Going global: future directions for the Journal.

In June 2024, the African Journal of Reproductive Health will begin its 28th year of publication. The International Conference on Population and Development (ICPD), held in 1994 in Cairo, was the impetus to start this peer-reviewed learned journal in the context of the anticipated increase in activities relating to sexual and reproductive health and rights in sub-Saharan Africa, to document achievements and successes while also pinpointing areas requiring remedial actions. Undoubtedly, the Journal has achieved these objectives in many phenomenal respects. First published as a biannual in 1997, the Journal became a quarterly in 2000, bimonthly in 2010, and, since January 2022, has been a monthly. The Journal is now ranked among the most influential in the fields of reproductive health and reproductive medicine not only in Africa1,2 , but worldwide3,4 .

Celebrating Africa's first endowed chair in sexual and reproductive health and rights.

This month, April 2024, the University of Benin, a federally-funded university in Southern Nigeria announced the first endowed professorial chair in sexual and reproductive health and rights (SRHR) in sub-Saharan Africa, and possibly the first such chair globally. This professorship is named in honour of Friday Okonofua1, the irrepressible champion who is a trailblazer in women's health, social advocate for women's social advancement, lead founder of the University's African Centre of Excellence in Reproductive Health, and founder of Nigeria's leading non-governmental organization, the Women's Health and Action Research Centre and the African Journal of Reproductive Health. The new professorship will be crucial in deepening and scaling up reproductive health curricula at the University of Benin, by drawing upon the principles and models of transparency, excellence, and accountability that Friday Okonofua has championed over several years. The University's Registrar alluded to this approach by explaining that the endowment "will strengthen the leadership of the University of Benin in Nigeria in this area of public health and educational delivery.

Ce mois-ci, en avril 2024, l'Université du Bénin, une université financée par le gouvernement fédéral dans le sud du Nigéria, a annoncé la création de la première chaire professorale dotée en santé et droits sexuels et reproductifs (SDSR) en Afrique subsaharienne, et peut-être la première chaire de ce type au monde. Cette chaire est nommée en l'honneur de Friday Okonofua1, champion irrépressible, pionnier de la santé des femmes, défenseur social de la promotion sociale des femmes, fondateur principal du Centre d'excellence africain en santé reproductive de l'université et fondateur de la principale organisation non gouvernementale du Nigeria, le Centre de recherche sur la santé et l'action des femmes et l'African Journal of Reproductive Health. La nouvelle chaire sera cruciale pour approfondir et élargir les programmes de santé reproductive à l'Université du Bénin, en s'appuyant sur les principes et les modèles de transparence, d'excellence et de responsabilité que Friday Okonofua défend depuis plusieurs années. Le registraire de l'Université a fait allusion à cette approche en expliquant que la dotation « renforcera le leadership de l'Université du Bénin au Nigeria dans ce domaine de la santé publique et de l'enseignement.

Reaffirming the value of continuing professional development.

With advances in clinical knowledge and changing norms for health services delivery, lifelong learning is essential for practitioners of sexual and reproductive health. Clinical topics should be complemented by various items, such as communications and management, to optimise the provision of care. Aiming to update knowledge, improve skills and enhance competence, professional development can take the form of diverse modalities ranging from the reading of professional journals through attendance at meetings to formal participation in schemes organised by licensing authorities. Already mandatory in numerous countries in Africa, continuing professional development is assuming more importance for medical, nursing, and midwifery practitioners.

Avec les progrès des connaissances cliniques et l'évolution des normes en matière de prestation de services de santé, l'apprentissage tout au long de la vie est essentiel pour les praticiens de la santé sexuelle et reproductive. Les sujets cliniques doivent être complétés par divers éléments, tels que la communication et la gestion, pour optimiser la prestation des soins. Visant à mettre à jour les connaissances, à améliorer les compétences et à améliorer les compétences, le développement professionnel peut prendre la forme de diverses modalités allant de la lecture de revues professionnelles à la participation à des réunions en passant par la participation formelle à des programmes organisés par les autorités chargées des licences. Déjà obligatoire dans de nombreux pays d'Afrique, la formation professionnelle continue prend de plus en plus d'importance pour les praticiens médicaux, infirmiers et obstétricaux.

Sexual and reproductive health of baby boomers.

Early baby boomers constitute a cohort that was the first to benefit from numerous innovative interventions in sexual and reproductive health services as exemplified by hormonal contraception, legal abortion, invitro fertilisation, screening mammography and menopausal hormone replacement besides medication for male erectile dysfunction. The quest for a youth elixir continues to be a challenge for sexual health sciences.

Les premiers baby-boomers constituent une cohorte qui a été la première à bénéficier de nombreuses interventions innovantes en matière de services de santé sexuelle et reproductive, comme en témoignent la contraception hormonale, l'avortement légal, la fécondation in vitro, la mammographie de dépistage et le remplacement hormonal de la ménopause, en plus des médicaments contre la dysfonction érectile masculine. La quête d'un élixir de jeunesse continue de constituer un défi pour les sciences de la santé sexuelle.

