Monday, March 21, 2016

Clinical Experience at the University College Hospital (UCH)

Oluwatosin( Tosin) Onibokun, MD
Resident in OB/GYN, BWH/MGH Combined Residency Program

While at the University College Hospital (UCH), I had a chance to observe clinical work at the family planning clinic.
Hallway at the Family planning clinic at the
University College Hospital (UCH)

I was impressed by the major role the nurses played in the counseling and  provision of contraception to women. Contrary to the norm in the United States, insertions of reversible long acting contraception were managed by the nurses at the family planning clinic (including placement and removal of contraceptive implants and intrauterine devices) with doctors available for back up as needed (which appeared to rarely happen).I think the training and empowerment of nurses in this area is very laudable and the right step towards expanding 

Posters in family planning clinic promoting promoting
contraception use as a form of child spacing

Of note, all reversible long-acting contraception ( IUDs and implants) provided at the family planning clinic at UCH are fully funded by the Nigerian Urban Reproductive Health Initiative (NURHI), which is a project funded by the Bill and Melinda Gates Foundation with the goal to eliminate the supply and demand barriers to contraceptive use in Nigeria, a very laudable and inspiring goal. The patients only pay a nominal fee to pay for the cost of syringes, needles and local anesthesia.  This highlights to me the role of philanthropy in making an immense significant impact in the lives of people and nations.

I think the available funding explains why I saw more implantable contraception devices inserted into patients than I initially expected given their relatively high cost in the United States. 

On the other hand, it was also interesting to note that the public awareness campaigns regarding contraception (with the exception of condoms) is skewed towards helping married women ensure adequate spacing between children and less as a way to prevent unwanted pregnancies in young unmarried women who are sexually active. This skew can be noted in the pictures that advertise contraception use. However,  I think it is important to modify this rhetoric so that young women, married or not and parous or not, can have equitable access to effective contraception.

In summary, it was a great learning experience to observe the efforts at improving access to contraception in a Nigerian setting, a cause I hope to continue to be involved in as an OB/GYN.

Oluwatosin( Tosin) Onibokun,
OB/GYN Resident PGY 3
BWH/MGH Combine Residency Program

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