health services and the unique barriers to health care experienced by young women.

Examining ways to simplify medication abortion protocols to better serve women in resource-poor settings.

■

Kimala Price, PhD specializes in the politics of language in reproductive policy debates, as well as grassroots organizing around reproductive justice in communities of color.

Bringing together physicians, legal experts, and advocates in Peru and the Caribbean to explore ways to increase access to safe abortion services within existing legal restrictions.

■

Rachel Roth, PhD investigates conflicts between women and the state over reproduction, especially women’s access to abortion and the reproductive and parental rights of women in prison.

Convening meetings of researchers and advocates to improve the quality of social science research on abortion.

■

Amy Schalet, PhD carries out research on sexuality and culture, including perceptions of adolescent sexuality in the US and Holland, and attitudes toward non-marital sexuality and abortion among various US populations.

Creating training materials on medication abortion for health service providers.

■

Launching a comprehensive website providing information about medication abortion in four languages.

■

Abortion.

2

Research Area | Contraception Contraception is vital for women to control their fertility and choose whether and when to have children. We strive to simplify regimens, increase access, and remove logistical barriers to the full range of existing and new contraceptive options. Our work includes:

Middle East and North Africa Program Information on reproductive health in the Middle East and North Africa (MENA) is scarce. Through original social science research, health policy analysis, and the development of culturally and linguistically appropriate educational resources, Ibis strives to improve women’s health and autonomy in the MENA region. We collaborate with academic, nongovernmental, and government institutions in these efforts.

Leading a broad-based coalition of researchers, advocates, and regulatory experts to assess whether oral contraceptives should be available over-the-counter in the US.

■

Expanding access to emergency contraception (EC) by documenting South African pharmacists’ willingness to dispense EC, identifying serious gaps in women’s access to EC after sexual assault in US hospital emergency rooms, and developing an educational website on EC in Arabic.

Highlights of our work include: investigating knowledge, attitudes, and practices about reproductive health and sexuality among college women in Jordan and Tunisia; assessing the reproductive health content of medical education in the MENA region; developing Arabic language materials on emergency contraception and medication abortion; conducting research on the religious permissibility of medication abortion in Islam; and co-sponsoring an international conference on medication abortion with nongovernmental agencies and health policy makers in North Africa.

■

Refuting the unsubstantiated claim that hormonal contraceptives cause cervical cancer, a claim that could result in needless fear and inappropriate discontinuation of this important contraceptive method.

■

Convening expert meetings to discuss research on ways to measure sexual activity and the effectiveness of barrier methods in clinical trials.

■

Cervical Barrier Advancement Society

Marshaling existing evidence and conducting new research to support freer access to contraceptive technologies.

■

Founded in June 2004, the Cervical Barrier Advancement Society (CBAS) aims to increase awareness of cervical barriers as contraceptives and as potential HIV and other sexually transmitted infection prevention methods. CBAS is an international professional networking organization whose members include researchers, advocates, program managers, health care providers, manufacturers, and consumers. CBAS creates educational tools and disseminates information to members and the general public. The CBAS website contains fact sheets, presentations, images of cervical barriers, and research updates: www.cervicalbarriers.org.

Contraception.

3

Research Area | HIV/STI Prevention For biological, social, economic and cultural reasons, women and girls are particularly vulnerable to HIV and other sexually transmitted infections (STI). Women now constitute the majority of new HIV infections worldwide and urgently need prevention methods that they can control.

Through research and policy analysis, we seek to expand women’s options for HIV/STI prevention. Our work includes:

Methods for Improving Reproductive Health in Africa Recent evidence shows that the cervix is highly susceptible to HIV infection. Research is underway to evaluate whether diaphragms, which cover the cervix, can reduce HIV transmission. The Methods for Improving Reproductive Health in Africa (MIRA) trial is a randomized, controlled trial of the effectiveness of the diaphragm and Replens® lubricant gel in preventing HIV and other sexually transmitted infections (STI).

Co-coordinating the Methods for Improving Reproductive Health in Africa (MIRA) trial, which evaluates the effectiveness of the diaphragm and Replens® lubricant gel in preventing HIV/STI transmission.

■

Over 5,000 women in South Africa and Zimbabwe are participating in this trial. They all receive condoms, safer sex counseling, and STI diagnosis and treatment. Half of the participants also receive a diaphragm, gel and counseling on how to use this method. Enrollment began in 2003 and results are expected in 2007.

Conducting qualitative research on diaphragm acceptability among MIRA trial participants.

■

Leading the Cervical Barrier Advancement Society (CBAS), which promotes cervical barriers as contraceptives and as potential HIV/STI prevention methods (see page 3).

■

The MIRA trial is led by researchers at the University of California at San Francisco. In addition to Ibis Reproductive Health, collaborating institutions include the University of Zimbabwe, the Perinatal HIV Research Unit, and the South African Medical Research Council.

Evaluating health care providers’ perceptions of the diaphragm and their willingness to recommend diaphragms for contraception and potentially for HIV/STI prevention.

