Breastfeeding For All?

Breastfeeding Families

Support For All Families

Breastfeeding is 100 percent natural, organic, and the best possible food for babies. We know that it is important for healthy babies. Support for reproductive health means access to information for all families. All Families benefit from support and information about breastfeeding.

Global Breastfeeding Conversations

Reproductive justice for all people includes women, trans men, trans women, and non-binary families and babies. The topic of breastfeeding must also include queer and gender queer families.

Reproductive Justice for All Families

Writing about National Breastfeeding Month seemed easy because I planned to write about breastfeeding and diversity. I began with what felt comfortable.  I considered all the breastfeeding information I had acquired over the years, both learned and lived experiences. Something was missing. I never had a conversation with a trans man or trans woman. I knew my information was stuck in a binary model and I recognized the absence of  an education which had not prepared me to talk about reproductive justice.


The Work We Love

IPRHglobal is based in New Mexico. In the past, we worked with diverse cultures and populations in other countries. In the wake of the COVID-19 pandemic, we look forward  to growing with the energy of New Mexico communities committed to reproductive health and reproductive justice.

Inspiring Stories from IPRHglobal

Global Health = Health for all Women

Global Health for Women: 70% of Frontline Workers are Women

Merry Christmas!

I hope you are safe and happily sharing the holidays with your loved ones.  Let’s take a moment to consider those who are less fortunate.

There is undeniable proof that the global scope of the pandemic has become a mind-altering, consciousness-building reality. The COVID-19 zeitgeist has resulted in displays of enormous will, great effort, and determination. The good news is the development of and distribution of vaccines against the coronavirus. The bad news is that many people living in low-and- middle-income countries (LMIC) face almost insurmountable obstacles in the process of acquiring vaccines.

Simien Mountains National Park: A Gathering of Children in Northern Ethiopia

2020 may become a monument to global health collaboration, or not. We are all looking forward to 2021 with hope and a sigh of relief that COVID-fatigue may soon come to an end. Our neighbors, both near and far, need more than hope. Global collaboration means facing uncomfortable truths. As an advocate for access to healthcare for all women, my commitment requires being aware that many global communities are dependent upon the work women provide. The women with the least access to healthcare face the highest risk of health complications. Frontline healthcare workers in LMIC perform a vital role in protecting their communities from the ravages of COVID-19. The disproportionate risk to women is a clear example of the negative impact gender has on global healthcare.

Genderized Risks

A recent article in Lancet,COVID-19 Vaccines and Women’s Security discussed the negative affect of the pandemic on women in terms of increased risk for domestic violence, economic insecurity, food insecurity, and decreased access to reproductive health, each with significant consequences. The COVID-19 pandemic remains a reality for healthcare agencies as they plan for 2021. The contrast of daily challenges encountered by healthcare professionals in wealthy countries compared to low- and- middle- income countries is striking. The repercussions of unequal access to critical supplies, personal protective equipment, testing, and vaccines represents a global problem. Political and economic boundaries do not limit the spread of the coronavirus, on-going daily exposure to the virus by women who work in the community results in an unequal negative outcome. The problem becomes multiplied by spread to family, and possible death. The complexity involved in recognizing genderized access to healthcare is a tangle of politics, economy, and cultural factors.

Essential Workers

Busy Street Near Adama with Sidewalk Café

In 2019, the International Labor Organization published a paper entitled Gender Equity in the Health Workforce: Analysis of 104 Countries, the key message was centered on the overwhelming presence of women in non-physician healthcare and the need for changes in policies that will benefit all women. The ILO paper estimated that 70% of the global healthcare workforce, frontline and essential workers are women.  The health of communities will rely on healthcare providers who will be responsible for delivering and facilitating community uptake of the vaccines. The personal security of the community healthcare worker is at risk from attacks and violence in many underserved communities. The genderized nature of sexual violence is a threat that was documented during the Ebola epidemic. Some male healthcare workers offered Ebola-related services, including vaccination, in exchange for sexual ‘favors’ from women and girls.

Difficult Decisions

Issues of inequality are a difficult discussion to undertake. Here in the US, the disparity of the ravages of COVID-19 are easy to see and difficult to acknowledge. Brown and black communities, Native American communities, and people who are poor, are sicker and more likely to die. Access to the COVID-19 vaccine becomes a problem of deciding between those who are first in line, and who will be forced to wait.

