Global Gag Rule

2018 ◽  
Author(s):  
Yana van der Meulen Rodgers
Keyword(s):  
Family Planning ◽  
Reproductive Health ◽  
Foreign Aid ◽  
Mexico City ◽  
Abrupt Change ◽  
Population Control ◽  
Sub Saharan Africa ◽  
George Bush ◽  
Large Fluctuations ◽  
Sub Saharan

This chapter discusses the evolution of the global gag rule and the existing evidence on its effects. When it was announced in Mexico City, the policy created global uproar with its abrupt change in position on population control and abortion. Pressure from domestic antiabortion groups weighed heavily in the administration’s new policy stance on family-planning assistance. Subsequent rescissions and reinstatements of the global gag rule have caused large fluctuations in US funding for family planning, as demonstrated in the chapter’s analysis of aggregate data. Evidence from qualitative studies indicates that the restrictions on US family-planning assistance under George Bush beginning in 2001 caused major disruptions in service delivery, especially in sub-Saharan Africa. This evidence is crucial for understanding the channels through which women’s reproductive health outcomes are related to restrictions on US foreign aid.

scholarly journals Assessing the Acceptability of Vasectomy as a Family Planning Option: A Qualitative Study with Men in the Kingdom of Eswatini

2019 ◽  
Vol 16 (24) ◽  
pp. 5158 ◽  
Author(s):  
Philile Shongwe ◽  
Busisiwe Ntuli ◽  
Sphiwe Madiba
Keyword(s):  
Family Planning ◽  
Reproductive Health ◽  
Urban Areas ◽  
Cultural Beliefs ◽  
Sub Saharan Africa ◽  
Group Discussions ◽  
Adult Men ◽  
Societal Norms ◽  
Willingness To Adopt ◽  
Sub Saharan

The uptake of vasectomy in many countries in sub-Saharan Africa is low. In Eswatini, a kingdom with strong patriarchal norms, the use of vasectomy is at 0.3%. This is despite great efforts to introduce vasectomy and involve men in reproductive health. This study explored the views of men about the acceptability of vasectomy and their willingness to adopt vasectomy as a family planning option. Focus group discussions were conducted with adult men recruited from health facilities located in rural, semi urban, and urban areas in two of the regions of Eswatini. A thematic approach was used to analyze the data. The acceptability of and intention to use vasectomy as a family planning option was very low. Cultural beliefs, societal norms, lack of knowledge about the procedure for vasectomy, and misconceptions influenced the acceptability of vasectomy greatly. The participants could not grasp the concept of a family planning method that is as permanent as vasectomy. However, the decisions to accept or reject vasectomy were influenced by their misconceptions and fears about vasectomy and were not based on facts. To address the need to involve men in reproductive health and improve the acceptability and adoption of vasectomy, planning should be conducted with them and informed by their understanding of their needs.

Reproductive Health and Family Planning Needs Among HIV-Infected Women in Sub-Saharan Africa

2013 ◽  
Vol 11 (2) ◽  
pp. 160-168 ◽  
Author(s):  
Clea C. Sarnquist ◽  
Lisa Rahangdale ◽  
Yvonne Maldonado
Keyword(s):  
Family Planning ◽  
Reproductive Health ◽  
Sub Saharan Africa ◽  
Sub Saharan

scholarly journals Bad girl and unmet family planning need among Sub-Saharan African adolescents: the role of sexual and reproductive health stigma

2018 ◽  
Vol 2 (1) ◽  
Author(s):  
Kelli Stidham Hall ◽  
Abubakar Manu ◽  
Emmanuel Morhe ◽  
Vanessa K. Dalton ◽  
Sneha Challa ◽  
...  
Keyword(s):  
Family Planning ◽  
Reproductive Health ◽  
Sexual And Reproductive Health ◽  
Sub Saharan Africa ◽  
Structured Interviews ◽  
Community Members ◽  
Sexually Transmitted ◽  
Enacted Stigma ◽  
Sub Saharan ◽  
Marital Sex

