scholarly journals 1409Legal abortion in the context of the COVID-19: a literature review focusing on Latin America

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Flávia B. Pilecco

Abstract Background The COVID-19 pandemic changed the functioning of several health services. This work aimed to understand how different countries, especially Latin Americans, dealt with legal abortion ones. Methods Narrative review on abortion and COVID-19 from January 1st, 2020 to March 10th, 2021. Databases searched included MEDLINE (through LitCOVID), Global Index Medicus, Virtual Health Library, and Journal Storage, complemented by gray literature. Results Of the 668 documents found, 111 were duplicated. After thematic screening, 75 were included. The vast majority reinforced the importance of abortion as a reproductive right and the maintenance of abortion services during the pandemic as essentials. Medical protocols without prior testing and supported by telemedicine were proposed to respect the distance measures. The pandemic amplified existing problems and restricted access to sexual and reproductive health services, such as legal abortion. This impact may be even stronger in low- and middle-income countries, especially in Latin America, where access to legal abortion is usually restricted. However, empirical peer-reviewed studies in this region are still scarce. Conclusions Latin American countries must place reproductive rights as a priority on their agendas and adapt legislation to accommodate alternative models of abortion care, or else they are at risk of increasing rates of unsafe abortions and maternal mortality, especially among the most vulnerable women. Key messages Maintaining legal abortion services during the pandemic is essential, at the risk of increasing maternal mortality, especially in contexts where access to these services is already restricted, such as in Latin America.

2021 ◽  
Vol 37 (6) ◽  
Author(s):  
Flávia Bulegon Pilecco ◽  
Cecilia Anne McCallum ◽  
Maria da Conceição Chagas de Almeida ◽  
Flávia Jôse Oliveira Alves ◽  
Aline dos Santos Rocha ◽  
...  

The COVID-19 pandemic may accentuate existing problems, hindering access to legal abortion, with a consequent increase in unsafe abortions. This scenario may be even worse in low- and middle-income countries, especially in Latin America, where abortion laws are already restrictive and access to services is already hampered. Our objective was to understand how different countries, with an emphasis on Latin Americans, have dealt with legal abortion services in the context of the COVID-19. Thus, we conducted a narrative review on abortion and COVID-19. The 75 articles included, plus other relevant references, indicate that the pandemic affects sexual and reproductive health services by amplifying existing problems and restricting access to reproductive rights, such as legal abortion. This impact may be even stronger in low- and middle-income countries, especially in Latin America, where access to legal abortion is normally restricted. The revision of sources in this article underlines the urgent need to maintain legal abortion services, both from women’s perspective, in support of their reproductive rights, but also from that of the international commitment to achieving the Millennium Development Goals. Thereby, Latin American countries must place reproductive rights as a priority on their agendas and adapt legislation to accommodate alternative models of abortion care. Furthermore, our results underscore the need for clear information on the functioning of sexual and reproductive health services as essential for understanding the impact of the pandemic on legal abortion and to identify the groups most affected by the changes.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S787-S788
Author(s):  
Catherine Garcia ◽  
Maria P Aranda

Abstract Population aging is occurring rapidly across Latin America, a region that includes some of the world’s most racially, ethnically, and culturally diverse populations. Aging in this region is occurring in a context of high levels of poverty and income inequality, which has implications for disease risk, cognitive health, and overall well-being. This symposium focuses on Mexico and Colombia, two of Latin America’s largest middle-income countries, which have recently undergone rapid epidemiological and demographic transitions. The papers in this symposium examine a variety of health dimensions among older Latinos that include physiological functioning, cognition, and psychological and physical well-being. García uses the Mexican Health and Aging Study (MHAS) and the Health and Retirement Study (HRS) to examine biomarkers known to predict health risk among Mexican-origin populations: Mexico-born living in Mexico, Mexico-born living in the U.S., and U.S.-born Mexican-Americans. Saenz examines the importance of education on late-life cognitive ability among Mexicans using data from the MHAS Cognitive Aging Ancillary Study. Using data from the Colombian Survey of Health, Well-Being, and Aging (SABE-Colombia), Ailshire examines variation in biological risk across key subgroups of the population. Osuna uses data from the Colombian National Quality of Life Survey (ENCV) to determine if social and economic inequalities are reflected in unequal health and well-being among older adults. Results highlight which Latin American populations have increased risk for poorer health, which merit further research and policy attention. The findings highlight the importance of understanding health and well-being in the rapidly growing older adult populations of Latin America.