Human papilloma virus (HPV) vaccine and cervical cancer prevention in Africa.

Cervical cancer remains a critical challenge in reproductive health worldwide, with especially high burden in Africa. A recent publication in the Lancet reported 604,127 cases of cervical cancer worldwide in 20201, of which 117,316 cases (19.4%) were in the five African regions. East Africa had the highest incidence rate followed by West Africa, while north and South Africa had the lowest rates. Similarly, the highest cervical cancer mortality rate worldwide, 28.6 deaths per 100,000 women years, was reported from East Africa, and was followed by South Africa.

Le cancer du col de l'utérus reste un défi majeur en matière de santé reproductive dans le monde, avec un fardeau particulièrement élevé en Afrique. Une publication récente du Lancet a fait état de 604 127 cas de cancer du col de l'utérus dans le monde en 20201, dont 117 316 cas (19,4 %) dans les cinq régions africaines. L'Afrique de l'Est avait le taux d'incidence le plus élevé, suivie de l'Afrique de l'Ouest, tandis que l'Afrique du Nord et l'Afrique du Sud avaient les taux les plus bas. De même, le taux de mortalité par cancer du col de l'utérus le plus élevé au monde, soit 28,6 décès pour 100 000 femmes-années, a été signalé en Afrique de l'Est, suivi par l'Afrique du Sud.

Challenges for Measuring Progress towards the Sustainable Development Goals.

With the adoption, in September 2015, of the Sustainable Development Goals with a time horizon of 2030, there is a dire need to exploit avenues for the monitoring of progress towards meeting the targets pertaining to sexual and reproductive health, whether at global, regional, national or grassroots level. The current process for the selection of indicators, to complement the targets, provides an opportunity for a concerted effort to improve monitoring procedures and ensure their relevance for programme adjustment and accountability. It is imperative for national processes to ensure effective reporting besides linkages with related sectors.

Sexual and Reproductive Health at 2015 and Beyond: A Global Perspective.

The International Conference on Population and Development and Millennium Development Goals propelled reproductive health into priorities for international development through declarations, statements, and frameworks. However, key indicators demonstrate that progress in both service provision and clinical outcomes has not been optimal, especially for certain disadvantaged groups. With the Sustainable Development Goals, efforts over the next two decades will focus on access to and quality of health services. Advocacy for mobilizing resources will be complemented by accountability, especially monitoring and evaluation, for utilization of these resources during the life cycle. Stakeholders should emphasize national commitments, with broad partnerships, to ensure long-term sustainability.

La Conférence internationale sur la population et le développement et les objectifs du Millénaire pour le développement ont porté la santé génésique au rang des priorités pour le développement international au moyen de déclarations, d'énoncés et de cadres de référence. Et pourtant, des indicateurs clés nous soulignent que le progrès (tant pour l'offre de services que pour les issues cliniques) n'a pas été optimal, particulièrement en ce qui concerne certains groupes désavantagés. Grâce aux objectifs de développement durable, les efforts déployés au cours des deux prochaines décennies seront centrés sur l'accès à des services de santé de qualité. La promotion de la mobilisation des ressources sera renforcée par l'obligation de rendre des comptes (particulièrement la surveillance et l'évaluation) quant à l'utilisation de ces ressources au cours du cycle de vie. Les intervenants devraient souligner l'importance des engagements nationaux, au moyen de partenariats élargis, pour ce qui est d'assurer la durabilité à long terme.

Factors influencing reproduction in captive-bred cynomolgus monkeys (Macaca fascicularis) from Mauritius.

The cynomolgus monkey is widely used in reproductive research. However, the effects on their reproductive parameters of infant and maternal factors such as birth order, sex of infants, twin births, maternal age and lactation status have not been fully examined. The aim of this retrospective study was to determine how such infant and maternal factors impact on infant birth weight, birth viability, neonatal loss and retained placenta in cynomolgus monkeys. The study was based on birth data from a cohort of 789 females over an eight-year period. Consistent with reports made in other macaque species, female offspring had lower birth weight compared with males. Birth weights of firstborn infants were lower compared with birth weights of higher birth order infants. Results from the logistic regression analysis showed that the risk of non-viable births was increased by advancing maternal age and retained placenta. As in other non-human primates, maternal age had predictive value for non-viable births in cynomolgus monkeys. The risk of neonatal loss decreased with advancing maternal age but was not affected by birth order. Firstborn offspring did not have an increased risk for neonatal loss, possibly from the practice of retaining mothers in their natal groups, which improved maternal skills in primiparous females. However, infant low birth weight and non-lactating females increased the risk of neonatal loss, and the delivery of low birth weight infants was associated with retained placenta. The results from this study can be useful for scientists conducting reproductive studies and for colony managers in maximizing fertility and infant survival of cynomolgus monkeys.