Adolescent pregnancy contributes to high maternal mortality rates in Sub-Saharan Africa. We explored stigma surrounding adolescent sexual and reproductive health (SRH) and its impact on young Ghanaian women’s family planning (FP) outcomes. We conducted in-depth, semi-structured interviews with 63 women ages 15-24 recruited from health facilities and schools in Accra and Kumasi, Ghana. Purposive sampling provided diversity in reproductive/relationship/socioeconomic/religious characteristics. Using both deductive and inductive approaches, our thematic analysis applied principles of grounded theory. Participants described adolescent SRH experiences as cutting across five stigma domains. First, community norms identified non-marital sex and its consequences (pregnancy, childbearing, abortion, sexually transmitted infections) as immoral, disrespectful, and disobedient, resulting in bad girl labeling. Second, enacted stigma entailed gossip, marginalization, and mistreatment from all community members, especially healthcare workers. Third, young sexually active, pregnant, and childbearing women experienced internalized stigma as disgrace, shame and shyness. Fourth, non-disclosure and secret-keeping were used to avoid/reduce stigma. Fifth, stigma resilience was achieved through social support. Collectively, SRH stigma precluded adolescents’ use of FP methods and services. Our resulting conceptual model of adolescent SRH stigma can guide health service, public health, and policy efforts to address unmet FP need and de-stigmatize SRH for young women worldwide.

scholarly journals Promoting Scale-Up Across a Global Project Platform: Lessons from the Evidence to Action Project

2021 ◽  
Author(s):  
Laura Ghiron ◽  
Eric Ramirez-Ferrero ◽  
Rita Badiani ◽  
Regina Benevides ◽  
Alexis Ntabona ◽  
...  
Keyword(s):  
Family Planning ◽  
Scale Up ◽  
Scaling Up ◽  
Sub Saharan Africa ◽  
Health System Strengthening ◽  
Country Level ◽  
Look Ahead ◽  
Republic Of The Congo ◽  
Sub Saharan ◽  
Multi Stakeholder

AbstractThe USAID-funded flagship family planning service delivery project named Evidence to Action (E2A) worked from 2011 to 2021 to improve family planning and reproductive health for women and girls across seventeen nations in sub-Saharan Africa using a “scaling-up mindset.” The paper discusses three key lessons emerging from the project’s experience with applying ExpandNet’s systematic approach to scale up. The methodology uses ExpandNet/WHO’s scaling-up framework and guidance tools to design and implement pilot or demonstration projects in ways that look ahead to their future scale-up; develop a scaling-up strategy with local stakeholders; and then strategically manage the scaling-up process. The paper describes how a scaling-up mindset was engendered, first within the project’s technical team in Washington and then how they subsequently sought to build capacity at the country level to support scale-up work throughout E2A’s portfolio of activities. The project worked with local multi-stakeholder resource teams, often led by government officials, to equip them to lead the scale-up of family planning and health system strengthening interventions. Examples from project experience in the Democratic Republic of the Congo, Kenya, Nigeria, and Uganda illustrating key concepts are discussed. E2A also established a community of practice on systematic approaches to scale up as a platform for sharing learning across a variety of technical agencies engaged in scale-up work and to create learning opportunities for interacting with thought leaders around critical scale-up issues.

scholarly journals Factors influencing access to and utilisation of youth-friendly sexual and reproductive health services in sub-Saharan Africa: a systematic review

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Lesley Rose Ninsiima ◽  
Isabel Kazanga Chiumia ◽  
Rawlance Ndejjo
Keyword(s):  
Reproductive Health ◽  
Health Services ◽  
Sexual And Reproductive Health ◽  
Health Workers ◽  
Sub Saharan Africa ◽  
Inclusion Criteria ◽  
Reproductive Health Services ◽  
Factors Influencing ◽  
Sub Saharan ◽  
Youth Friendly

Abstract Background Despite the global agreements on adolescents’ sexual and reproductive health and rights, access to and utilisation of these services among the youth/adolescents remain unsatisfactory in low- and middle-income countries which are a significant barrier to progress in this area. This review established factors influencing access and utilisation of youth-friendly sexual and reproductive health services (YFSRHS) among the youth in sub-Saharan Africa to inform programmatic interventions. Methodology A systematic review of studies published between January 2009 and April 2019 using PubMed, Web of Science, EMBASE, Medline, and Cochrane Library, and Google Scholar databases was conducted. Studies were screened based on the inclusion criteria of barriers and facilitators of implementation of YFSRHS, existing national policies on provision of YFSRHS, and youth’s perspectives on these services. Findings A total of 23,400 studies were identified through database search and additional 5 studies from other sources. After the full-text screening, 20 studies from 7 countries met the inclusion criteria and were included in the final review. Structural barriers were the negative attitude of health workers and their being unskilled and individual barriers included lack of knowledge among youth regarding YFSRHS. Facilitators of utilisation of the services were mostly structural in nature which included community outreaches, health education, and policy recommendations to improve implementation of the quality of health services and clinics for adolescents/youth to fit their needs and preferences. Conclusion Stakeholder interventions focusing on implementing YFSRHS should aim at intensive training of health workers and put in place quality implementation standard guidelines in clinics to offer services according to youth’s needs and preferences. In addition, educating the youth through community outreaches and health education programs for those in schools can facilitate utilisation and scale up of the service.

