Dear AGOI colleagues,

Warm Greetings from AGOI.

The scientific committee of ASGO 2015 has extended the deadline of abstract submission until June 30, 2015, in order to make more exciting meeting with sharing the latest researches and studies of doctors from India.

You can Submit abstract and participate in ASGO meeting. Also, the newsletter from domestic gynecologic oncologist is attached.


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The Lancet: Women’s contribution to healthcare constitutes nearly 5% of global GDP, but nearly half is unpaid and unrecognised

Women’s contribution to health amounts to around US $3 trillion annually, more than the US and UK governments’ total expenditure combined

A major new Commission on women and health has found that women are contributing around $3 trillion to global health care, but nearly half of this (2.35% of global GDP) is unpaid and unrecognised. 

Published in The Lancet, the Commission offers one of the most exhaustive analyses to date of the evidence surrounding the complex relationships between women and health, and demonstrates that women’s distinctive contribution to society is under-recognised and undervalued—economically, socially, politically, and culturally. 

The report underlines that women are important providers as much as recipients of health care, and that globally, their changing needs in both of these respects are not being met.

According to Professor Ana Langer, head of the Women and Health Initiative at Harvard T. H. Chan School of Public Health in Boston, USA, who co-led the commission, “Too often, women’s health is essentially equated to maternal and reproductive health.  However, the evidence outlined by this Commission overturns this conventional interpretation, and we urge the global health community and policymakers worldwide to embrace a more holistic – and realistic – understanding of women and health.  It’s time to acknowledge women’s comprehensive health needs throughout their lives, and their productive contributions to health care and society as a whole, as well as their similarly important roles as mothers and homemakers.” [1]

The Commission, which brought together leading thinkers, heads of programmes, and activists from around the world, examines the complex links between biological, economic and social factors in improving women’s health throughout their lives – including the substantial effects of rapid globalisation, urbanisation, and climate change, all of which have inequitable effects on women’s health. 

According to Professor Afaf Meleis from the University of Pennsylvania School of Nursing, Philadelphia, USA, who co-led the Commission with Langer, “Often urban areas are developed without any input from women, and without addressing their needs for adequate lighting, safe transportation, access to healthy food, to infrastructures that promote community connectivity, and to integrated health care, child and elderly care. This puts women at increased risk of violence, non-communicable diseases and stressful life overload, which may in turn have adverse consequences for their families.” [1]

The authors conclude that gender equality and empowerment must be central to the policies and interventions used to improve healthcare and to human, social and economic development, especially in the post-2015 era.

Additionally, the Commission analyses data from 32 countries, accounting for 52% of the world’s population, to estimate that the financial value of women’s paid contribution to the health system in 2010 was 2.47% of the global gross domestic product (GDP) and 2.35% of GDP for unpaid work (largely domestic care for family members, which is only officially acknowledged and compensated in a small number of countries, including Costa Rica, Turkey, and the UK). Women’s contributions to health care amount to a total of US$3 trillion, more than the US and UK government’s combined total annual expenditure [2].

According to Commission co-author Dr Felicia Knaul, Director of the Harvard Global Equity Initiative, Boston, USA, who led the economic calculations, “Our findings on women’s paid and unpaid financial contributions to health worldwide only begin to explore and quantify the work of women as health professionals in the paid health care labour force, and their unpaid work to support health and prevent illness undertaken in their own homes, in the homes of others and through volunteering in the health sector. The contributions of women to health and health care are myriad, and the data to fully measure them are lacking.” [1]

“Worldwide, most providers of health care are women,” says Professor Langer, “But the health systems to which they contribute so much are often completely unresponsive to their needs – despite the fact that they rely heavily on their paid and unpaid contributions.  Women are undervalued and unsupported by the systems in which they work, and this problem is exacerbated by inequitable access to healthcare experienced by too many women worldwide – particularly those in the most vulnerable groups.” [1]

Professor Meleis adds, “Nurses form the largest global workforce in health care, and the majority of them are women. Many nurses work in unprotected environments and their scope of authority is incongruent with education and experience. All this can lead to burnout, attrition, severe shortage and affects their health, and the health of others.” [1]

The Commission concludes with a series of recommendations, including a call to recognise the importance of timely and appropriate investments in girls and women to enhance their status, strengthen health systems, and improve health outcomes, and to ensure that development planning and financing for health is responsive to the concerns and needs of women.  Among other recommendations, the authors urge women to participate at all levels of decision making in society, fostering leadership in health nationally and internationally.

