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Lancet. 2017 Jul 01; 390(10089):1.Add to my documents.
Guttmacher Policy Review. 2015 Spring; 18(2):27-33.The U.S. overseas program for family planning and reproductive health has been under attack from policymakers who are antiabortion and increasingly anti-family planning. The two most notorious of these attacks are the blocking of U.S. funding for the United Nations Population Fund and the enforcement of the global gag rule, which prohibits aid to foreign nongovernmental organizations that engage in abortion services or advocacy with non-U.S. funds. In an ongoing counterproductive cycle, these restrictions have come in and out of effect depending on the political party in power -- a struggle that is expected to heat up again with a socially conservative Congress.
Systematic review of integration between maternal, neonatal, and child health and nutrition and family planning. Final report.
Washington, D.C., Global Health Technical Assistance Project, 2011 May. 284 p. (Report No. 11-01-303-03; USAID Contract No. GHS-I-00-05-00005-00)This reveiw seeks to focus on the MNCHN and FP components of SRH to examine the evidence for MNCHN-FP integration, review the most up-to-date factors that promote or inhibit program effectiveness, discuss best practices and lessons learned, and identify recommendations for program planners, policymakers, and researchers. The objective was to address these key questions: 1) What are the key integration models that are available in the literature and have been evaluated?; 2) What are the key outcomes of these integration approaches?; 3) Do integrated services increase or improve service coverage, cost, quality, use, effectiveness, and health?; 4) What is the quality of the evaluation study designs and the quality of the data from these evaluations?; 5) What types of integration are effective in what context?; 6) What are the best practices, processes, and tools that lead to effective, integrated services? What are the barriers to effective integration?; 7) What are the evidence/research and program gaps? What more do we need to know?; and 8) How can future policies and programs be strengthened?
The World Health Organization Multicountry Survey on Maternal and Newborn Health project at a glance: the power of collaboration.
BJOG: An International Journal of Obstetrics and Gynaecology. 2014 Mar; 121 Suppl 1:v-viii.Add to my documents.
Global Public Health. 2014 Jun 3; 9(6):607–619.On the twentieth anniversary of the International Conference on Population and Development (ICPD), activists, governments and diplomats engaged in the fight for sexual and reproductive health and rights (SRHR) are anxious to ensure that these issues are fully reflected in the development agenda to succeed the Millennium Development Goals after 2015. In inter-governmental negotiations since 1994 and particularly in the period 2012-2014, governments have shown that they have significantly expanded their understanding of a number of so-called ‘controversial’ issues in the ICPD agenda, whether safe abortion, adolescent sexual and reproductive health services, comprehensive sexuality education or sexual rights. As in the past and in spite of an increasingly complex and difficult multilateral environment, countering the highly organized conservative opposition to SRHR has required a well-planned and determined mobilization by progressive forces from North and South.
Bulletin of the World Health Organization. 2014; 92:155.Unsafe abortion is defined by the World Health Organization (WHO) as a procedure for terminating a pregnancy as performed by persons lacking the necessary skills or in an inappropriate environment that fails to meet minimal medical standards, or both. Concepts first outlined in a 1992 WHO Technical Consultation are embodied in this definition. However, although this definition is widely used, it is inconsistently interpreted. In this editorial, we discuss its correct interpretation and operationalization. (excerpt)
International Journal of Gynaecology and Obstetrics. 2013 Feb; 120(2):200-3.Since its first publication in 2003, the World Health Organization's "Safe abortion: technical and policy guidance for health systems" has had an influence on abortion policy, law, and practice worldwide. To reflect significant developments in the clinical, service delivery, and human rights aspects of abortion care, the Guidance was updated in 2012. This article reviews select recommendations of the updated Guidance, highlighting 3 key themes that run throughout its chapters: evidence-based practice and assessment, human rights standards, and a pragmatic orientation to safe and accessible abortion care. These themes not only connect the chapters into a coherent whole. They reflect the research and advocacy efforts of a growing field in women's health and human rights. Copyright (c) 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
WHO Guidelines on preventing early pregancy and poor reproductive outcomes among adolescents in developing countries.