scholarly journals Family planning program under low fertility: where to go

2021 ◽  
Author(s):  
Baochang Gu
Keyword(s):  
Family Planning ◽  
Reproductive Health ◽  
Unmet Needs ◽  
Family Planning Program ◽  
Population Control ◽  
First Century ◽  
Low Fertility ◽  
Planning Program ◽  
The People ◽  
The Family

AbstractThis commentary is intended to take China as a case to discuss the mission of the family planning program under low fertility scenario. After a brief review of the initiation of family planning program in the 1970s, as well as the reorientation of family planning program since ICPD in 1994, it will focus on the new mission for the family planning program under low fertility scenario in the twenty-first century, in particular concerning the issue of induced abortion among the others. Given the enormous evidence of unmet needs in reproductive health as identified in the discussion, it is argued that family planning programmes are in fact even more needed than ever before under low-fertility scenario, and should not be abandoned but strengthened, which clearly has nothing to do to call back to the program for population control in the 1970s–1980s, and nor even go back to the program for “two reorientations” in the 1990s, but to aim to serving the people to fulfill their reproductive health and reproductive rights in light of ICPD and SDGs, and to become truly integral component of “Healthy China 2030” Strategy.

scholarly journals Wealth-related inequalities in demand for family planning satisfied among married and unmarried adolescent girls and young women in sub-Saharan Africa

2021 ◽  
Vol 18 (S1) ◽  
Author(s):  
Martin K. Mutua ◽  
Yohannes D. Wado ◽  
Monica Malata ◽  
Caroline W. Kabiru ◽  
Elsie Akwara ◽  
...  
Keyword(s):  
Family Planning ◽  
West Africa ◽  
Adolescent Girls ◽  
Young Women ◽  
Rate Of Change ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Sexually Active ◽  
Sub Saharan ◽  
Over Time

Abstract Background The use of modern contraception has increased in much of sub-Saharan Africa (SSA). However, the extent to which changes have occurred across the wealth spectrum among adolescents is not well known. We examine poor-rich gaps in demand for family planning satisfied by modern methods (DFPSm) among sexually active adolescent girls and young women (AGYW) using data from national household surveys. Methods We used recent Demographic and Health Surveys and Multiple Indicator Cluster Surveys to describe levels of wealth-related inequalities in DFPSm among sexually active AGYW using an asset index as an indicator of wealth. Further, we used data from countries with more than one survey conducted from 2000 to assess DFPSm trends. We fitted linear models to estimate annual average rate of change (AARC) by country. We fitted random effects regression models to estimate regional AARC in DFPSm. All analysis were stratified by marital status. Results Overall, there was significant wealth-related disparities in DFPSm in West Africa only (17.8 percentage points (pp)) among married AGYW. The disparities were significant in 5 out of 10 countries in Eastern, 2 out of 6 in Central, and 7 out of 12 in West among married AGYW and in 2 out of 6 in Central and 2 out of 9 in West Africa among unmarried AGYW. Overall, DFPSm among married AGYW increased over time in both poorest (AARC = 1.6%, p < 0.001) and richest (AARC = 1.4%, p < 0.001) households and among unmarried AGYW from poorest households (AARC = 0.8%, p = 0.045). DPFSm increased over time among married and unmarried AGYW from poorest households in Eastern (AARC = 2.4%, p < 0.001) and Southern sub-regions (AARC = 2.1%, p = 0.030) respectively. Rwanda and Liberia had the largest increases in DPFSm among married AGYW from poorest (AARC = 5.2%, p < 0.001) and richest (AARC = 5.3%, p < 0.001) households respectively. There were decreasing DFPSm trends among both married (AARC = − 1.7%, p < 0.001) and unmarried (AARC = − 4.7%, p < 0.001) AGYW from poorest households in Mozambique. Conclusion Despite rapid improvements in DFPSm among married AGYW from the poorest households in many SSA countries there have been only modest reductions in wealth-related inequalities. Significant inequalities remain, especially among married AGYW. DFPSm stalled in most sub-regions among unmarried AGYW.

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