High-income countries, Vaccine Nationalism and Advanced Purchase Agreements (APA)

Vaccines against COVID-19 are available in the United States and the United Kingdom. Immunizing our frontline workers, doctors, nurses, and elderly is a plan that is also acceptable for other countries. The availability of the vaccine in other European countries (Germany, Italy, Spain, and France) will be determined by are strategically considering how much of the vaccine to procure. The fair and equitable distribution of the vaccines is severely tested as wealthy people push to the head of the line. The ease of access was demonstrated recently when Donald Trump and Rudy Giuliani were diagnosed with COVID-19 and received a level of care unattainable for the average citizen. Legal determinants are involved in issues of access to vaccines and are driven by vaccine nationalism [hyperlink]. Through mechanisms like legal determinants, governments can secure Advance Practice Agreements (APAs) directly with vaccine manufacturers. APAs can result in inequalities in access which may extend the duration of the pandemic as some countries wait in line. APAs can be used to secure vaccines as a part of an Advanced Market Commitment.

Global Vaccine Equity

Access to vaccines for low and middle- income countries (LMIC) is dependent on the generosity and commitment of many organizations.  The participation of the Global Alliance for Vaccines and Immunizations (GAVI), the World Bank, UNICEF, World Health Organization, and the Bill and Melinda Gates Foundation are important. GAVI’s model of “public-private” partnerships also include private sector partners, research agencies, vaccine manufacturers, and other countries (Norway, Canada, Kuwait, Denmark, New Zealand, Netherlands, Singapore, Estonia). Ensuring a just and equitable distribution of vaccines to promote global health security becomes rhetorical when nationalism supersedes global well-being. Advanced Market Commitments, funded by donors through GAVI, can allow deals through APAs for guaranteed purchase of vaccines.


The COVID-19 Global Access (COVAX) was launched in April 2020. COVAX  facility is a collaborative effort under the leadership of GAVI, World Health Organization (WHO), and the Coalition for Epidemic Preparedness Innovations (CEPI). The COVAX platform allows governments to access a diversified portfolio of COVID-19 vaccines as they become available. The goal of the COVAX initiative is securing two billion doses of approved vaccines and to beginning vaccination of 20% of the population in LMIC countries. The COVAX Facility currently has 190 participating economies and 86 economies have submitted detailed vaccine requests. Country preparedness includes regulatory preparedness as well as the availability of infrastructure, appropriate legal framework (for issues of vaccines as intellectual property) frameworks, training, and capacity.

Every life has Equal Worth: Ethical Considerations

Children Walking to School (Ethiopia 2009)

The aphorism “the personal is the political” is powerful and relevant when discussing global health, genderized health, and pandemics. The geopolitical dominance of rich countries impact have a negative impact on LMIC in the battle for survival. The frontline workers and community health workers are an indispensable. Women who form the cadre of community healthcare workers provide information, contact tracing, and testing – in addition to managing their families and economies. It is important to  search for equitable solutions that involve women in positions of leadership.




IPRHglobal Cervical Cancer Screening Update: 12/9/21

IPRHglobal: Global Community News

IPRHglobal keeping you current with news from Sister Birhane in Adama, Ethiopia.

International projects are difficult to sustain for many reasons. Communication and on-the-ground contact is often unreliable. Establishing channels of communication are an essential aspect of sustainable projects.

Sister Birhane is the Head Matron at Sister Aklesia Memorial General Hospital.



Sr. Birhane

Sister Birhane, Head Matron and Cervical cancer screening nurse

She is the face of the IPRH/SAMGH Cervical Cancer Screening Project.  I was delighted to connect with Sister Birhane, thanks to Demrew Bejiga. Mr. Demrew is the SAMGH Hospital Manager.

Sister Birhane and I talked about the number of appointments she had today and the assistance she receives from 2 other nurses at SAMGH. She is very interested in educational information to help keep everyone current on cervical cancer screening and techniques for treating non-cancer cervical changes.

Learn more:

Global Women’s Health: Human Papilloma Virus  WHO

New Mexico Birth and Reproductive Justice Summit 2021

Sandia Mountain Sunset, NM

Connections, Remediation, Healing, Regrowth, Co-Creation and Emergence


The virtual New Mexico Birth and Reproductive Justice Summit 2021 (NMBRJ), hosted by Tewa Women United ( began on Friday, 8-6-21, with music, song, and poetry. The speculative goal for the three-day summit was understanding the impact of the COVID-19 pandemic on ecosystems of birth and reproductive justice. (more…)

Menstrual Hygiene Equity

October 26: Menstrual Hygiene Equity

The dynamic energy of Bentasia Parker and Candace Turner caused me to pause with interest and fascination. I turned up the volume on the podcast and listened closely.

