Dilemmas, difficulties and hope – reproductive health in developing countries

CMF Blogs occasionally include posts by guest authors on a variety of topics.
The views expressed do not necessarily reflect those of CMF.

faizabadDespite my determination a few years ago not to be a GP with a Women’s Health interest that’s exactly what I’ve found that I love!  Having exhausted the UK Diplomas and Letters of Competence and with a long-standing interest in working in developing nations, I wondered just how much difference a GP can make in these settings. So I took three months off work and went to Liverpool to do the Diploma in Reproductive Health in Developing Countries (DRH).

So what is the DRH?

The DRH is a 12-week program run each year between January and the end of March and organised by the Maternal & Newborn Health Unit at the Liverpool School of Tropical Medicine, in partnership with the Royal College of Obstetricians and Gynaecologists.

It is designed to equip a variety of health professionals, from program developers to doctors, to understand some of the complexities and challenges of providing quality reproductive healthcare to developing nations,. It examines what kind of interventions have evidence to support improvement, encompassing everything from family planning services to post-natal care .  The DRH is the only course of its kind – hence people travel from all over the world to undertake it.

What did I learn?

Loads.  On the academic side, I can now tell you about strategies for improving aspects of reproductive healthcare; everything from stemming the tide of STIs, providing evidence based obstetric care, initiating quality improvement activities to tackling issues of sexual and gender based violence…but as with many things, what I gained from the course was as much about the people I met and the relationships built as writing papers and sitting exams.

There were 15 students on the course – from all disciplines, ages, backgrounds, religions and countries; many of them will take back what they have learnt directly into their districts and hospitals, being agents for change. Each had stories to tell and a wealth of experience whilst being willing to learn – they were inspiring to listen to and a privilege to spend time with.  It was also an environment where no conversation was off limits so matters of faith, ethics and conscience echoed around wherever we met – often in quite heated and passionate debate.














Faith-based organisations and faith-based challenges

It was interesting to hear different understandings of the place of faith in medicine, and to see how this played out both in the classroom and in the places where participants are working. One example of this was a lady who works for a faith-based organisation trying to set up what we would understand as a family planning clinic in an environment where it is perceived that ‘God determines how many children and when.’ She is desperately trying to reduce the maternal death rates in very young primagravidas, grand multips and those with significant chronic illness, while providing contraceptive options that would be acceptable to their faith and their husbands.

As expected there are no easy answers! The more we delved, explored and debated tools and solutions, the more complex things became – on the one hand we began to have a structure of how to tackle certain problems and on the other we became more aware of just how difficult it is to implement lasting and life-giving change to those who need it the most. The importance of understanding the convoluted and multifaceted nature of different cultures is paramount in achieving any enduring improvement.  The dilemmas and difficulties are endless, but those who hope in Jesus as their Saviour are not prepared to give up the fight!

Who should do the DRH?

This is quite a specific qualification but if you intend to work in this area you may find that it provides you with a very different skill set to the traditional tropical medical diploma. It also gives an opportunity to do some specific research into an area of interest with a literature review – great if you know where you are going and want to work out how best to help and not hinder.

Want to find out more? Contact me at

CMF’s Developing Health Course is coming up – June 30- July12, with two excellent days on Women’s Health…could be a great forerunner to the next DRH!

Posted by Dr Claire Hollingsworth, CMF member




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