Author(s):  
Salima Meherali ◽  
Bisi Adewale ◽  
Sonam Ali ◽  
Megan Kennedy ◽  
Bukola (Oladunni) Salami ◽  
...  

Adolescents living in low- and middle-income countries (LMICs) are struggling with accessing sexual and reproductive health (SRH) services, and COVID-19 has escalated the problem. The purpose of this review was to identify and assess the existing literature on the impact of the pandemic on SRH needs and access to services by adolescents in LMICs. A scoping review was conducted to collate findings on the topic. Searches were performed on eight databases. Data were extracted and categorized into various themes. After removing duplicates and performing a full-text reading of all articles, nine articles were included in our review. Our findings generated several themes related to adolescents’ sexual and reproductive health during the COVID-19 pandemic. These include (1) limited access to sexual and reproductive health services, (2) school closure and increased rate of early marriages, (3) sexual or intimate partner violence during COVID-19, (4) disruption in maternity care, (5) adolescents’ involvement in risky or exploitative work, (6) intervention to improve sexual and reproductive health services during COVID-19, and (7) policy development related to adolescent sexual and reproductive health. Several recommendations were made on policies—for instance, the use of telemedicine and community-based programs as a way to deliver SRH services to adolescents during and after a pandemic.


Author(s):  
Ross C. Brownson ◽  
Graham A. Colditz ◽  
Enola K. Proctor

This chapter highlights just a sample of the many rich areas for dissemination and implementation research that will assist us in shortening the gap between discovery and practice, thus beginning to realize the benefits of research for patients, families, and communities. Greater emphasis on implementation in challenging settings, including lower and middle-income countries and underresourced communities in higher income countries will add to the lessons we must learn to fully reap the benefit of our advances in dissemination and implementation research methods. Moreover, collaboration and multidisciplinary approaches to dissemination and implementation research will help to make efforts more consistent and more effective moving forward. Thus, we will be better able to identify knowledge gaps that need to be addressed in future dissemination and implementation research, ultimately informing the practice and policies of clinical care and public health services.


2020 ◽  
Vol 17 (S3) ◽  
Author(s):  
Melissa Bauserman ◽  
Vanessa R. Thorsten ◽  
Tracy L. Nolen ◽  
Jackie Patterson ◽  
Adrien Lokangaka ◽  
...  

Abstract Background Maternal mortality is a public health problem that disproportionately affects low and lower-middle income countries (LMICs). Appropriate data sources are lacking to effectively track maternal mortality and monitor changes in this health indicator over time. Methods We analyzed data from women enrolled in the NICHD Global Network for Women’s and Children’s Health Research Maternal Newborn Health Registry (MNHR) from 2010 through 2018. Women delivering within research sites in the Democratic Republic of Congo, Guatemala, India (Nagpur and Belagavi), Kenya, Pakistan, and Zambia are included. We evaluated maternal and delivery characteristics using log-binomial models and multivariable models to obtain relative risk estimates for mortality. We used running averages to track maternal mortality ratio (MMR, maternal deaths per 100,000 live births) over time. Results We evaluated 571,321 pregnancies and 842 maternal deaths. We observed an MMR of 157 / 100,000 live births (95% CI 147, 167) across all sites, with a range of MMRs from 97 (76, 118) in the Guatemala site to 327 (293, 361) in the Pakistan site. When adjusted for maternal risk factors, risks of maternal mortality were higher with maternal age > 35 (RR 1.43 (1.06, 1.92)), no maternal education (RR 3.40 (2.08, 5.55)), lower education (RR 2.46 (1.54, 3.94)), nulliparity (RR 1.24 (1.01, 1.52)) and parity > 2 (RR 1.48 (1.15, 1.89)). Increased risk of maternal mortality was also associated with occurrence of obstructed labor (RR 1.58 (1.14, 2.19)), severe antepartum hemorrhage (RR 2.59 (1.83, 3.66)) and hypertensive disorders (RR 6.87 (5.05, 9.34)). Before and after adjusting for other characteristics, physician attendance at delivery, delivery in hospital and Caesarean delivery were associated with increased risk. We observed variable changes over time in the MMR within sites. Conclusions The MNHR is a useful tool for tracking MMRs in these LMICs. We identified maternal and delivery characteristics associated with increased risk of death, some might be confounded by indication. Despite declines in MMR in some sites, all sites had an MMR higher than the Sustainable Development Goals target of below 70 per 100,000 live births by 2030. Trial registration The MNHR is registered at NCT01073475.


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