May 2018 Monthly News Review

Online newsletter version available at: https://conta.cc/2Kt9OyD

Anniversaries Good and Bad

May marked the 50^th anniversary of the declaration at the 1968 International Conference on Human Rights that “Family planning is a human right!”. Amid calls to “accelerate progress” for greater sexual and reproductive health and rights for all, once and for all, another anniversary reminded that “the battle for reproductive rights is never over.”

The month marked one year since the start of implementation of the Trump administration’s extreme enforcement of the “Mexico City Policy” – the Global Gag Rule cutting off as much as $9 billion in funding for organizations in 60 countries that provide or mention abortion, or “exporting censorship”. One year on, the policy is harming the most vulnerable, threatening progress towards integrated health systems, and will have long-lasting effects on civil society. The last time it was in effect, it had the opposite effect and abortion rates spiked. That has been the case so far in Kenya, as clinics are losing millions of dollars in support, thousands of women don’t have access to affordable contraceptives, and the costs of unsafe abortion complications is in the millions as well.

Basic family planning services have been curtailed across African nations – “from Burkina to Zimbabwe”. In Uganda groups offering contraception and family planning have lost millions in US aid; Malawian NGOs and human rights organizations bemoan a rise of maternal deaths in rural areas due to inadequate services; Nigerian agencies say the policy is “hitting hardest the organisations working with the most vulnerable populations and severely disrupting health supplies,” threatening the work of healthcare providers who may be the only “entry point for receiving a wide range of primary health services.”

And to mark the anniversary, the Trump administration is expanding it domestically, cutting off fund for women’s health to any organization that has anything to do with abortion services, in particular Planned Parenthood, which serves millions of women with primary health care across the country.

Across the states, more than 400 abortion restrictions have been put in place since 2011. The latest in Iowa prohibits abortion after six weeks, a so-called “heartbeat” law which defies medical science and was immediately challenged in the courts.

Texas offers an example of how defunding actually affects women and girls:

In 2011, in an attempt to defund Planned Parenthood, the Texas Legislature slashed the state’s family planning budget by two-thirds, and reorganized the funding system to give least priority to dedicated family planning providers like Planned Parenthood. As a result, 82 family planning clinics closed, and the number of Texans receiving services through Title X dropped by 50 percent in the year after the budget cuts. A study last year identified a spike in teen births following the cuts.

Soon after, in 2013, Texas completely excluded Planned Parenthood from its separate low-income women’s health program, electing to forgo millions in federal funds. After Planned Parenthood, which previously saw more than 40 percent of the clients in the program, was kicked out, tens of thousands of women lost access to family planning services. Researchers in 2016 found a decline in contraceptive use and increase in Medicaid births in communities that had been previously served by Planned Parenthood clinics.

CIRHT and Michigan Research Highlights

Congratulations to our partner Almaz Berhe from Mekelle University (top) on presentation at the American College of Nurse-Midwives 2018 conference of her research: “Levels and determinants of postnatal care utilization in Tigray, Ethiopia”. See her poster here. Thanks to her mentors University of Michigan School of Nursing‘s Lee Roosevelt & Ruth Zielinski (seen above) who presented it when Almaz was unable to attend.

Other relevant University of Michigan research of note includes the omnipresent Ruth Zielinski’s work in South Sudan helping women through better contraceptives education.

Michigan Medicine colleagues Vanessa K. Dalton, Lisa H. Harris, Sneha Challa, Dana Loll, Jessica L. Dozier and Melissa K. Zochowski, along with collaborators from Ghanaian universities and Emory University, published important work, Bad girl and unmet family planning need among Sub-Saharan African adolescents: the role of sexual and reproductive health stigma.

CIRHT’s work with the Ethiopian Society of Obstetrics and Gynecology and the American College of Obstetrics and Gynecology as well as Michigan Medicine’s Frank Anderson and the “1000+ OB-Gyn Project” are part of an overview, “Obstetrics and gynecology in global health: Lessons learned for advancing public health to achieve universal health care” in the Bulletin of the American College of Surgeons.

The School of Nursing also highlighted research from Janis Miller and Alain Mukwege in DR Congo on fistula treatment, working to establish the “Panzi Score” to create treatment protocols.

The William Davidson Institute at the University of Michigan “is part of two separate grants awarded by the Reproductive Health Supplies Coalition (RHSC) Innovation Fund, the organization’s flagship initiative to spur and finance promising new ideas and strategies. The coalition, which is the largest network of reproductive health organizations, aims to ensure that a range of quality reproductive health supplies are available equally to all people who need them regardless of income.”

The Irish Referendum and Global Abortion Access

The huge vote to repeal the Eighth Amendment of the Irish constitution and allow for abortion will allow for reproductive choice for Irish women and girls. The vote was a “momentous result for reproductive rights” and led to worldwide public debates about female reproductive rights and abortion restrictions in Malawi (where “each year 141,000 women have abortions, almost all clandestine”), Zimbabwe, South Korea, Poland, Belgium, Northern Ireland, Argentina, Colombia, and El Salvador. In Mexico, the Supreme Court ruled that prohibiting abortions to rape victims is unlawful. It’s simple: the overwhelming majority of abortions are safe in countries where the procedure is broadly legal, while most are unsafe in countries where it is highly restricted, (26 countries where it is completely banned with no exceptions, 37 more where it is prohibited except to save the life of the mother). And the consequences of unsafe abortion are devastating. Worldwide, “at least 22,800 women die each year from complications of unsafe abortion,” and “millions more risk serious illness or injury from clandestine or unsafe abortions.”

Even in countries where abortion is legal, vigilance is required. South Africa has one of the most liberal abortion laws, but only 7% of health facilities provide abortions and illegal abortions are taking a toll. A recent attempt to pass a more stringent law was rejected. Mauritius also defended its abortion laws against opponents.

In Chile, since it was legalized in September 2017, 111 abortions have taken place according to official statistics. There is pushback from a new conservative government, which wants to strengthen conscientious objection. In Italy, while free and safe abortions have been legally guaranteed since 1978, a record 70.9% of doctors refuse to perform them on moral grounds.

Complete News References:

Angola

Des chefs religieux contre l’avortement volontaire, ANGOP, 24 May 2018

Benin

Young Champions at the crossroads of innovative ideas / Les jeunes champions au carrefour des idees novatrices, Youth Against Abortion Stigma, 14 May 2018

Ceradis décroche la «mention spéciale» pour son engagement en santé sexuelle et reproductive, La Nouvelle Tribune, 11 May 2018

Burkina Faso

Semaine nationale de la planification familiale: Une panoplie de méthodes gratuites, Sidwaya, 21 May 2018

Grossesses et paternite precoces: Le terminus de l’avenir de jeunes, Le Pays, 16 May 2018

Cote d’Ivoire

Promotion de la planification familiale : Bayer offre du matériel de santé à l’Aibef, Fratmat, 30 May 2018

DRC