Adamorobe is a village in Ghana where the historical presence of a hereditary form of deafness resulted in a high number of deaf inhabitants. Over the centuries, a local sign language emerged, which is used between deaf and hearing people in everyday life, rendering Adamorobe into a unique place of inclusion of deaf people. However, in 1975, a law was introduced to reduce the number of deaf people in Adamorobe: deaf people cannot marry each other in order to avoid deaf offspring. In the long term, this law threatens the linguistic and cultural diversity in this village where the use of sign language is omnipresent and where deaf people are perceived as fully productive and worthy members of society. This article is structured around two sets of tensions in the village, Firstly, hearing people’s acceptance and inclusion of the deaf inhabitants, versus the wish to live in a village with no (or less) deaf people. Secondly, there is a tension between deaf people’s subjection to, and resistance against, the law, this is a tension that can be observed in the existence of relationships between deaf partners, and abortions when these unions lead to pregnancies.
Background Although abortion is technically legal in Zambia, the reality is far more complicated. This study describes the process and results of galvanizing access to medical abortion where abortion has been legal for many years, but provision severely limited. It highlights the challenges and successes of scaling up abortion care using implementation science to document 2 years of implementation.
Methods An intervention between the Ministry of Health, University Teaching Hospital and the international organization Ipas, was established to introduce medical abortion and to address the lack of understanding and implementation of the country’s abortion law. An implementation science model was used to evaluate effectiveness and glean lessons for other countries about bringing safe and legal abortion services to scale...
Results After two years, 25 of 28 sites provided abortion services, caring for more than 13,000 women during the intervention. For the first time, abortion was decentralized, 19% of all abortion care was performed in health centres. At the end of the intervention, all providing facilities had managers supportive of continuing legal abortion services....
Conclusions These findings provide a case study of the medical abortion introduction in Zambia and offer important lessons for expanding safe and legal abortion access in similar settings across Africa...
Incidence of induced abortion in Uganda in 2013: new estimates since 2003
Elena Prada, Lynn M Atuyambe, Nakeisha M Blades, Justine N Bukenya, Christopher Garimoi Orach, Akinrinola Bankole
PLoS One 2016;11(11). DOI:10.1371/journal.pone.0165812
In 2003, 294,000 induced abortions were estimated to occur each year in Uganda. In the first research on abortion incidence since then, data from 418 health facilities were used in 2013 to estimate the number and rate of induced abortion nationally and by major regions...
In 2013, an estimated 314,304 induced abortions occurred and an estimated 128,682 women (almost one in three) were treated for abortion complications, compared to 294,000 and 110,000 in 2003, respectively...
The authors conclude that the majority of pregnancies to Ugandan women were still unintended. And although the use of modern contraception has increased, it seems a large proportion of women/couples are having difficulty practising contraception effectively.
As regards abortion, according to the Guttmacher Institute's press release about the article, although Ugandan law explicitly allows abortion to save a woman’s life and the 2012 National Policy Guidelines and Service Standards for Sexual and Reproductive Health and Rights permit abortion in cases of fetal anomaly, rape and incest, and HIV, in practice, legal abortion is both difficult to obtain and to provide. The country’s abortion laws and policies are inconsistently interpreted by law enforcement officials and the judicial system, and many providers and women remain unaware of the circumstances under which abortion is legal. As a result, most abortions in Uganda are clandestine procedures, which are often unsafe. Moreover, notwithstanding the Ugandan government’s efforts to improve post-abortion care services, stigma and fear of mistreatment are significant barriers for many women in need of these services...
An estimated 246 million girls and boys are harassed and abused in and around school every year. While girls and boys can be both victims and perpetrators of violence, the extent and form differs. Incidents of SRGBV have been recorded in every region and country where it has been studied and cuts across cultures, regions, peoples and economies, and affects boys and girls. SRGBV is a human rights issue and an education issue: a violation of human rights and a serious barrier to learning. It has long lasting consequences on children’s psychological, social and physical well-being and affects their ability to learn and stay in school.
In August 2014, a coalition of governments, development organizations, civil society activists and research institutions came together to collaborate on ending gender-based violence in and around schools, and formed the Global Working Group to End School-Related, Gender-Based Violence (SRGBV). It is comprised of more than 30 of the leading international agencies, civil society organizations and institutions promoting girls’ education and gender equality, and is co-hosted by the United Nations Girls’ Education Initiative (UNGEI) and UNESCO.
In November 2016, they released this publication. Its aim is to help Ministries of Education and education stakeholders understand more about SRGBV and identify ways to prevent and respond to it.
Post-abortion contraception; up-to-date, evidence-based information
Sam Rowlands Centre of Postgraduate Medical Research & Education, Bournemouth University, Bournemouth, Dorset, UK; Correspondencesrowlands@bournemouth.ac.uk, Kristina Gemzell-Danielsson Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden for and on behalf of the European Society of Contraception Expert Group on Abortion
This short communication explains the recommended timing of starting reversible contraceptive methods after abortion. All women should receive information about and be offered a supply of contraception, including emergency contraception, before leaving a healthcare facility. It is safe to initiate contraception immediately after abortion; all contraceptive options may be chosen from, unless there are medical restrictions for an individual woman.
Ideally, contraception should be offered and provided on the same day and in the same place as the abortion procedure. For women undergoing early medical abortion it may be more convenient to initiate their method at the time of mifepristone administration; this timing is not possible or optimal for all methods. If the contraceptive method chosen by the woman cannot be provided on-site, the woman should be given information about where and how she can obtain it, and be offered an interim method.
Individual contraceptive methods are covered in the full text.
Country rankings on access to contraception in 45 European countries
The Contraception Atlas at www.ContraceptionInfo.eu is a map that scores 45 countries in Europe on access to modern contraception. It was launched on 14 February in Brussels. The scores are based on access to contraceptive supplies, family planning counselling and online information. They reveal a very uneven picture across Europe.
The European Parliamentary Forum on Population & Development (EPF) produced the Atlas in partnership with Third-i, while experts in sexual and reproductive health and rights designed the methodology.
“Access to contraception should be a key concern of governments in empowering citizens to plan their families and lives. Yet every country we analysed should be doing more to improve access. Our findings show that for many European countries, ensuring that people have control over their reproductive lives is not a priority,” commented Neil Datta, EPF Secretary. “This is borne out by statistics on unintended pregnancy: over 43% pregnancies in Europe are unintended. Contraception is used by 69.2% of European women aged between 15 and 49 who are married or living with a partner – lower than the usage rates of both the North America and Latin America/Caribbean regions.”...