Journal of Adolescent Health. 2013 May; 52(5):517-522.Adolescent pregnancy and its consequences represent a major public health concern in many low- to middle-income countries of the world. The World Health Organization has recently developed evidence-based guidelines addressing six areas: preventing early marriage; preventing early pregnancy through sexuality education; increasing education opportunities and economic and social support programs; increasing the use of contraception; reducing coerced sex; preventing unsafe abortion; and increasing the use of prenatal care childbirth and postpartum care. In each of these areas, the World Health Organization recommends directions for future research. The summary concludes with a brief look at global and regional initiatives that provide a window of opportunity for stepping up action in this important area.
American Journal of Public Health. 2013 Apr; 103(4):593-6.We discuss the history of the World Health Organization's (WHO's) development of guidelines for governments on providing safe abortion services, which WHO published as Safe Abortion: Technical and Policy Guidance for Health Systems in 2003 and updated in 2012. We show how the recognition of the devastating impact of unsafe abortion on women's health and survival, the impetus of the International Conference on Population and Development and its five-year follow-up, and WHO's progressive leadership at the end of the century enabled the organization to elaborate guidance on providing safe abortion services. Guideline formulation involved extensive review of published evidence, an international technical expert meeting to review the draft document, and a protracted in-house review by senior WHO management.
Bulletin of the World Health Organization. 2012 Sep 1; 90(9):712.The World Health Organization’s (WHO) update of its 2003 publication Safe abortion: technical and policy guidance for health systems has responded to a major neglected public health need of women. The substantial revisions in the 2012 update reflect developments in safe abortion methods and clinical care, providing guidance about the range of safe options available to women seeking elective abortion. Women’s participation in the choice of abortion method, pain control and post-abortion contraception is a crucial element, seeing as unsafe induced abortion is not only public health problem but also a human rights issue. The report discusses developments in the application of human rights principles in policy-making and in legislation related to induced abortion. National courts and regional and international human rights bodies, such as the United Nations treaty monitoring bodies, have increasingly applied these principles to facilitate women’s transparent access to safe abortion services.
Reproductive Health Matters. 2011 Nov; 19(38):35-41.This paper explores the actors who replaced the agreements about the global development agenda made in the International Conference on Population and Development (ICPD) in Cairo 1994 and the 4th UN World Women's Conference in Beijing in 1995 with the Millennium Development Goals (MDGs). It also surveys the processes which shape and affect the exercise of power, which can lead to radical changes.
Reproductive Health Matters. 2011 Nov; 19(38):102-18.Over the past 20 years, advocates have gained formal recognition for some rights in sexuality and reproduction and established the application of human rights standards to sexual and reproductive health issues more generally. However, careful reflection on the state of norm development across sexuality and reproduction as a field reveals fractures and stagnation in the development of standards, and a lack of synergy among advocates and between frameworks for similar rights. This paper seeks to stimulate a more careful accounting for these realities. It examines the formal processes and rules guiding standard-setting, in light of the different intellectual and ideological genealogies of sexual and reproductive rights. We use (homo)sexual orientation and abortion as case studies of current high-profile human rights standard-setting, with specific attention to the contemporary state of human rights law-making in the United Nations today. By placing these two issues in conjunction, we seek to make visible relationships between the vicious political debates in the UN on abortion and sexual orientation, and the multiple and sometimes divergent statements of independent experts and expert bodies in the UN human rights system on these and other sexual and reproductive rights issues. We offer no answers but seek to highlight the need for more investigation and self-reflection by advocates and scholars on how these forces operate and how to work with them. Copyright (c) 2011 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.