The Advocate Academy podcast, a production from the Women and Gender Resource Center at the University of Alabama. I tuned in on March 31 and listened to “Menstrual Hygiene Equity: An Interview with the Founding Members of “October 26: Driven by Women.”

Normalizing the Natural

Two young Black women, Bentasia Parker and Candace Turner, are on a mission to raise awareness about the importance of access to menstrual products, normalizing menstruation, and menstrual cycles.


Creative Innovations: IPRHglobal and Rice University

Look Doc No Hands!


Creative Prototypes

I love meeting people and making connections.
My husband and I attended a dinner party three years ago and looked forward to making acquaintances and learning about our new community.
Our friends were encouraging and hopeful that we would find a comfortable niche in the Southwest after leaving the Midwest. We soon realized that many families inhabiting the town during the summer were escaping Houston’s heat and humidity. Such was the case for our hosts. The food was delicious, and our conversations were fascinating.

One of the guests happened to hear about our work in Ethiopia and that was how we made an exciting connection.
Matthew offered me a sample of his carrot greens pesto and introduced himself. We shared stories about living and working in Ethiopia.  He mentioned having returned from Addis Ababa, Ethiopia, quite recently.
His work involved teaching and constructing prototypes from readily available materials. The engineering students at Addis Ababa University were participants in his seminar.

Design and Build: Medium Fidelity

The Freshman Engineering class at Rice University began work on “Look Doc No Hands” in August 2018. The team started the process of constructing the first medium-fidelity prototype of a hands-free handwashing sink. The main objectives were to integrate each component and get a sense of what does and doesn’t flow from the initial planning. The frame was made of PVC, initially. This was changed to a sturdier and stronger material. The reservoir of the initial prototype held 5 gallons, the goal was to create capacity for 10 to 30 gallons of water. The flow rate was a success at around 50 fluid ounces per minute.

Design and Build: High Fidelity

The final prototype included a wooden frame connected with screws. The wheels were four three-inch caster wheels with an integrated braking mechanism placed on the corners of the bottom of the frame. The three-inch caster wheels could sustain a weight of 440 pounds!

A yellow 20-gallon cylindrical reservoir, twenty-two, and a half inches in height and twenty-one inches in diameter was used for the water. It turned out that 20-gallons of water promoted a more regular refilling of the water, allowed the water to sit for less time, and thus, reducing the risk of contamination.

Eight-inch long siphon pumps with three-inch diameters were fastened into place using zip-ties. A dual foot pedal mechanism that allowed two pumps to be depressed simultaneously to achieve at least a 1.2-gallon/minute flow rate. All tubing (norprene tubing and PVC hose piping ) functioned to move the water from the bottom of the reservoir (PVC pipe) to the top. The two fifty-four-inch norprene tubes attached the inlet side of the siphon pumps to the reservoir.

Sister Aklesia Sanitation Solutions, (SASS) 2021

This year, a different class, taught by Dr. Deirdre Hunter, will focus on function, project testing, and implementation. The project is now the Sister Aklesia Sanitation Solutions, (SASS). Team SASS will conduct rigorous testing and implementation. Once the tests are completed, a manual will be assembled with details and design specifications for materials easily obtained in Ethiopia.

Special thanks to Dr. Matthew Wettergreen, PhD., Associate Teaching Professor at the Oshman Engineering Design Kitchen (ODEK) and Director of the Global Medical Innovation (GMI) ProgramThank You Rice University School of Engineering and ODEK

Special Thanks to Dr. Deirdre Hunter, PhD. Oshman Engineering Design Kitchen

“Just One Baby”: Access to Reproductive Health

Ajete’s Story

I met Ajete while working at Sister Aklesia Memorial Hospital in Adama, Ethiopia.

She looked into my eyes from across the crowded waiting room. She knew exactly what she wanted and she told me in no uncertain terms, “just one baby.”

Ajete was unsure of her age, but she knew that she and her husband had been trying to get pregnant for twelve years.