■

Ibis Reproductive Health leads the social science component and policy and advocacy efforts associated with the MIRA trial. The social science component asks women about their experiences using the diaphragm and as trial participants. It also investigates their partners’ attitudes toward diaphragm and gel use. In its policy and advocacy work, Ibis collaborates with the MIRA partners and other experts in the field to raise awareness of cervical barrier methods among researchers and policymakers, and to support increased research on these methods.

Developing a “smart diaphragm” that will measure women’s exposure to semen using a miniaturized sensing system in order to validate women’s self-reported diaphragm use.

■

HIV/STI

Prevention 4

Dr. Charlotte Ellertson was a brilliant thinker and fearless leader.

She founded Ibis Reproductive Health in 2002 with the vision of a dynamic organization that could bridge academic research and women’s immediate health needs. In its first three years, Ibis grew from three people in an unheated church basement to a staff of over 20 working in Cambridge, San Francisco, and Johannesburg. Ibis’ swift growth reflected Charlotte’s energy, bold ideas, and stature in the field.

During the course of her career, Charlotte published over 100 journal articles, book chapters, and commissioned reports, with a special focus on emergency contraception and medication abortion. She was instrumental in achieving the regulatory, clinical, and policy changes that made these methods more widely available to women around the world. Her professional experience included seven years at the Population Council, the final four as Director of Reproductive Health for Latin America and the Caribbean in Mexico City. Charlotte held a Masters in Public Affairs and PhD in Demography from Princeton University.

Our Inspiration Charlotte Ellertson, MPA, PhD Founder, Ibis Reproductive Health

Raised in South Africa and Minnesota, Charlotte was humble despite her many achievements. She spoke several languages, played the viola, and was an inspired cook, among other talents. She lived in Cambridge with her husband and two young daughters. In March 2004, at age 38, Charlotte died of breast cancer.

We will always miss Charlotte’s leadership, energy, and sense of humor.

Her memory inspires us to work toward a world in which women have healthy reproductive lives characterized by autonomy and choice.

5

Ibis | Funding & Revenue Annual Revenue –

Ibis is grateful for the generous support of our funders: Anonymous The Fred H. Bixby Foundation Catholics for a Free Choice

$2,500,000

$2,313,673

Charlotte Ellertson Fund (individual donations in memoriam) Family Health International

$2,000,000 Bill and Melinda Gates Foundation

$1,670,937 Richard and Rhoda Goldman Fund

$1,500,000

Gynuity Health Projects The William and Flora Hewlett Foundation

$1,000,000

JHPIEGO (affiliated with Johns Hopkins University)

$706,655

The John Merck Fund National Institutes of Health

$500,000

The David and Lucile Packard Foundation The Population Council

$0

Program for Appropriate Technology in Health (PATH)

2002

The Mary Wohlford Foundation University of California at San Francisco

6

2003

2004

Ibis | Board & Staff Board of Directors:

Current Staff and Fellows:

Chair Christopher Elias, MD, MPH President, PATH

Kelly Blanchard, President

Cambridge, Massachusetts Katy Backes Kozhimannil, Project Manager Ann Brown, Office Manager Angel Foster, Associate Teresa Harrison, Project Manager Sarah Martin, Research Assistant Julia Matthews, Project Manager Kate Miller, Senior Associate Laurel Morrison, Director of Finance & Administration Chelsea Polis, Assistant Researcher Kimala Price, Fellow Rachel Roth, Fellow Kate Schaffer, Project Manager Emily Shortridge, Research Associate

Treasurer Frances Kissling Director, Catholics for a Free Choice Clerk Firoze Katrak, ScD Charles River Associates Incorporated Member at large Allan Rosenfield, MD Dean, Joseph L. Mailman School of Public Health Member at large Rebecca Kramnick, JD VP/General Counsel, Women’s Housing and Economic Development Corporation (WHEDco)

Johannesburg, South Africa Chiweni Chimbwete, Associate Mantwa Lerobane, Program Manager Naomi Lince, Project Manager Khwezi Madikiza, Office Administrator Laaiqah Martin, Office Manager Tanusha Mudlay, Program Manager Ethel Qwana, Program Manager

Member at large Paull Hejinian, JD Attorney, Fragomen, Del Rey, Bernsen and Loewy Member ex officio Kelly Blanchard, SM President, Ibis Reproductive Health

San Francisco, California Sarah Gilbert, Administrative Assistant Dan Grossman, Medical Associate Jillian Henderson, Fellow (UCSF) Sarah Jane Holcombe, Associate Amy Schalet, Fellow (UCSF)

7

Ibis | Selected Publications Abortion Towey S, Poggi S, Roth R. Abortion funding: a matter of justice. National Network of Abortion Funds. 2005.

Ellertson C, Webb A, Blanchard K, Bigrigg A, Haskell S, Shochet T, Trussell J. Modifying the Yuzpe regimen of emergency contraception: a multicenter randomized controlled trial. Obstetrics and Gynecology. 2003;101(6):1160-1167.