 The Commission is accompanied by commentary pieces from Jim Yong Kim of the World Bank, and Melinda Gates of the Bill & Melinda Gates Foundation, and Lancet Editor-in-Chief Richard Horton.  The report will be launched on Friday 5 June at the Harvard T. H. Chan School of Public Health, Boston, USA, followed by launch events in Philadelphia and Miami, USA, London, UK, and Mexico, among other locations.  For more information on the Boston launch event, see:


[1] Quotes direct from authors and cannot be found in text of Commission

[2] 2012 UK and US government expenditure figures taken from CIA World Factbook

THE FOLLOWING Link will go live at 00:01 [UK time] Friday 5 June, 2015:

Misoprostol for treatment of PPH added to WHO's List of Essential Medicines!



Misoprostol for the treatment of postpartum hemorrhage (PPH) has been added to the World Health Organisation's 19th Model List of Essential Medicines (EML). This decision was reached by the 20th Expert Committee on the Selection and Use of Essential Medicines when in April 2015 it met at the WHO Headquarters in Geneva to revise and update the EML for both adults and children.  

The new edition of the EML recommends the use of misoprostol for the "Prevention and treatment of postpartum haemorrhage where oxytocin is not available or cannot be safely used."

A proposal for the inclusion of misoprostol for the treatment of PPH was submitted by Gynuity Health Projects for consideration by the Expert Committee. Research has demonstrated that a single sublingual dose of 800mcg (200mcg x 4 tablets) of misoprostol is a safe and effective uterotonic for the treatment of PPH: nine out of ten women who receive misoprostol after PPH diagnosis will have bleeding controlled (Winikoff 2010; Blum 2010). For further information, see here.

Misoprostol is already included on the EML's core list because of its proven safety and efficacy for the prevention of PPH, medical abortion (following mifepristone), management of incomplete abortion/miscarriage, and induction of labor. 

Background Information

Postpartum hemorrhage, or excessive bleeding after childbirth, is one of the most significant causes of maternal death and disability globally. The administration of a uterotonic drug is central in the management of PPH due to uterine atony (failure of the uterus to contract following childbirth). Misoprostol is available in tablet form and is stable at room temperature, making it an important option for PPH management.

Inclusion of misoprostol for its PPH treatment indication on the EML has brought the Model List into line with recommendations by global health organizations and health professional associations. The World Health Organisation (WHO 2012), the International Federation of Gynecology and Obstetrics (FIGO 2012), the International Confederation of Midwives (ICM-FIGO 2014), and the United Nations Commission on Life-Saving Commodities (UNCoLSC 2012) recommend the use of misoprostol to treat PPH in settings in which intravenous oxytocin --the gold standard for PPH treatment-- is not available and is not feasible to use or if the bleeding does not respond to oxytocin.

Expert Committee on the Selection and Use of Essential Medicines and Model List of Essential Medicines  

The Expert Committee on the Selection and Use of Essential Medicines meets every two years to review and update the EML. Essential medicines are selected with due regard to disease prevalence, evidence on efficacy and safety, and comparative cost-effectiveness. The core list presents a list of minimum medicine needs for a basic health care system. Governments and institutions around the world are increasingly using the WHO list to guide the development of their own essential medicines lists.

Gynuity Health Projects is an international research & technical assistance organization committed to ensuring that affordable reproductive & maternal health technologies are available & accessible to all. For further information 

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