Geneva, Switzerland, WHO, .  p.The Preventing early pregnancy: What the evidence says? in Developing Countries presents the evidence to design national policies and strategies. It contains recommendations on action and research for preventing: (1) early pregnancy: by preventing marriage before 18 years of age; by increasing knowledge and understanding of the importance of pregnancy prevention; by increasing the use of contraception; and by preventing coerced sex; (2) poor reproductive outcomes: by reducing unsafe abortions; and by increasing the use of skilled antenatal, childbirth and postnatal care. These guidelines are primarily intended for policy-makers, planners and programme managers from governments, nongovernmental organizations and development agencies. They are also likely to be of interest to public health researchers and practitioners, professional associations and civil society groups. They have been developed through a systematic review of existing research and input from experts from countries around the world, in partnership with many key international organizations working to improve adolescents’ health. Similar partnerships have been forged to distribute them widely and to support their use. (Excerpt)
Studies In Family Planning. 2010 Dec; 41(4):241-50.Unintended pregnancy can carry serious consequences for women and their families. We estimate the incidence of pregnancy by intention status and outcome at worldwide, regional, and subregional levels for 2008, and we assess recent trends since 1995. Numbers of births are based on United Nations estimates. Induced abortions are estimated by projecting from recent trends. A model-based approach is used to estimate miscarriages. The planning status of births is estimated using nationally representative and small-scale surveys of 80 countries. Of the 208 million pregnancies that occurred in 2008, we estimate that 41 percent were unintended. The unintended pregnancy rate fell by 29 percent in developed regions and by 20 percent in developing regions. The highest unintended pregnancy rates were found for Eastern and Middle Africa and the lowest for Southern and Western Europe and Eastern Asia. North America is the only region in which overall and unintended pregnancy rates have not declined. We conclude with a brief discussion of global and regional program and policy implications.
Inter-agency field manual on reproductive health in humanitarian settings. 2010 revision for field review.
[New York, New York]. Inter-agency Working Group on Reproductive Health in Crises, 2010.  p.The 2010 Inter-agency Field Manual on Reproductive Health in Humanitarian Settings is an update of the 1999 Reproductive Health in Refugee Situations: An Inter-agency Field Manual, the authoritative guidance on reproductive health interventions in humanitarian settings. The 2010 version provides additional guidance on how to implement the Minimum Initial Service Package (MISP) for Reproductive Health, a minimum standard of care in humanitarian response. It also splits the original chapter on HIV and Sexually Transmitted Infections (STIs) into two separate chapters to accommodate new guidance on HIV programming. A new chapter on Comprehensive Abortion Care has been developed to cover more than post-abortion care. The chapters on Program Design, Monitoring and Evaluation and Adolescent Reproductive Health have been placed earlier in the manual to address the cross-cutting nature of these topics. Information on human rights and legal considerations has been integrated into each of the thematic chapters to ensure that program staff can address rights-related concerns. The updated information is based on normative technical guidance of the World Health Organization. It also reflects the good practices documented in crisis settings around the world since the initial field-test version was released in 1996. The latest edition reflects the wide application of the Field Manual's principles and technical content beyond refugee situations, extending its use into diverse crises, including conflict zones and natural disasters.
