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‣ Strategies for the prevention of unsafe abortion

Faundes, Anibal
Fonte: Elsevier; Clare Publicador: Elsevier; Clare
Tipo: Artigo de Revista Científica
Português
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69.737427%
Unsafe abortion is one of the main causes of maternal mortality and severe morbidity in countries with restrictive abortion laws. In 2007, the International Federation of Gynecology and Obstetrics (FIGO) created a Working Group on the Prevention of Unsafe Abortion and its Consequences (WGPUA). This led to a FIGO initiative with that aim which has the active participation of 43 FIGO member societies. The WGPUA has recommended that the plans of action of the countries participating in the initiative consider several levels of prevention shown to have the potential to successfully reduce unsafe abortions: (1) primary prevention of unintended pregnancy and induced abortion; (2) secondary prevention to ensure the safety of an abortion procedure that could not be avoided; (3) tertiary prevention of further complications of an unsafe abortion procedure that has taken place already, through high-quality postabortion care; and (4) quaternary prevention of repeated abortion procedures through postabortion family planning counseling and contraceptive services. This paper reviews these levels of prevention and the evidence that they can be effective. (c) 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

‣ "...and then she died" : Indonesia Maternal Health Assessment

World Bank
Fonte: World Bank Publicador: World Bank
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49.92928%
Maternal health remains one of the top priorities of the Government of Indonesia (GoI) and the Ministry of Health (MoH) because reductions in maternal mortality have been slows. The current Maternal Mortality Ratio (MMR) for Indonesia is 228 but with existing programs and interventions the government does not believe it will be able to achieve its stated millennium development goal of 102 maternal deaths per 100,000 live births by 2015. There are positive trends in an increased use of skilled birth attendants, almost universal access to some level of antenatal care and continued use of family planning but these are not enough to stem the tide of maternal death. Interventions by the skilled birth attendants in many cases are not in line with existing standards and prove to be ineffective in trying to address the emergence of complications. Antenatal care is important, but it is not where gains in decreased mortality will be obtained. The continued use of traditional birth attendants (TBA) and delivering at home are contributory factors to maternal mortality in Indonesia. In collecting data from verbal autopsies in three districts...

‣ Fertility Regulation Behaviors and Their Costs : Contraception and Unintended Pregnancies in Africa and Eastern Europe & Central Asia

Lule, Elizabeth; Singh, Susheela; Chowdhury, Sadia Afroze
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Português
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49.85847%
The report consists of three parts: global trends in fertility, contraceptive use and unintended pregnancies; studies of two regions (Africa and Eastern Europe/Central Asia) and two countries (Nigeria and Kazakhstan) on the costs of fertility regulation behaviors and provider attitudes towards contraceptive use. Fertility levels have declined steadily over the last three decades but the pace of decline varies among regions. Countries that have achieved a high level of contraceptive use have reached a lower fertility level. A gap continues to exist between actual and desired family size, resulting in unintended pregnancies. More than one-third of the pregnancies that occur are unintended and one in five pregnancies ends in induced abortion. Almost half of all induced abortions are unsafe, and the proportion of all abortions that are unsafe have increased during the last decade. Sixty-six percent of unintended pregnancies occur among women who are not using any method of contraception. Investing in quality family planning programs is a cost-effective way to address unmet need for contraception and reduce the risks of unsafe abortion...

‣ Maternal and Child Mortality Development Goals : What Can the Transport Sector Do?

Babinard, Julie; Roberts, Peter
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Português
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28.902676%
The reduction of child mortality and the improvement of maternal health are two of the Millennium Development Goals. Child and maternal mortalities continue to represent severe burdens in many developing countries. Every year, 527,000 women in developing countries die of pregnancy-related complications and nearly 4 million children die during their first month (accounting for 40 percent of all deaths under 5 years of age) with nearly all (98 percent) of them in developing countries. The risks of dying from pregnancy-related complications and a child dying under the age of five are highest in Sub-Saharan Africa. The risk of a mother or an infant dying can be significantly reduced by a continuum of basic care, which should include preventive measures and a skilled attendant during childbirth with access to the necessary equipment, drugs, and other supplies for effective management of any pregnancy-related complications. Yet, many women spend excessive time trying to reach a health facility with the capacity to treat obstetric or infant complications. It is estimated that 75 percent of maternal deaths might be prevented through timely access to essential emergency childbirth-related care. This paper focuses on the ways in which transport and road infrastructure play key roles in the overall delivery of and access to health services...

