Moving forward with changing times.

Abstract

In recent years, progress has been made in several aspects of women′s health world-wide. Women′s life expectancy has increased, a significant reduction in maternal mortality has been achieved and access to education for girls is getting better. With better access to contraception and safe abortion, women′s reproductive health is improving. However, women′s healthcare issues continue to be dominated by problems related to access, affordability and discrimination. For example, a recent report from Guttmacher Institute 1 estimates that nearly half (49%) of pregnancies among adolescent women (aged 15–19) living in developing regions are unintended, and many of these end in abortion under unsafe conditions. Meeting the contraceptive needs of these women would avert 3.2 million abortions and 5,600 maternal deaths annually. Therefore, having access to modern contraceptive methods and freedom of choice are of utmost importance. An article published in this issue of AOGS by Lindh et al (pages 19-28) shows that the use of contraception and choice of method vary even among women living in Nordic countries with comparable socioeconomic backgrounds. Ability to measure and monitor appropriate health indicators is of paramount importance and many tools may not be adequate in this respect. Data are usually missing from the most vulnerable countries and layers of societies, and estimates are not always reliable. Revision of existing tools and development of new methods is required for more robust and reliable data collection and evaluation of interventions that may help improve women′s health. It is good to see that some efforts have been made in this direction 2, 3, but much more needs to be done in this area. This is demonstrated by a report by Symon et al (pages, 53-60) from the University of Dundee, UK in this issue of AOGS, indicating that alcohol consumption before and during pregnancy might be underestimated using standard tools of assessment. Hopefully, the rapid progress observed in information and communication technology will help to obtain better quality data on the global status of women′s health, drive quality research and yield trustworthy results that will help to improve their situation. Women also need to take responsibility for their own health as well as that of their offspring. Education has to be key in developing a culture of healthier living and empowering women to make beneficial choices. In the past couple of years, the issues associated with migration, political conflicts, war, economic instability, and natural disasters have dominated problems related to women′s health. The scale of human suffering has been historically high. There have been significant political changes around the globe, including in Europe and North America recently, that are likely to have a global impact on health policies in general and women′s health issues in particular. Saving lives and reducing suffering is the mission of all health professionals, which becomes ever more important in times of crisis. It is estimated that approximately 38% of health workers suffer physical violence at some point in their careers. Unfortunately, attacks on hospitals and healthcare facilities are becoming more common in conflict areas and women′s health is not a focus in many disaster zones 4. According to the WHO, in the last two years (January 2014 to December 2015), there were 594 reported attacks on healthcare facilities resulting in 959 deaths and 1561 injuries, in 19 countries with emergency situations 5. Failure of the parties involved in conflict to abide with international humanitarian law is indeed a very worrying trend as women and children are the most vulnerable civilians and hence likely to be affected foremost by the destruction and damage to healthcare facilities. There is an urgent need to effectively address these issues in a global context. Times are changing and adapting to the circumstances is necessary for existence, survival, development and growth. We need to move forward however challenging it may be, and this applies to our journal too. This year, Dr Jens Langhoff-Roos from Denmark retires after providing more than a decade of excellent, uninterrupted service to our journal in different editorial positions, and for the first time in the history of our journal, we have appointed a Deputy Chief Editor from outside the Nordic countries to replace him. Prof. Anthony O. Odibo from the University of South Florida, Tampa, USA joins the editorial team this month. I sincerely believe that AOGS will greatly benefit from his international profile, professional expertise, and vast editorial experience and acumen. At 96 years, AOGS - an international journal with Scandinavian quality - is a mature journal with good standing. Its scope and outlook may have changed over the years, but the principles remain the same. We are committed to disseminating high quality, honest and ethical research (clinical, basic and translational) covering all aspects of obstetrics and gynecology and contributing to the improvement of women′s health globally.