International Journal of Gynaecology and Obstetrics. 2010 Jul; 110 Suppl:S17-9.Unsafe abortion is a recognized public health problem that contributes significantly to maternal mortality. At least 13% of maternal mortality is caused by unsafe abortion, mostly in poor and marginalized women. The International Federation of Gynecology and Obstetrics (FIGO) launched an initiative in 2007 to prevent unsafe abortion and its consequences, building on its work on other major causes of maternal mortality. A Working Group was identified with collaborators from many international organizations and terms of reference provided direction from the FIGO Executive Board as to possible evidence-based interventions. A total of 54 member associations of FIGO, representing almost half its member societies, requested participation in the initiative, with 43 subsequently producing action plans that are country specific and involve the national government and multiple collaborators. Obstetrician/gynecologists have demonstrated the importance of the initiative by an unprecedented level of engagement in efforts to reduce maternal mortality and morbidity in country and by sharing experiences regionally. (c) 2010 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Chapel Hill, North Carolina, Ipas, 2008. 4 p.The United Nations Population Fund estimates that 25-50 percent of maternal deaths in refugee settings are attributable to unsafe abortions. Making pregnancy safer includes timely and appropriate management of unsafe and spontaneous abortion for all women, and the provision of or referral for safe abortion services to the full extent allowed by law. Manual vacuum aspiration (MVA) has been used worldwide for more than three decades, enabling millions of women in developed and developing countries to undergo safe and effective uterine evacuation for treatment of incomplete abortion and first-trimester abortion, as well as endometrial biopsy. This brochure highlights how MVA is an important part of safe, effective abortion and postabortion care in conflict settings.
Applying the WHO strategic approach to strengthening first and second trimester abortion services in Mongolia.
Reproductive Health Matters. 2008 May; 16(31 Suppl):127-34.Abortion was made legal on request in Mongolia in 1989, following the collapse of the socialist regime, and later bound by a range of regulations. Concerned about the high number of abortions and inadequate quality of care in abortion services, the Ministry of Health applied the World Health Organization's Strategic Approach to issues related to abortion and contraception in 2003. The aim was to develop policies and programmes to reduce unintended pregnancies, mitigate complications from unsafe abortion, and improve the quality of abortion and contraception services for all socio-economic groups, including adolescents. This paper describes the changes that arose from a strategic assessment, highlighting the introduction of mifepristone-misoprostol for second trimester abortion. The aim was to replace mini-caesarean section and intra-uterine injection of Rivanol (ethacridine lactate), so that second trimester abortions could take place earlier than at 20 weeks gestation. National standards and guidelines for comprehensive abortion care were developed, the national pre-service training curriculum was harmonized with the new guidelines, at least one-third of the country's obstetrician-gynaecologists were trained in manual vacuum aspiration and medical abortion, and three model comprehensive abortion care units were established to provide high quality services to women, high quality training for providers and serve as nodes for further scaling up.
Sexual and reproductive health of women living with HIV / AIDS. Guidelines on care, treatment and support for women living with HIV / AIDS and their children in resource-constrained settings.
Geneva, Switzerland, WHO, 2006.  p.The sexual and reproductive health of women living with HIV/AIDS is fundamental to their well-being and that of their partners and children. This publication addresses the specific sexual and reproductive health needs of women living with HIV/AIDS and contains recommendations for counselling, antiretroviral therapy, care and other interventions. Improving women's sexual and reproductive health, treating HIV infections and preventing new ones are important factors in reducing poverty and promoting the social and economic development of communities and countries. Sexual and reproductive health services are uniquely positioned to address each of these factors. (excerpt)
International Journal of Gynecology and Obstetrics. 2007 Nov; 99(2):157-161.National and international courts and tribunals are increasingly ruling that although states may aim to deter unlawful abortion by criminal penalties, they bear a parallel duty to inform physicians and patients of when abortion is lawful. The fear is that women are unjustly denied safe medical procedures to which they are legally entitled, because without such information physicians are deterred from involvement. With particular attention to the European Court of Human Rights, the UN Human Rights Committee, the Constitutional Court of Colombia, the Northern Ireland Court of Appeal, and the US Supreme Court, decisions are explained that show the responsibility of states to make rights to legal abortion transparent. Litigants are persuading judges to apply rights to reproductive health and human rights to require states' explanations of when abortion is lawful, and governments are increasingly inspired to publicize regulations or guidelines on when abortion will attract neither police nor prosecutors' scrutiny. (author's)
Sexual and reproductive health -- laying the foundation for a more just world through research and action: biennial report, 2004-2005.