‣ The Potential for Integrating Community-Based Nutrition and Postpartum Family Planning : Review of Evidence and Experience in Low-Income Settings

Alvesson, Helle M.; Mulder-Sibanda, Menno
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Publications & Research :: Working Paper; Publications & Research
Português
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The objective of this review was to study where community-based family planning and nutrition programs have been integrated, how this has been accomplished, and what the results have been. Although family planning is a nontraditional intervention in community-based nutrition programs, it can have profound effects on maternal and child health and nutrition. When family planning does not occur, short intervals between pregnancies deplete mothers' reserves of nutrients needed for pregnancy and later for breastfeeding. As a result, short birth intervals are associated with higher maternal and neonatal mortality and malnutrition rates of infants. Family planning, which promotes contraceptive use and the lactational amenorrhea method, can thus improve nutrition outcomes in both mothers and babies. The authors identified a few studies on integrated services in the published literature; thus the main part of the review is built on operational research studies and unpublished smaller scale intervention studies. However...

‣ Maternal Mortality; Mortalidade materna Mortalite maternelle Mortalidad materna

World Bank
Fonte: Washington, DC Publicador: Washington, DC
Tipo: Publications & Research :: Brief; Publications & Research
Português
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Over 529,000 women die annually from complications during pregnancy, childbirth, or the postpartum period. Nearly all of these deaths occur in developing countries, where fertility rates are higher and a woman's life time risk of dying during pregnancy and childbirth is over 400 times higher than in developed countries. Additionally, an estimated 20 million women endure lifelong disabilities such as pelvic pain, incontinence, obstetric fistula, anemia and infertility. The main direct causes of maternal death are severe bleeding, unsafe abortion, infection, eclampsia, and obstructed labor; the indirect causes include anemia, malaria, heart disease, and HIV. Pregnancy complications are the main cause of death for women aged 15-19. High maternal mortality rates in many countries result from poor reproductive health care, including not having access to skilled care during pregnancy and childbirth and access to safe abortion even where it is legal, especially for the poorest women. Risks of poor outcomes during pregnancy and childbirth are exacerbated by poverty...

‣ Fertility Regulation in Kazakhstan : The Role of Providers and the Public Financial Cost

Rani, Manju; Chao, Shiyan; Arystanova, Gulzada; Rakhimova, Meruert
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Publications & Research :: Working Paper; Publications & Research
Português
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49.31066%
This study examines fertility regulation in Kazakhstan, with dual emphases on providers' attitudes toward abortion and the public financial costs of abortion provision. Though abortion incidence declined sharply in the 1990s in Eastern European countries and in the former Soviet republics, it stagnated at relatively high levels in the early 2000s, accounting for a substantial proportion of gynecological morbidity and maternal mortality. Limited literature is available on the role of health service providers' attitudes that may encourage or discourage abortion culture. Additionally, most studies examine abortion incidence from the perspective of its impact on women's health, while the issue of the public financial burden imposed by the provision of services for "avoidable" abortions remains unexplored. This study sheds lights on these two areas by conducting a two-part field survey in Kazakhstan. Three-stage stratified sampling was used to select 126 providers from 52 health facilities from four oblasts and two major cities (Almaty and Astana) at different administrative levels to assess providers' attitudes and perceptions; and to analyze the public costs of providing abortion and family planning services. Findings from the provider survey suggest that providers' biases towards certain contraceptive methods-partly attributable to their lack of training in alternative methods-lead them to limit the choice of contraceptive methods on offer...

‣ Clients' reports on postabortion family planning services provided in Mexico City's public sector legal abortion program

Becker, Davida; Díaz-Olavarrieta, Claudia; Garcia, Sandra G.; Harper, Cynthia C.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Português
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