Resources

Last year saw a relentless assault on human rights, leaving many feeling anxious and pessimistic about the prospects for people from all walks of life to come together. It was a year of wartime atrocities livestreamed onto billions of smartphones in real time. And if climate, security and human rights fared poorly, the economy did not do much better and many countries cut their aid budgets.  Against this backdrop, we launched our new strategy, Come Together 2028. IPPF Member Associations (MAs) were still able to deliver a total of 222.4 million sexual and reproductive health services during 2023. We served 71.2 million clients. Pretty impressive in such a challenging year in which we embarked on our new strategy.  Read more by downloading the 2023 IPPF Annual Performance Report. 

What is menopause? Menopause is a retrospective diagnosis: it is defined after a woman or person who can menstruate is amenorrheic for 12 months. At this time, estrogen levels are diminished, the ovaries no longer ovulate and spontaneous conception is no longer possible. The average age of the final menstrual period (FMP) is between 46-52 years of age globally. Early menopause occurs between the ages of 40-45 and premature ovarian insufficiency refers to menopause occurring spontaneously before 40 years of age. Of note, although most professional societies define menopause occurring following 12 months of amenorrhea, the United Kingdom Faculty of Sexual and Reproductive Health defines it as 12 months in people over the age of 50 years of age and 24 months in those between 40-50 years of age. The menopause transition is the start of menopausal symptoms and/or menstrual irregularities until the FMP. Perimenopause includes the menopause transition, during which time contraception may continue to be needed, and one year after the FMP, when menopause is officially diagnosed. Both menopause and perimenopause are a time of great transition. Perimenopause is associated with significant hormonal fluctuations with an eventual reduction in ovarian estrogen production. In the initial years after the FMP, estrogen levels may still fluctuate but, over time, will diminish to a persistent low estrogen state. These hormonal changes can have significant physical, emotional, and mental effects. Menopause occurs naturally but other types exist. Surgical menopause occurs when both ovaries are surgically removed. Menopause can also be induced after medical treatments, such as with chemotherapy, that result in cessation of ovarian function which may be permanent or reversible. Globally, life expectancy is increasing, albeit varying by geographical location. Some people may spend decades in perimenopause and menopause. Often the needs of those in perimenopause/menopause are unmet; recognizing and addressing these needs are essential to ensure the health and wellness of this often-overlooked population. Purpose of the Statement The purpose of this statement is to define the health impact of perimenopause and menopause and review therapeutic options to address the healthcare needs of this population.

Recognizing the significant global impact of sexually transmitted infections (STIs), this statement affirms IPPF’s commitment to people-centred STI care as a critical aspect of comprehensive sexual and reproductive health and well-being. A holistic approach to sexual and reproductive health and rights acknowledges that true sexual and reproductive well-being extends beyond the prevention and treatment of diseases. It emphasizes the importance of promoting healthy, satisfying sexual and reproductive experiences. This includes advocating for personcentred care, encouraging self-care strategies, and supporting the development of innovative healthcare delivery models tailored to meet the diverse needs of individuals in various circumstances and contexts, particularly reaching those who are often excluded and marginalized. This statement updates the latest information on STIs. It provides practical recommendations for IPPF Member Associations on how to develop a comprehensive, people-centred approach to STI care, emphasizing integrated services, adherence to guidelines, rights-based care, community engagement, advocacy, and a positive perspective on sexual health and well-being.

Background IPPF offers a comprehensive approach to sexual and reproductive health and rights through its Integrated Package of Essential Services (IPES) which is offered at affiliate service delivery points. The IPES includes HIV testing, HIV prevention, HIV care and treatment, services for sexually transmitted infections and reproductive tract infections, contraception, abortion care, obstetrics and gynaecology, fertility support, and support for sexual and gender-based violence Purpose The purpose of our HIV Theory of Change is to clarify the goals and vision of IPPF’s HIV programme and to articulate the different pathways and strategies IPPF uses to contribute towards its HIV goals and vision. This Theory of Change endeavours to represent a conceptual model that is complex and non-linear in the format of a readable diagram. Therefore, this Theory of Change diagram is a simplified representation of a complex process which cannot be fully captured in this format. Our Theory of Change describes causal pathways for how the work in our HIV programme contributes to the ultimate goals and vision. The purpose of this conceptual model is not to provide a detailed description of the components of our HIV services, as these are described in the 2020 ‘IPPF Comprehensive HIV Services Package’ and the IPPF 2022 ‘Client-centred-clinical guidelines for sexual and reproductive health care’. Reading the diagram Our Theory of Change diagram is read from left to right, representing movement in time from the world we currently live in (left side) towards the future we would like to see, which is represented by our vision (right side). There are 7 pathways (page 1), each with a set of strategies (shown on pages 4 and 5 as close-ups of the diagram), whose work contributes towards achieving our HIV goals and vision. The 7 pathways are divided into cross-cutting pathways (community engagement, evidence and learning, capacity strengthening and sharing, strategic partnership building) and core pathways (advocacy, empowerment, comprehensive service delivery). The cross-cutting pathways are iterative and intersecting, contributing to each other and collectively contributing to the 3 core pathways. The core pathways represent the 3 main areas of our HIV programme, which, like all elements of the diagram, also interact with each other synergistically. The strategies of all 7 pathways working together contribute towards a set of outcomes. The outcomes interacting together contribute towards our goals, which in turn interact with each other, and contribute towards our ultimate vision.

Frontline workers for sexual and reproductive health and rights (SRHR) provide life-changing and life-saving services to millions of people every year. From accompanying the pregnant, delivering babies and caring for the newborn to supporting those subjected to sexual violence; from treating debilitating infections to expanding contraceptive choices; from enabling access to safe abortion services to countering homophobia: all over the world frontline SRHR carers and advocates make it possible for so many more to experience dignity in sex, sexuality and reproduction. Yet they are also subjected to hostility for what they do, for whom they provide care, for where they work and for the issues they address. From ostracistion and harassment in the workplace to verbal threats and physical violence, hostilities can extend even into their private lives. In other words, as SRHR workers seek to fulfil the human rights of others, their own human rights are put at risk. Yet, as grave as that is, it is a reality largely undocumented and thus also underestimated. This scoping review sets out to marshal what is known about how hostilities against frontline SRHR workers manifest, against whom, at whose hands and in which contexts. It is based on review of six sources: peer-reviewed and grey literature, news reports, sector surveys, and consultations with sector experts and, for contrast, literature issued by opposition groups. Each source contributes a partial picture only, yet taken together, they show that hostilities against frontline SRHR workers are committed the world over—in a range of countries, contexts and settings. Nevertheless, the narratives given in those sources more often treat hostilities as ‘one-off’, exceptional events and/or as an ‘inevitable’ part of daily work to be tolerated. That works in turn both to divorce such incidents from their wider historical, political and social contexts and to normalise the phenomena as if it is an expected part of a role and not a problem to be urgently addressed. Our findings confirm that the SRHR sector at large needs to step-up its response to such reprisals in ways more commensurate with their scale and gravity. Authors: Victoria Boydell, Kate Gilmore, Jameen Kaur, Jessica Morris, Rebecca Wilkins, Frieda Lurken, Sarah Shaw, Kate Austen, Molly Karp, Sally Pairman, Maria Antonieta Alcalde