The Journey

I met Ajete while working in Adama, Ethiopia in 2007. She arrived at Sister Aklesia Memorial General Hospital SAMGH) before the Registration lady and before the custodians. She came with the hope of medical treatment to cure her infertility.

During the week, the local radio announcer kept repeating that Dr. Sharon, a visiting American Obstetrician/Gynecologist, provided cervical cancer screening and general care for women at SAMH.

The sunny waiting room filled up quickly with women of all ages. They sat patiently and seemed alert with expectation. Their soft voices filled the waiting room and mixed with the morning sounds of Adama waking up. Through the hospital’s open doors, we saw glimpses of people walking to work. Some young women and men carried trays laden with carafes of bunna (coffee) and pastries. The Sunrise Bakery filled the air with the scent of breakfast. 

The women dressed in colorful scarves, shawls, and white cotton shawlcalled a gabi (traditional Ethiopian handwoven cotton wrap) because the morning air was chilly. 

One woman seemed particularly alert; each time I passed through the waiting room, her eyes met mine. I smiled, and so did she.

Selam, the nurse, escorted Ajete into the exam room. I listened as their conversation in Amharic flowed back and forth in the question/answer of getting Ajete’s history. Selam turned to me and began by introducing Ajete. She pointed to the folder of papers Ajete carried and told me that she wanted to get pregnant. She married twelve years ago and has never been pregnant. Her search for answers had led her from Addis Ababa, Ethiopia, to South Africa, and then to Abu Dhabi, UAE.

The papers in her thick folder contained correspondences from Tikur Anbessa Hospital (Black Lion Hospital) in Addis Ababa with lab results and her husband’s semen analysis. There were surgical notes from South Africa, her diagnosis, severe endometriosis that damaged her Fallopian tubes. Another surgery performed in Adama was an attempt to repair damaged tubes.

To be continued…


Spotlight on Eshetu Lemma Haile and HPV Research in Ethiopia

Human Papilloma Virus Research

Eshetu Lemma studies HPV

This interview has been edited

“Cervical cancer is 100% preventable.”

These are the words of Eshetu Lemma Haile, MSc, MA, PhD. (c), a brilliant young scientist engaged in research on the human papillomavirus (HPV). 


Since 2015, Mr. Eshetu has worked and consulted in the ICL, GIZ, WHO, EPHI, Quality Africa Network, QCC, Afriqual, and the HEMA laboratory in Addis Ababa. He learned that IPRH was returning to Adama, Ethiopia, to continue the cervical cancer screening project at Sister Aklesia Memorial Hospital. I connected with Eshetu via email, and we started the beginning of a long friendship. Our work in Adama often involves long days, sometimes up to ten hours, and little socializing.

I wanted to know more about Mr. Lemma and share his work with you. 

HPV Research in Ethiopia

Eshetu is a dedicated researcher who was born and raised in Addis Ababa, Ethiopia. His father and mother reside in Addis Ababa, as do his two brothers and his sister. Eshetu is married to Betselot and has two young sons and a daughter. Mavel is eighteen years of age, and Nataniem is twelve, Eyosiyas is ten years of age. The demands of research are often in conflict with family, but Eshetu manages to do both quite well.

IPRH and Eshetu commit to eradicating cervical cancer, and that focus resulted in critical supplies needed by Eshetu to conduct his study. Through the generosity of Hologic, IPRH provided five hundred vials of ThinPrep solution and four hundred and fifty collection devices for collecting and studying cervical cell samples. Mr. Eshetu’s research focuses on self-collection/testing compared to collection performed by physicians. The study of self-collection may be highly beneficial for women living outside of large cities like Addis Ababa and Adama. Mr. Eshetu stated that more than 80% of women reside in rural communities. The possibility of self-collection may be the most efficient way to identify Ethiopian women who are at risk for developing cervical cancer.

A Need for Pathologists

There are additional conditions that impact reliable detection initiatives; for example, Ethiopia has a significant need for pathologists. The work of the pathologist requires a scanning microscope to analyze the cervical cells. The appearance of cervical cells changes dramatically due to HPV infection. Cells that show pre-cancer changes require treatment, and cells that show signs of cervical cancer need treatment very quickly. 

Mr. Eshetu stated that there is a critical need for pathologists in Ethiopia, there are few pathologists, and their workload is overwhelming. The use of telepathology (digital transfer of images) makes the job easier. Digital photos use telecommunications technology to transfer data. 

