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Brazil, India, Senegal, USA, Ethiopia, Africa
Microcephaly in infants of people with Zika virus seems to be declining but is not ending
The headline in the Washington Post on 7 February was: "The panic is over at Zika’s epicenter. But for many, the struggle has just begun." The fact is, cases have not disappeared, even though the numbers have fallen, and families are coping with the children who were born, as the article reports with many examples.
As many as 70% of Recife’s inhabitants contracted Zika in 2015 and 2016, according to Pedro Pires, an obstetrician-gynaecologist who specializes in Zika. However, that high rate of infection likely prevented a revival of the epidemic in recent months because most of the population has become immune. It's now a year since a global health emergency was declared. By mid-2016, the number of reported cases of microcephaly in Brazil had fallen to about 100 per week, compared to the highest reported number of 640 cases in mid-November 2015. But it is still around 100 a week.
Meanwhile, in 2016, the birth rate among the more affluent population of the state dropped by as much as 45%, while state-wide it fell by 7%. Other causes of the syndrome in infants, that may have interacted with Zika, are still being sought...
Abstract (with additions from main text) Background: Abortion services were legalized in India in 1972, however, the access to safe abortion services is restricted, especially in rural areas. In 2002, medical abortion using mifepristone- misoprostol was approved for termination of pregnancy, however, its use has been limited in primary care settings.
Results: A total of 9,076 women with unwanted pregnancies sought care from these clinics, and abortion services were provided to 70% of these. A majority of the women were currently married, and nearly two-thirds of women belonged to socio-economically underprivileged scheduled caste or tribe groups. Only 5% were nulliparous, while 56% had 3 or more children. One fifth had undergone a prior induced abortion, while less than a sixth had ever used a contraceptive.
Conclusions: The results of our intervention indicate that integrating medical abortion into primary care settings is feasible and has a potential to improve access to safe abortion services in rural areas. Our experience can be used to guide program managers and service providers about reducing barriers and making abortion services more accessible to women...
The Association of Women Jurists of Senegal continue to put pressure on the government for abortion to be legalised following rape and incest
Some 250 cases of rape of girls aged 13 to 18 years which led to a pregnancy in 52 cases were reported in the first 11 months of 2016 in Senegal. Of those, at least 25 were cases of incest followed by pregnancy, yet abortion on the grounds of rape and incest is not permitted. "This situation is grave," said the President of the Association, Mme Fanta Ndiaye Gueye. She called on the government to reconsider its position without delay by implementing a change in the law. She pointed out that Senegal signed the Maputo Protocol in 2014, which also calls for abortion to be made legal and safe on a number of grounds, including following rape and incest. The Association of Women Jurists has made it a goal to convince the whole society of the justice of this cause, but the road is a long one, not least due to the conservative opposition from both Muslim and Christian religious figures...
Women seeking out birth control that can outlast a presidency
In the past few months, before and after Trump took office, both Planned Parenthood in Washington DC and several private gynaecologists who provide birth control methods who were interviewed by the Washington Post have said that women have been visiting their offices more than usual specifically to ask about birth control.
An increase in the use of IUDs and implants has been taking place for some time, but now women are worried about losing benefits. Since 2012, Obama's Affordable Care Act has required that private health insurance plans cover prescription contraceptives with no cost-sharing for patients. Both President Trump and Rep. Tom Price, Trump's appointee to head the Department of Health and Human Services, have vowed to repeal and replace the Affordable Care Act. Neither supports a policy that would continue contraceptive coverage. If the Act is repealed, contraceptives could get a lot more expensive.
Depending on the type of insurance women have, birth control pills can cost between US$160 and $600 annually, while IUDs and other long-acting reversible contraceptives can cost up to $500 to $1,000 for the initial insertion, but last for a number of years.
Among the commercially insured patients who make up 75% of the Athena Health sample, the rate of IUD-related visits rose by approximately 25% after the election, while for the Medicaid population, whose health care coverage would not change, those visits remained constant. But this evidence is only for the month of January 2017; whether the increase continues is as yet unknown...
This edutainment drama, produced in north-western Tigray, Ethiopia, aims to initiate discussion on youth sexual and reproductive health in relation to contraceptive use and abortion. The six main characters are secondary school students Solyana, Kibrom, Azeb, Tedy, Helen and Teamrat, who make different choices that have consequences for their future lives when entering puberty. The drama addresses gender norms that influence youth sexuality in a context where the different options of contraceptive methods and safe abortion services are actually legally available for them. Knowledge about these options is low, however, and the silence around youth sexual and reproductive health issues prevails. When sexual abstention before marriage is reinforced by the female virginity ideal, it also becomes difficult for girls to be prepared and protect themselves if sex “just happens”. This short edutainment drama also asks whether other options for being a responsible man are thinkable. The drama is financed by Norwegian Research Council/NORGLOBAL through the University of Bergen-based research project: “Competing discourses impacting girls’ and women’s rights: Fertility control and safe abortion in Ethiopia, Tanzania and Zambia”. Research data will be generated from the discussions of the drama with youth, parents, teachers and other community members...
The rising age of first marriage across sub-Saharan Africa over the past 25 years has led many scholars to predict a concurrent increase in pre-marital childbearing. We examine whether this anticipated increase has materialized using data from 27 countries. Our results reveal considerable heterogeneity. Although levels of pre-marital fertility have risen by up to 13% in recent years in some African countries, other countries have experienced a 7% decline.
Adolescent pre-marital childbearing, in particular, has shown marked decline in several countries. Furthermore, although the rising age of marriage exerts clear upward pressure on pre-marital fertility, decomposition analyses indicate that in half of the countries examined, other factors such as delayed sexual debut and use of contraception counteract this effect. These results temper concerns about the rising numbers of unwed mothers and demonstrate that countries can simultaneously delay marriage and achieve relatively stable, or even declining, levels of premarital childbearing...