Geneva, Switzerland, WHO, 2006.  p.This report presents an overview of RHR's work over the biennium 2004--2005. For the first time, we have produced a consolidated report, covering both the Department's research activities -- coordinated by the UNDP/UNFPA/WHO/ World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP) -- and its technical support initiatives. HRP activities are presented on white sheets and those relating to technical programme support to countries (Programme Development in Reproductive Health -- PDRH) are presented on blue pages. (excerpt)
Geneva, Switzerland, World Health Organization [WHO], 2006. 35 p.On 1--5 November 2004, in Bellagio, Italy, the UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), organized a meeting entitled International Consensus Conference on Non-surgical (Medical) Abortion in Early First Trimester on Issues Related to Regimens and Service Delivery. This document is the result of the deliberations of the participants in that meeting, who included highly experienced researchers and clinicians in the area of medical abortion. Prior to the meeting health-care personnel providing abortion services in various countries were asked to provide a list of the most frequently asked questions about medical abortion. The meeting participants reviewed those questions and compiled answers to them based on the scientific literature and their own clinical experience. The answers are presented in this publication. (excerpt)
Sanger File. 2002 Jul 24; (8): p..President Bush's refusal to release $34 million in aid to the United Nations Population Fund -- which assists women in 140 nations -- reflects his determination to win a majority in both houses of Congress by mobilizing his party's anti-abortion wing. Political pandering by the Bush administration to its anti-choice supporters once again threatens the health and lives of women and children around the globe. President Bush decided Monday [7/22/02] not to approve $34 million in aid for the United Nations Population Fund, which provides voluntary family planning assistance in more than 140 nations worldwide. A bipartisan Congress appropriated the money in the fiscal 2002 budget, but Bush withheld these funds after accusations were made that the U.N. agency supports or participates in programs of coerced abortion and sterilization in China. The President's own fact-finding team came back from China with a report that clears the U.N. agency of involvement in these activities, but Bush denied the funds anyway. (excerpt)
Geneva, Switzerland, World Health Organization [WHO], Department of Reproductive Health and Research, 2002. 67 p.Today, more than half of the world's one billion couples of reproductive age use some form of contraception and so are able to choose how many children they will have and when. In developing countries, about 55% of couples use contraceptives, compared to only 9% nearly fifty years ago. Much of the increase reflects a greater availability of reliable contraceptive methods. It also reflects continuing efforts by the international reproductive health community to promote the use of those methods. Since its inception in 1972, the UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), a member of that community, has stimulated and funded research aimed at expanding the choice of contraceptive methods available to couples. By generating, collating and disseminating the evidence produced by this research, HRP has built up a knowledge base such that this choice need no longer be based on intuition, hearsay, faith or dogma, but rather on scientifically sound information. (excerpt)
Ensuring women's access to safe abortion: essential strategies for achieving the Millennium Development Goals.
Chapel Hill, North Carolina, Ipas, 2005.  pApproved by world leaders in September 2000, the Millennium Development Goals (MDGs) articulate a series of time-bound, quantitative targets for ending poverty, improving health and promoting gender equality. The MDGs lack, however, any mention of human rights or reproductive and sexual health. In particular, the MDG framework does not include the critical issue of abortion, despite the fact that unsafe abortion leads to the unnecessary and completely preventable deaths of women and is a persistent problem rooted in poverty, gender inequity and the failure to implement human rights. Over the past decade, the international community has committed itself in a series of political and legal agreements to promoting and fulfilling women’s and men’s sexual and reproductive rights. Governments at the International Conference on Population and Development (ICPD) in 1994 agreed to a definition of reproductive health that includes abortion in circumstances where it is legal under national legislation. The MDGs echo elements of the ICPD consensus, but none specifically address its core commitment to ensure universal reproductive-health services. At the Fourth World Conference on Women, held in Beijing in 1995, sexual rights were acknowledged as integral to human rights and women’s empowerment, and countries were encouraged to review restrictive abortion laws. (excerpt)