Grossman D, Ellertson C, Grimes D, Walker D. Routine follow-up visits after first trimester induced abortion.Obstetrics and Gynecology. 2004;103(4):738-745.

Trussell J, Ellertson C, von Hertzen H, Webb A, Bigrigg A, Ferden S, Evans M, Leadbetter C. Estimating the effectiveness of emergency contraception.

Contraception. 2003;67:259-265.

Kade K, Kumar D, Polis C, Schaffer K. Effect of nurse’s attitudes on hospitalbased abortion procedures in Massachusetts. Contraception. 2004;69(1):59-62.

Catholics for a Free Choice. Second chance denied: emergency contraception in Catholic hospital emergency rooms. A national survey conducted by Ibis Reproductive Health for Catholics for a Free Choice. 2002.

Roth R. Do prisoners have abortion rights? Feminist Studies. 2004;30(2):353-381.

Weitz T, Foster A, Ellertson C, Grossman D, Stewart F. ‘Medical’ and ‘surgical’ abortion: rethinking the modifiers. Contraception. 2004;69(1):77-78.

HIV/STI Prevention

Blanchard K, Taneepanichskul S, Kiriwat O, Sirimai K, Svirirojana N, Mavimbela N, Winikoff B. Two regimens of misoprostol for treatment of incomplete abortion. Obstetrics and Gynecology. 2004;103(5):860-865.

Backes K, Forbes A, Polis C. One choice is no choice: the need for femalecontrolled HIV prevention tools for women and girls worldwide. Harvard Health Policy Review. 2005;6(1):19-30.

Foster A, van Dis J, Steinauer J. Educational and legislative initiatives affecting residency training in abortion. Journal of the American Medical Association. 2003;290(13):1777-1778.

Harrison T, Backes K. Cervical barrier methods: expanding women’s options for HIV/STI prevention. American Sexuality Magazine. 2004;2(5). Available at http://nsrc.sfsu.edu/.

Blanchard K, Fonn S, Xaba M. Abortion law in South Africa: passage of a progressive law and challenges for implementation. Gaceta Medica de Mexico.

2003;139(1):S109-114.

Ellertson C, Burns M. Re-examining the role of cervical barrier devices.

Outlook. 2003;20(2):1-8.

Other Reproductive Health Topics

Contraception

Price K. The discursive politics of reproductive health. Anthropology News.

2005;46(2):13.

Harrison T. Availability of emergency contraception: a survey of hospital emergency department staff. Annals of Emergency Medicine. 2005;45(5):105-110.

Price K. Black women’s health disparities put community at risk; National Women’s Health Week offers opportunity to protect health. The Milwaukee Star. May 19, 2005;40(47).

Wynn L, Foster A, Rouhana A, Trussell J. The politics of emergency contraception in the Arab world: reflections on Western assumptions and the potential influence of religious and social factors. Harvard Health Policy Review.

Spring. 2005;6(1):38-47.

Roth R. “No New Babies?” Gender inequality and reproductive control in the criminal justice and prison systems. American University Journal on Gender, Social Policy & the Law. 2004;12(3):391-425.

Abuabara K, Becker D, Ellertson C, Blanchard K, Schiavon R, Garcia SG. As often as needed: appropriate use of emergency contraceptive pills.

Contraception. 2004;69(4):339-342.

Miller K. Assisted reproduction may change birth intentions. Fertility and Sterility. 2004;81(3):572-581.

Becker D, Garcia S, Ellertson C. Do Mexico City pharmacy workers screen women for health risks when they sell contraceptive pills over-the-counter?

Contraception. 2004;69(2):295-299.

Schalet A. “Must we fear adolescent sexuality?” Medscape General Medicine.

2004;6(4). Available at www.medscape.com.

Miller K, Blumenthal P, Blanchard K. Oral contraceptives and cervical cancer.

Contraception. 2004;69(5):347-351.

Harvey SM, Bird ST, Henderson JT, Beckman LJ, Huszti HC. He said, she said: concordance between sexual partners. Sexually Transmitted Diseases.

2004;31(3):185-191.

8

Ibis Offices Headquarters: Ibis Reproductive Health 2 Brattle Square, 4th Floor Cambridge, MA 02138 USA Phone: (617) 349-0040 Fax: (617) 349-0041 admin@ibisreproductivehealth.org

Other Offices: Ibis Reproductive Health P.O. Box 1985 Parklands 2121 Johannesburg, South Africa Phone: 27 (0) 11-447-1346 Fax: 27 (0) 11-447-1353 joburg@ibisreproductivehealth.org

Contact Us

Ibis Reproductive Health c/o Bixby Center for Reproductive Health Research & Policy 3333 California Street, #335 San Francisco, CA 94143 USA Phone: (415) 502-4076 Fax: (415) 502-8479 sanfran@ibisreproductivehealth.org

Ibis Websites www.ibisreproductivehealth.org www.cervicalbarriers.org www.medicationabortion.org http://ec.princeton.edu/arabic Ibis Reproductive Health is a non-profit 501(c)(3) organization.

9

Š2005 Ibis Reproductive Health