News Review – 29 September 2017 | Center for International Reproductive Health Training

A week of days… Contraception

World Contraception Day gave a spotlight to efforts around the world to increase access, investment and understanding. The essential point: 214 million women have an unmet need for modern contraception.

Contraception access is a health issue, a human rights issue, a women’s empowerment issue and an economic issue.

The need for more access was clear in articles from Uganda, where “only three in ten currently married women are using modern method of family planning,” DRC, where services are desperately low, with a “high potential for improvement,” and Kenya, where “one in four married women of reproductive age reported having an unmet need for family planning,” and “43 per cent of pregnancies are unplanned.”

The health benefits are clear: access will reduce maternal mortality in Nigeria, allow for healthy timing of and spacing of pregnancies (HTSP), and prevent 70% of maternal deaths and 44% of newborn deaths. Some indicators are positive. In Burundi the number of people using contraceptives in increasing. Initiatives in Senegal, Nigeria and Benin.

Outreach to children and adolescents is the focus of campaigns in Burkina Faso, Kenya, Nigeria, and Uganda, including a teaching through animation and art in Tanzania, a digital marketplace in Kenya, a new website in Lesotho and the marketing of the “Icon Gold” condom in Zimbabwe. Young mothers and child brides are among the most vulnerable, and most important, constituencies.

Some inspiring first-person stories from Family Planning Voices, the Universal Access Project and DKT in about the life-changing effects contraceptives can have. Jhpiego “celebrates the midwives, nurses, physicians and community health workers who are delivering FP services across West Africa with respect and care in service of all.”

Achieving increased access requires investment: This week, a €10 million investment in Togo, sh182 billion announced in Uganda, and $10.5 million “for three years from the Bill & Melinda Gates Foundation and Children’s Investment Fund Foundation to empower women and adolescent girls with expanded contraceptive options.” And that investment is worthwhile in economic terms as well. A Sierra Leone paper calls investment in family planning a “smart investment”. In Tanzania, where adolescent fertility is much higher than global rates, and “the Tanzania Adolescents and Reproductive Health (TAYARH) said beefing up the funding for sexual and reproductive health (SRH) is the cheapest way to achieve Tanzania’s middle income status aspirations by the year 2025.”

Part of that investment is in distribution of family planning materials. An interesting study by Shops Plus looks at the “regulation of drug shops and pharmacies relevant to family planning” in 32 developing countries and concludes that a new regulatory framework is needed, but that “future research is needed to explore the link between regulatory frameworks and contraceptive prevalence rates.” The Pace Project shows that “use of modern contraceptives increases as more methods are made available.” Gambia’s community-based distributors include local police stations to reach vulnerable population. Zimbabwe distributes some 100 million condoms every year. And a Namibian official admitted that they “sneak condoms into prisons.”

Yet stigma and misunderstanding remain barriers to expanded usage. “Myths” are hindering usage in Ghana, “religious and cultural beliefs” in Nigeria.

K4Health gave a reminder of its favorite family planning resources.

And a challenge from Open IDEO, looking for input: How might we radically improve access to, and quality of, sexual and reproductive health education and services for young people?

A week of days… Abortion

International Safe Abortion Day (“Global Day of Action for Access to Safe and Legal Abortion”) created its own spotlight, “advocating for the decriminalization of abortion, reducing the negative stigma surrounding abortions, and ensuring equal access to safe abortions for all individuals.” The essential point: An estimated 25 million unsafe abortions occur each year – nearly half of all abortions globally – leading to 7 million health complications and 47,000 deaths. The WHO adds, “in countries where abortion is completely banned or allowed only to save the women’s life or her physical health, only 1 in 4 abortions were safe.”

On the global stage, UN special rapporteurs in the areas of health, law, discrimination, human rights and extrajudicial killings, urged “all States to end the criminalization of abortion and to ensure that all women are able to access all necessary health services, including sexual and reproductive health care, in a manner that is safe, affordable and consistent with their human rights.” Another joint statement signed by some 285 organizations from around the world, urges “the [UN] Human Rights Council to address the human rights violations arising from criminalization of abortion and the denial of access to safe and legal abortion services.” IPPF states it plainly: Make abortion safe. Make abortion legal.”

Regionally, calls for an end to stigma in Africa, legal liberalization in Brazil (“hundreds of thousands of women and girls risk their health and lives”), Burundi (“rising numbers of illegal abortion”), Egypt (“among the most restrictive laws worldwide), Malawi (“Why retain a law the kills women?”), and Nicaragua (“making victims into criminals”). Dame Billie Miller notes that after she helped legalize abortion in her native Barbados, the maternal mortality ratio plummeted by 53%, and asks, “Why do politicians still force women through unwanted pregnancies? Ireland announced it will hold a referendum on Article 8 of its constitution in the spring. Nova Scotia became the latest Canadian territory to make the abortion pill available for free at pharmacies. In the 21 years since South Africa guaranteed the legal right to abortion, abortion-related deaths and injuries are estimated to have reduced by over 90%; nevertheless, access remains limited, because of “conscientious objection” and a lack of public information.

In the political fight in the US, where teen pregnancies have plummeted 51% over the past decade, Congress may consider a 20-week ban. A watchdog in Arizona notes the millions of wasted taxpayer dollars spent defending indefensible abortion restrictions; Illinois increased access and affordability; an Indiana judge permanently struck down provisions of a law “that would have banned abortions sought due to fetal genetic abnormalities and required that aborted fetuses be buried or cremated;” Arkansas restricted access to the abortion pill. The Campaign for Accountability is calling for an investigation of fraud by the Texas anti-abortion “Heidi Group”. One opinion writer posited that he was “pro-choice, but anti-abortion.”

Another grim reminder of how women have suffered through the use of unsafe abortion methods over the past several thousand years, including herbs, “massages” (more like pounding on the belly), and bears’ feet.

Complete News Review References:

General/Global

Challenge: How might we radically improve access to, and quality of, sexual and reproductive health education and services for young people?, Open IDEO, 1 Oct 2017

Commemorating International Safe Abortion Day, Feminist Newswire, 29 Sep 2017

UN Special Rapporteurs Call for Strong Action on International Safe Abortion Day, IWHC, 28 Sep 2017

Illinois Just Expanded Government-Funded Abortion Access, Ms. Magazine, 28 Sep 2017

How Hugh Hefner Used a Sexist Magazine to Champion Women’s Reproductive Rights, Fortune, 28 Sep 2017

Why do politicians still force women through unwanted pregnancies?, The Guardian, 28 Sep 2017

Women and girls continue to be at risk of unsafe abortion, WHO, 28 Sep 2017

Africa: It’s Time to End the Stigma and Silence Around Abortion, AllAfrica.com, 28 Sep 2017

The Struggle to Provide Culturally-Appropriate Maternity Care, MHTF, 28 Sep 2017

Appeals court won’t reconsider Arkansas abortion pill ruling, AP, 28 Sep 2017