July 2018 News Review

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World Population Day Generates dialogue about Family Planning as a Human Right

The theme of this year’s World Population Day was “Family Planning is a Human Right”, which “means big progress for the Sustainable Development Goals” and “sustainable economic growth.” It represents “One investment, many returns.”

Marking the day generated calls in the press and by governments for improving access to family planning in many African countries, including initiatives in among other places Zimbabwe, Tanzania, Guinea, Namibia, Cameroon, and Burkina Faso, where immediate postpartum contraception is being promoted. The news listings below show dozens of articles about national strategies and investments.

A UNFPA report speaks of how family planning is “liberating” for women in rural Ethiopia. In Sierra Leone, it is a “key to development.” The governments of Algeria and Egypt are struggling with the consequences of overpopulation and acknowledging the role family planning can have to boost the health and development of their populations.

With so much lip service to its value, nevertheless implementation can be a struggle: Malawi public hospitals run out of contraceptive drugs, which is also the case for clinics in Uganda. In South Africa the question is whether the shortages are “intentionally caused by Big Pharma.”

A symposium at the Wilson Center noted “Fully addressing the unmet need for family planning would reduce the number of maternal deaths by about 76,000 per year.” And it would save money too: “For each additional dollar invested in family planning, the health system saves $2.20 on pregnancy-related care. The cost of preventing an unintended pregnancy through family planning is much lower than the cost of providing pregnancy and maternity care.”

In Nigeria, effective family planning “can reduce maternal mortality by 40%.” And two newspapers noted another advantage: We No Longer Deny Our Husbands Sex, Kudos To Family Planning – Lagos Mothers, according to The Independent and The Whistler posts: I Now Enjoy My Sex Life, Thanks To Family Planning.

A satirical glimpse of a scary, dystopian future can be seen in this video about “The Department of Reproductive Control.”

Abortion law debates

Amnesty International updated its policy on abortion, calling on “States not just to decriminalise abortion, but to guarantee access to safe and legal abortion in a broad way that fully respects the rights of all women, girls and people who can get pregnant.” FIGO simply states: Reproductive Health should not be a Political Football.

In DRC, legal access to abortion is growing, as the country’s implementation of the Maputo Protocol is being promoted in the media. Movement and debate about liberalization of laws took place in Madagascar, Malawi, and Côte d’Ivoire. An article from Zimbabwe noted that country’s restrictive laws have not led to a reduction in unsafe abortion, which number 70,000 per year and can be attributed to some 16% of maternal deaths.

A specific case in Kenya, in which a teenager died from an unsafe abortion (one of the estimated 465,000 illegal abortions performed in the country per year), brought abortion the issue of access to the high court. It’s another case that shows that laws alone cannot provide women and girls with the healthcare they need. The same is true in South Africa, where “backstreet abortions are rife” and an article describes “Durban’s abortion abyss.” The Social Development on Abortion and Reproductive Justice conference convened to look at how to address the non-legal barriers.

Latin America, which has the world’s highest abortion rates, is seeing some small gains in rights undermined by “conscientious objection,” and “offer a look at what America could look like if Roe is struck down,” with challenges to laws in Brazil, Chile, and Argentina.

While in Malaysia women and medical professionals face imprisonment for infanticide, in next-door Indonesia the country’s laws are under scrutiny after a teen who was raped by her brother was imprisoned for having an abortion.

Wales legalized “take-home” abortion pills; Queensland is poised to decriminalize abortion; protests continue in South Korea, Poland and Belgium.

The attention in the United States is on the next Supreme Court nominee and how the protections of Roe v. Wade could erode. Currently barriers to access exist in many states (“23 creative ways”!), and 22 are ready to ban abortion immediately should the court rescind Roe. Many articles note that a potential post-Roe world would be very different from a pre-Roe world, thanks in large part to medical advances and technology – decriminalizing home use of the abortion pill, purchasing them online and through the mail, and “Plan C”.

Research Highlights

Our University of Michigan colleagues produced an insightful update in JAMA: Long-acting Reversible Contraception—Highly Efficacious, Safe, and Underutilized, which states, “Increasing access to long-acting reversible contraception (LARC) is a critical strategy for decreasing the US rate of unplanned pregnancy.”

Ibis Reproductive Health published a study in BMJ Sexual & Reproductive Health shows that “a safe-abortion hotline staffed by trained abortion counselors can help women who are more than 12 weeks pregnant to safely self-manage medication abortion.”

The World Health Organization looked at Delivering Quality Health Services – a Global Imperative for Universal Health Coverage, which concludes “low quality healthcare is increasing the burden of illness and health costs globally.” Specifically on reproductive health, “The report cites research from eight high-mortality countries—Haiti, Kenya, Malawi, Namibia, Senegal, Rwanda, Tanzania and Uganda—which found that just 28% of antenatal care, 26% of family planning services and 21% of sick-child care qualified as ‘effective.”

IPAS produced the latest version of its useful “Clinical Updates in Reproductive Health”. At the other end of the spectrum, UNFPA released a disturbing look at “dozens of examples of the ineffective – and even harmful – strategies people resort to while trying to prevent pregnancy, described in a new feature, ‘Unsafe, unreliable: Dangerous pregnancy prevention methods.’”

A wonderful graphic website looks at posters from “50 Year of Choice”. Have a look as an antidote to some of the challenging headlines.

Algeria

Algeria struggles to keep up with rapid population growth and own ambitions, The Arab Weekly, 29 Jul 2018

Burkina Faso

Camp national du MAJ/ABBEF édition 2018, MAJ/ABBEF, 23 Jul 2018

Planification familiale – Se mettre sous contraception 10 mn après l’accouchement, Sidwaya, 17 Jul 2018

UNFPA-Burkina :Plus de 42 milliards de F CFA mobilisés pour le 7e programme, Sidwaya, 8 Jul 2018

Burundi

African Union Shouldn’t Tolerate Banning Pregnant Girls from School, Human Rights Watch, 19 Jul 2018

Les jeunes filles bientôt privées d’école si elles tombent enceintes, RFI, 6 Jul 2018

Burundi school ban on expectant teens ‘skewed’ against girls’ education, Thomson Reuters Foundation, 4 Jul 2018

Cameroon