The Cost of HPV Vaccine

I asked Eshetu how he became interested in HPV and cervical cancer. His immediate answer was that cervical cancer is 100 % preventable. He went on to say that 80% of women seeking care for symptoms are diagnosed with advanced stages of cervical cancer. He also noted that the uptake of the HPV vaccine is very costly for the Ethiopian Ministry of Health to provide. Although the Global Alliance of Vaccines and Immunizations) (GAVI) offsets the cost of the HPV vaccine for developing countries; however, vaccinating eligible populations would still be extremely expensive.

WHO and HPV vaccines in Ethiopia

Mr. Eshetu’s HPV research has identified several high-risk (HR) HPV types-51,52, and 58 in Ethiopia. Worldwide, the HR HPV types that significantly increase the risk of cervical cancer are HPV 16 and HPV 18. 

Mr. Eshetu is the Principal Investigator on the Covid-19 and pathology laboratory safety project in Africa and a study supported by the American Society of Clinical Pathology (ASCCP). 

The urgent message for many women is to get their cervical cancer screening done. Early detection will save your life. 

Cervical Cancer is Preventable

IPRH and Eshetu have a commitment to the eradication of cervical cancer worldwide.

Through the generosity of Hologic, IPRH provided five hundred vials of ThinPrep solution and four hundred and fifty collection devices for collecting and studying cervical cell samples. Mr. Lemma’s research focuses on self-collection/testing compared to collection performed by physicians. The study of self-collection may be extremely beneficial for women living outside of large cities like Addis Ababa and Adama. Mr. Lemma stated that more than 80% of women reside in rural communities. The possibility of self-collection may be the most efficient way to identify Ethiopian women who are at risk for developing cervical cancer.

Self-Collection of Cervical Specimen

Global Women’s Health: 2021

We Are a Global Community of Women

I don’t know about you, but, my 2021 is going to be FEARLESS!

Designing and creating the year that takes care of the whole you is about renewal and making space for wellness.

Spiritual health and physical health are equally important.

Let’s welcome health-seeking that involves mind, body and spirit. Global health for the whole woman!

Engaging in global activism and advocacy, despite the Pandemic, is possible.

The Basics: Food and Water

Have you considered activism and advocacy that involves the basics?

Keeping ourselves healthy is about being selective and replacing quick food with food made by our hands, with ingredients we select.

Being mindful is about the big picture. Me, you, and everyone.

Global health requires understanding issues such as food insecurity.

The health of many families suffer because of  limited nutrition.


Access to clean water is very difficult for many communities living with low resources. We can be mindful of  water use and learn how to be  clean water advocates for our communities.

Children getting water

Reproductive Health and Our Environment

Climate change and environmental  issues impact all of us, including the global community of women. Women living in low resource communities face a higher risk of  exposures that  may negatively impact their reproductive function.

Read More: climate change

Charity Begins at Home

The work of advocating for the health of all women begins at home. The COVID-19 Pandemic has changed our lives in many ways. This year, let’s work together.

Read More:


Healthy food

3 Activists working to fight world hunger

Top 10 Building Blocks for Global Reproductive Health

Want to Know more?

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What is GAVI?

GAVI  & Vaccines

HPV vaccines

The 1st Global Summit on Women Cancers in Africa occurred September 1st-2nd in 2010 at the United Nations Conference Centre in Addis Ababa, Ethiopia. Representatives for the Global Alliance for Vaccines and Immunizations (GAVI) were present to discuss Human Papilloma Virus (HPV) vaccine support for African countries. Partnering with GAVI would be a very benefit, due to the absence of routine cervical cancer screening in many countries. Representatives from pharmaceutical companies, Glaxo-Smith Kline, Merck, and Qiagen, were also present. The following year (2011), GAVI reported their success in negotiating  a reduced cost per dose for HPV vaccines. By 2012, 3.9 million girls had received the HPV vaccine.


Global Health = Health for all Women

Hepatitis B

The World Health Organization estimates that 325 million people worldwide are living with Hepatitis B and Hepatitis C infections. Hepatitis B virus is the leading cause of liver cancer.


In Uganda, the Maternal and Neonatal Tetanus Elimination campaign  worked to eliminate neonatal tetanus. In 2017 the WHO estimated over 30,000 neonatal death, worldwide, were due to tetanus.

What is CEPI?

knowledge center